Delirium increases risk of death in cardiac patients

Research suggests more than half of acute cardiac patients age 85 and older have experienced delirium, a disruption of normal brain function.
By Amy Wallace   |   March 16, 2017 at 10:00 AM

March 16 (UPI) -- A new study found delirium is linked to a five times higher increase in mortality in acute cardiac patients age 85 and older.

Delirium is a common condition in the elderly and affects one in 10 hospitalized patients. Symptoms of delirium include disorientation, confusion, incoherence, hallucinations, disordered speech and memory disturbances. It is often described as being in a dream-like state. Delirium can lead to negative long-term prognosis and complications.

"Among hospitalized patients, those admitted to an intensive care unit are more likely to develop delirium and there are strategies to limit its consequences," Dr. Giovanni Falsini, an interventional cardiologist at San Donato Hospital in Italy, said in a press release. "Less is known about delirium and its significance in patients admitted to cardiac intensive care units. This study investigated the incidence and clinical impact of delirium in patients with acute cardiac diseases."

The researchers studied all patients age 65 and older admitted to two cardiac intensive care units over a 15-month period, all of whom were evaluated for delirium at admission and during their hospital stay.

Researchers found delirium was a common condition among elderly patients with acute cardiac diseases. Of the 726 patients in the study, 15 percent had delirium, with 52 percent of patients age 85 and older having delirium.

The study also revealed that patients with delirium had a five times increase in in-hospital and 30-day mortality and a two times increase in six-month mortality, which was also associated with longer hospital stays and frequent re-admission to hospitals.

Researchers suggest the reason for the increased risk of death associated with delirium is that patients have preexisting conditions such as dementia, visual and hearing loss, depression, use of psychoactive drugs, electrolyte imbalances and infections.

"The more complex and frail the patient is, the higher the rate of delirium and subsequent worse outcomes," Falsini said, adding that "delirium is common, serious, costly and under-recognized. A protocol is needed to identify and treat delirium in high-risk settings, like cardiac intensive care units."

The study was published in the European Heart Journal: Acute Cardiovascular Care.

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