6533b851fe1ef96bd12a8e6c

RESEARCH PRODUCT

"Delirium Day": a nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Giuseppe BellelliAlessandro MorandiSimona G. Di SantoAndrea MazzoneAntonio CherubiniEnrico MosselloBo MarioAngelo BianchettiRenzo RozziniErmellina ZanettiMassimo MusiccoAlberto FerrariNicola FerraraMarco TrabucchiStefano BoffelliFabio Di StefanoFrancesco De FilippiFabio GueriniErik BertolettiAlbert MarchAlessandro MargiottaPatrizia MecocciDesireè AddesiFausto FantòBabette DijikPaola PorrinoAntonino Maria CotroneoGiovanni GalliAmalia Cecilia BruniBruno BernardiniCarla CorsiniAnnachiara CagninAmedeo ZurloGiuseppe BarbagalloMaria Lia LunardelliEmilio MartiniGiuseppe BattagliaRaffaele LatellaDonatella PetritolaElena SinforianiAlberto CesterMarino FormilanPasqualina CarboneIldebrando AppollonioDiletta CeredaLucio TremolizzoEdo BottacchiLucio LucchettiClaudio MarianiPiero RapazziniGiuseppe RomanelliAlessandra MarengoniGiovanni ZulianiLara BianchiTeresa SuardiEttore MutiRenato BotturaGiovanni SgròAntonella MandasLuca SerchisuPatrizia CrippaClaudio IvaldiAndrea UngarDaniele VillaniClara RaimondiChiara MussiGiancarlo IsaiaGiuseppe ProvenzanoDaniela MariPatrizio OdettiFiammetta MonacelliRaffaele Antonelli IncalziAlice PluderiClaudio BellamoliLuciano TerranovaElio ScarpiniFerdinando D'amicoMaria Chiara CavalliniGianbattista GuerriniAnna Maria ScotuzziAntonino ChiarelloAlberto PilottoSara TogniniGiuseppina Dell'aquilaGabriele ToigoGiuliano CeschiaMaristella PiccininiAndrea FabboMarco ZoliPaola FortiChristian WenterGiorgio BasileAnna LasagniAlessandro PadovaniLuca RozziniMaria CottinoSilvia VitaliGabriele TripiStefano AvanziGiorgio AnnoniGiovanni RuotoloFederica BoschiPaolo BoninoNiccolo MarchionniSara FascendiniGabriele NoroRenato TurcoMaria C. UbezioCarlo SerratiMaria InfanteSimona GentileLuigi M. PernigottiCarlo A. BiaginiEnzo CanonicoPietro BonatiPietro GareriPaolo CaffarraArcangelo CerettiRosanna CastigliaCarlo GabelliMario Lo StortoPaolo PutzuSimona Di SantoAlba MalaraFausto SpadeaSerena Di CelloFrancesco CeravoloFrancesco FabianoVincenzo RispoliGiuseppe ChiaradiaAmedeo GabrieleVincenzo SettembriniDomenico CapomollaAntonella CitrinoAntonietta ScrivaIrene BrunoRoberto SecchiEugenio De MartinoRoberto MuccinelliGerardo LupiPatrizio PaonessaAndrea FabbriSofia CastellariPo AndreaGuido GaggioliMassimo VaresiPaolo MonetiSebastiano CapursoVincenzo LatiniStefano GhidottiFrancesco RiccardelliMaurizio MacchiStefano BoffelliAngela CassinadriGabriele ToniniLaura AndreaniMirco CoralliAntonio BalottaRoberto CancelliereMara StrazzacapaPierangela CavallinoStefano FabioFrancesco De FilippiChiara GiudicePatrizia FlorisCosimo DentizziKatia D’eliaMargherita AzziniMarco CazzadoriClaudia BenatiChiara TobaldiniAngela AntonioliFabio GueriniPaolo MombelloniFulvio FontaniniMartina OliverioLuciano Del GrossoCristina GiavedoniGiuliano BidoliBruno MazzeiAndrea CorsonelloSergio FuscoSilvio VenaTommaso De VuonoGiorgio