Older adults discharged from the hospital with delirium: 1-year outcomes

J Am Geriatr Soc. 2006 Aug;54(8):1245-50. doi: 10.1111/j.1532-5415.2006.00815.x.


Objectives: To compare 1-year institutionalization and mortality rates of patients who were delirious at discharge, patients whose delirium resolved by discharge, and patients who were never delirious in the hospital.

Design: Secondary analysis of prospective cohort data from the Delirium Prevention Trial.

Setting: General medicine service at Yale New Haven Hospital, March 25, 1995, through March 18, 1998, with follow-up interviews completed in 2000.

Participants: Four hundred thirty-three patients aged 70 and older who were not delirious at admission.

Measurements: Patients underwent daily assessments of delirium from admission to discharge using the Confusion Assessment Method. Nursing home placement and mortality were determined at 1-year follow up.

Results: Of the 433 study patients, 24 (5.5%) had delirium at discharge, 31 (7.2%) had delirium that resolved during hospitalization, and 378 (87.3%) were never delirious. After 1 year of follow-up, 20 of 24 (83.3%) patients discharged with delirium, 21 of 31 (67.7%) patients whose delirium resolved, and 157 of 378 (41.5%) patients who were never delirious were admitted to a nursing home or died. Compared with patients who were never delirious, patients with delirium at discharge had a multivariable adjusted hazard ratio (HR) of 2.64 (95% confidence interval (CI)=1.60-4.35) for nursing home placement or mortality, whereas resolved cases had a HR of 1.53 (95% CI=0.96-2.43).

Conclusion: Delirium at discharge is associated with a high rate of nursing home placement and mortality over a 1-year follow-up period. Interventions to increase detection of delirium and improvements in transitional care may help reduce these negative outcomes.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Delirium / mortality
  • Delirium / rehabilitation*
  • Female
  • Follow-Up Studies
  • Geriatric Assessment / methods*
  • Health Status Indicators
  • Humans
  • Male
  • Nursing Homes / statistics & numerical data
  • Outcome Assessment, Health Care*
  • Patient Discharge / statistics & numerical data*
  • Retrospective Studies
  • Risk Factors
  • Survival Rate / trends
  • Time Factors
  • United States / epidemiology