DELIRIUM OUTCOMES AND ITS RELATION TO NUTRITIONAL STATUS IN ELDERLY PATIENTS ADMITTED TO ACUTE GERIATRIC MEDICAL WARD
W.M. Abd-El-Gawad, R.M. Abou-Hashem, M.O. El Maraghy, G.E. Amin
J Aging Res Clin Practice 2013;2(2):226-230
Background and Objectives: Malnutrition is a prevalent and under diagnosed problem among elderly and it is considered as a major risk for delirium. So, the primary aim was to clarify the effect of nutritional status on delirium and its outcomes: length of stay (LOS), and three month mortality, in recently hospitalized elderly patients. Method: A prospective cohort study was conducted on 190 patients aged 60 and over admitted to acute geriatric medical wards. Patients were subjected to screening for delirium using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and nutritional assessment using Mini Nutritional Assessment-Short Form-Arabic version (MNA-SF-A) score, serum prealbumin, total protein (TP), and albumin. Results: Mean age was 68.72±7.60 years. Delirium prevalence was 17.6% (n=21). Three month mortality and median LOS were significantly higher in delirious than non-delirious patients (p= 0.003, 0.002 respectively). Delirious patients had statically significant lower MNA-SF-A scores, prealbumin, TP, albumin levels (p=0.028, <0.001, 0.037, 0.033 respectively) than non–delirious patients. By regression, delirium was predictor of the three month mortality (Odds Ratio=1.314, p value=0.022) and delirium and TP were predictors of increased LOS (β= 4.059, 1.655, p value=0.020, 0.019). MNA-SF-A scores, TP, albumin, and prealbumin levels were predictors of delirium (β=0.251, 0.592, 1.012, 0.448, p value=0.025, 0.034, 0.016, <0.001). Conclusion: Delirium is an independent predictor of increased length of stay and three month mortality. MNA-SF scores, total protein, albumin and prealbumin levels are independent predictors for the occurrence of delirium in hospitalized elderly patients.