MaiuriEugenio CastegnaroSalvatore De RosaRossella Bazzano SechiEnrico BenvenutiIlaria Del LungoSante GiardiniChiara GiuliettiErik BertolettiFerdinando D’amicoFrancesco CaronzoloAlessandro GrippaGiuseppina LombardoTiziana PipicellaAlbert MarchMaria Teresa NittiAlessandro FeliciSilvia PavanFabrizio PiazzaniAlessandra LunelliSergio DimoriAngelo MagnaniAlessandro MargiottaTiziano SogliaDemetrio PostacchiniRoberto BrunelliSilvia SantiniMonia FrancavillaIlenia MacchiatiFrancesca SorvilloCinzia GiuliPatrizia MecocciFrancesco PerticoneDesireè AddesiPaola Cerra RosaGiuseppe BencardinoTania FalboNadia GrilloFausto FantòGianluca IsaiaStella PezzilliDaniele BergamoElisabetta FurnoSokol RrodheSimonetta LucariniBabette DijikFrancesca Dall’acquaFrancesco CappellettoDonatella CalvaniDimitri BecheriLucia GambardellaCarlo ValentePaola PorrinoGiacomo CeciEvaristo EttorreSara TironiMaria Grazia GrassiElio TroisiAnna GabuttoNino BagliettoLoredana QuazzoAnnalisa RosatelloDomenico SuraciBenedetta TagliabueChiara PerroneLucia FerraraAlberto CastagnaMaria Luisa TremoladaSimonetta PianoGaetano ServiddioAurelio Lo BuglioTiziana GurreraValeria MerloCarla RovaiAntonino Maria CotroneoRosaria CarlucciAnna AbbaldoFabio MonzaniAhmad Amedeo QasemGiacomo BiniSilvia TafutoGiovanni GalliAmalia Cecilia BruniGiovanna MancusoBruno BernardiniCarla CorsiniAnnachiara CagninFederica FragiacomoSara PompaninAmedeo ZurloGianluca GuerraMarco PalaLuca MenozziChiara Delli GattiStefania MagonVincenzo Di FrancescoSilvia FaccioliLuca PellizzariGiuseppe BarbagalloMaria Lia LunardelliEmilio MartiniMaria MacchiaruloMaria CorneliMonica BacciGiuseppe BattagliaMario Lo StortoChiara SeresinMatteo SimonatoMichele LoreggianFausta CestonaroMario DurandoRaffaele LatellaMarta MazzoleniGiuseppe RussoMartino PonteAlessandro ValcheraGiuseppe SalustriDonatella PetritolaAlfredo CostaElena SinforianiMatteo Ramusino CottaSimonetta PianoRenato Nicola PizioGermana PeregoAlberto CesterMarino FormilanPasqualina CarboneIldebrando AppollonioDiletta CeredaLucio TremolizzoEdo BottacchiElisabetta BucciantiniMarco Di GiovanniFabrizio FranchiLucio LucchettiSara Barbieri Claudio MarianiGiulia GrandePiero RapazziniGiuseppe RomanelliAlessandra MarengoniLuciano FugazzaChiara GuerriniGiovanna De PaduanisLucia IallonardoPasquale PalumboGiovanni ZulianiBeatrice OrtolaniEleonora CapattiCecilia SoaviLara BianchiDaniela FrancesconiAgata MiselliTeresa SuardiCinzia ZaccariniGianluca MirraEttore MutiRenato BotturaPiero SecretoErika BisioMarco CecchettaniTamara NaldiAlessandra PallavicinoMichela PuglieseRosaria Cosima IozzoGiovanni Sgrò Guido GrassiRaffaella Dell’oroAntonio MannironiElisa GiorliSara ObertiBrigida FierroTommaso PiccoliFabio GiacaloneAntonella MandasLuca SerchisuDiego CostaggiuElisa PinnaFrancesca OrrùMartina MannaiZeno CordioliLuca PelizzariRoberta ChiloiroRosella CiminoCarmen RubertoPierluigi Dal SantoAntonino AndriolliGiuseppe BurattinLaura RossiFabiana TezzaPatrizia