Hospital use, institutionalisation and mortality associated with delirium

Objective: To investigate the hypotheses that delirium affects the most vulnerable older adults and is associated with long term adverse health outcome. Design: Prospective, cohort study. Setting and Participants: 278 medical patients aged 75 years and over admitted acutely to a district general hospital in South Wales. Measurements: Patients were screened for delirium at presentation and on alternate days throughout their hospital stay. Assessments also included illness severity, preadmission cognition, co-morbidity and functional status. Patients were followed for 5 years to determine rates of institutionalization and mortality. Number of days in hospital in the 4 years prior to and 5 years after index admission were recorded. Results: Delirium was detected in 103 patients and excluded in 175. Median time to death was 162 days [Interquartile range (IQR) 21-556] for those with delirium compared to 1444 days (25% mortality 435 days, 75% mortality >5 years) for those without (P