CrippaPaola AloisioTiziana Di MondaGloria GalbassiniClaudio IvaldiAnna Maria RussoAlberto PesciGiulia SuigoMassimo ZanasiGiovanni MonielloCarlo RostagnoAlessandro CarteiGianluca PolidoriAndrea UngarMaria Ramona MelisEleonora MartelliniBruno BattistonMaurizio BerardinoSimona CavalloBruna LombardiPierpaolo D’ippolitoAngela FuriniDaniele VillaniClara RaimondiMassimo GuarneriStefano PaolucciAndrea BassiPaola CoiroDomenico De AngelisGiovanni MoroneVincenzo VenturieroLorenzo PalleschiPaolo RaganatoGiuseppina Di NiroAlessandra ImoscopiGiancarlo IsaiaVittoria TibaldiGiuliana BottignoleElisa CalviCarlotta ClementiMauro ZanocchiLuca AgostaAntonio CriasiaElena SpertinoAntonella NortarelliGiuseppe ProvenzanoPietro PrincipatoAnita RizzoEleonora CelluraAngelo ZanghieratoDaniela MariFederica Y. RomanoFrancesca RosiniMarta MansiSilvia RossiAlex RiccardelliAlfredo PotenaMihaela LichiiTiziana CandianiWilliam GrimaldiEmiliano BertaniPietro CalogeroDaniela PintoRoberto BernardiFrancesco NicolinoCaterina GalettiAlice GianstefaniPatrizio OdettiFiammetta MonacelliMatteo PrefumoGiuseppe PaolissoMaria Rosaria RizzoRaffaele PrestanoAnna Maria DaliseDavide BarraLivio Dal BoscoVincenzo AsprinioLuciana DallapeElisa PerinaRaffaele Antonelli IncalziIsaura Rossi BartoliAlice PluderiAntonella MainaElisabetta PecoraroMichela SciarraAngela PrudenteLucia BeniniFrancesco LevatoVictor MhiutaFlorin AliusDiana DavidoaiaVittorio GiardiniMattia GaranciniClaudio BellamoliLuciano TerranovaClaudia BozziniPaolo TosoniEmma ProvoliLuisa CasconeAndrea DioliGianfranco FerrarinAnna GabuttoAdelmo BucciGuido BuaSara FenuGiovanna BianchiSilvia CasellaValentina RomanoGloria BelottiSabina CavaliereEstella CuniNina MerciucRosella ObertiKatia ColomboPaolo D’arcangeloNicola MontenegroGiovanni GalliRoberto MontanariPierpaolo LamannaBeatrice GasperiniElio ScarpiniAndrea ArighiFerdinando D’amicoAntonino GranataCarlo RostagnoClaudia RanalliAlessandra CammilliMaria Chiara CavalliniManola TriccaDaniela NatellaGianbattista GuerriniAnna Maria ScotuzziFerdinando SozziLuigi ValentiAntonino ChiarelloMonella MoniaAlberto PilottoCamilla PreteBarbara SenesiAnna Cristina MetaEnrico PendenzaGiuseppe PasqualettiAntonio PoliniSara TogniniElena BallinoGiuseppina Dell’aquilaPina Maria GasparriniElisabetta MarottiMonica MigaleAntonia ScrimieriGabriele ToigoGiuliano CeschiaAlessia RossoChiara TongiorgiCristina ScarpaMaurizio PacchioniLuigino De DominicisEugenio PucciSara RenziElisabetta CartechiniGiuseppe BarilaroPietro GareriFrancesca UgentiPasquale RomeoAnna NardelliFulvio LauretaniSandra VisioliIlaria MontanariFrancesca ErminiAntonio GiordanoGiorgio PigatoEmilio SimeoneFranco ColamecoAntonella CecamoreRosa ScurtiMaria Cristina LupinettiMario BarbujaniBeatrice PerazziMarina GiampieriRaffaele AmorusoMaristella PiccininiCamilla FerrariClaudio GambettiMario SfrappiniLetizia SemeraroRinaldo StriuliClaudia MarianiGiuseppe PelliccioniDonatella MarinelliTommaso RossiMartina PesallacciaDebora SabbatiniBeatrice GobbiRaffaella CerquaGiancarla TaglianiElena SchlauserLuciano CaserElisa CaramelloFranca SandiglianoGiorgio RossoChiara BendiniMoreno ScevolaEnrico VitaleDomenico MaugeriRosaria SoraceMassimiliano AnzaldiRoberto De GesuGiuseppe MorroneFederica DavolioAndrea FabboMarco ZoliPaola FortiLuca PirazzoliElisa FabbriChristian WenterIngrid RuffiniMiriam InsamElisabeth AbrahamChristine KirchlechnerDomenico CucinottaGiorgio BasilePasquale PariseAndrea BoccaliSerena AmiciMaurizia GambacortaAnna LasagniRoberto LovatiFrancesca GiovinazzoElzbieta KimakMarika Lo CastroFlavia MauroAlessandro De LucaGiuseppe SancesarioAlessandro MartoranaBeatrice ScaricamazzaSofia TonioloFrancesco Di LorenzoClaudio LiguoriAntonino LascoNatale VitaMirna GiomiSergio DimoriFloriana ForteAlessandro PadovaniLuca RozziniAnna CerasoMaria CottinoSilvia VitaliEleonora MarelliGabriele TripiSalvatore MiceliGiovanni UrsoGiuseppe GrioniGiuliana VezzadiniGiulia MisaggiChiara ForlaniStefano AvanziFrancesco IemoloAntonello GiordanoEnzo SanzaroGabriele D’astaMaria ProiettoAnna CarnemollaGrazia RazzaDaniela SpadaroMarco BertolottiChiara MussiFrancesca NevianiFrancesca BalestriMonica TorriniGiulio MannarinoFrancesca TesiMichela BigolariAlessia NataleSimona GrassiCinzia BottaroSara StefanelliUgo BovoneUmberto TortoroloRoberto QuadriGiuseppe LeoneMaria PonzettoPaola FrassonGiorgio AnnoniAdriana BruniRoberto ConfalonieriMaurizio CorsiDaniela MorettiFabiola TeruzziSimona UmidiPaolo CaffarraFederica BaroccoMarco SpallazziPaolo ChioattoSandra BortolameiLucia SoattinGiovanni RuotoloAlberto CastagnaMarco BertazzoliElisabetta RotaAnnamaria AdobatiAlberto ScarpaSerena GranzieraPaola ZuccherAngela Dal FabbroDaniela ZaraAmbra Lo NigroLorena FranchettiMarika TonioloCinzia MarcuzzoSimonetta PianoMarco RolloneFabio GuerrieroCarmelo SgarlataAlessandro MassèMaurizio BerardinoSimona CavalloGiovanni ZattiMassimiliano PiattiJole GraciGiuseppe BenatiFederica BoschiMario BiondiNicoletta FiumiSergio M. LocatelliSabrina MauriMauro BerettaLaura MargheritisGiovanbattista DesideriEster LiberatoreAnna Cecilia CarucciPaolo BoninoMargherita CaputMaria Paola AntoniettiGiuseppe PolistenaFranz De La PierreMarcello MariPaola MassignaniFabio TombesiFabio SelvaggioBrunella VerboPaolo BodoniNiccolò MarchionniMaria Chiara CavalliniTony SabatiniEleonora MussioGiulia TitoldiniBeatrice CossuSara FascendiniCristina LiciniAngela TomasoniMassimo CalderazzoRaffaella PrampoliniRita Maria MelottiAlbina LilliSimona BudaMarco AdversiGabriele NoroRenato TurcoMaria C. UbezioAnna Roberta MantovaniMaria C. ViolaCarlo SerratiMaria InfanteSimona GentileViviana D’ambrosioPaolo MazzantiCristina BrambillaSilvia SportelliDaniela QuattrocchiLuigi M. PernigottiCristina PisuFrancesca SicuroPiergiuseppe ZagnoniStefania GhigliaMassimiliano MoscaIleana CorazzinMariangela DeolaCarlo Adriano BiaginiFrancesca BenciniClaudia CantiniElisabetta TononSilvia PierinelliMarco OnofrjAstrid ThomasLaura BonanniGabriella CacchiòGiancarlo ComiGiuseppe MagnaniRoberto SantangeloSalvatore MazzeoCristina BarbieriLiviana GiroldiFederica DavolioFabio BandiniMarco MasinaSimona MalservisiAnnalena CicognaniLaura RiccaTiziana TassinariDavide BrogiAnnalisa Sugo

subject

MaleCross-sectional studyHospitalized patientsPrevalence0302 clinical medicineSurveys and Questionnaires80 and overOdds RatioPrevalenceMedicine030212 general & internal medicineProspective StudiesProspective cohort studyMulticenterAcute hospital2. Zero hungerAged 80 and overMedicine(all)Medicine (all)Settore BIO/14General Medicine3. Good health4AT; Delirium; Hospital; Multicenter; Prevalence; Aged; Aged 80 and over; Cross-Sectional Studies; Delirium; Female; Humans; Inpatients; Italy; Logistic Models; Male; Odds Ratio; Prevalence; Prospective Studies; Surveys and QuestionnairesItalyFemalemedicine.symptomResearch ArticleRehabilitation hospitalmedicine.medical_specialty4AT; Delirium; Hospital; Multicenter; Prevalence; Aged; Aged 80 and over; Cross-Sectional Studies; Delirium; Female; Humans; Inpatients; Italy; Logistic Models; Male; Odds Ratio; Prevalence; Prospective Studies; Surveys and Questionnaires; Medicine (all)NO03 medical and health sciencesHospital4AT Delirium Hospital Multicenter Prevalence Aged Aged 80 and over Cross-Sectional Studies Delirium Female Humans Inpatients Italy Logistic Models Male Odds Ratio Prevalence Prospective Studies Surveys and Questionnairesmental disordersHumans4ATPsychiatry4AT; Delirium; Hospital; Multicenter; Prevalence;AgedInpatientsbusiness.industryDeliriumOdds ratio4AT; Delirium; Hospital; Multicenter; Prevalence; Medicine (all)Cross-Sectional StudiesLogistic ModelsEmergency medicineDeliriumDelirium; Prevalence; Hospital; Multicenter; 4ATbusiness030217 neurology & neurosurgery

description

Background To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods This is a point prevalence study (called “Delirium Day”) including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01–1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12–1.27), dementia (OR 3.25, 95 % CI 2.41–4.38), malnutrition (OR 2.01, 95 % CI 1.29–3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45–2.82), feeding tubes (OR 2.51, 95 % CI 1.11–5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06–1.87), urinary catheters (OR 1.73, 95 % CI 1.30–2.29), and physical restraints (OR 1.84, 95 % CI 1.40–2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29–3.14), while admission to other settings was not. Conclusions Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The “Delirium Day” project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys. Electronic supplementary material The online version of this article (doi:10.1186/s12916-016-0649-8) contains supplementary material, which is available to authorized users.

yearjournalcountryeditionlanguage
2016-07-18
10.1186/s12916-016-0649-8http://www.cnr.it/prodotto/i/368312