Persistent delirium predicts greater mortality

J Am Geriatr Soc. 2009 Jan;57(1):55-61. doi: 10.1111/j.1532-5415.2008.02092.x.


Objectives: To examine the association between persistent delirium and 1-year mortality in newly admitted postacute care (PAC) facility patients with delirium who were followed regardless of residence.

Design: Observational cohort study.

Setting: Eight greater-Boston skilled nursing facilities specializing in PAC.

Participants: Four hundred twelve PAC patients with delirium at admission after an acute hospitalization.

Measurements: Assessments were done at baseline and four follow-up times: 2, 4, 12, and 26 weeks. Delirium, defined using the Confusion Assessment Method, was assessed, as were factors used as covariates in analyses: age, sex, comorbidity, functional status, and dementia. The outcome was 1-year mortality determined according to the National Death Index and corroborated using medical record and proxy telephone interview.

Results: Nearly one-third of subjects remained delirious at 6 months. Cumulative 1-year mortality was 39%. Independent of age, sex, comorbidity, functional status, and dementia, subjects with persistent delirium were 2.9 (95% confidence interval 51.9-4.4) times as likely to die during the 1-year follow-up as subjects whose delirium resolved. This association remained strong and significant in groups with and without dementia. Additionally, when delirium resolved, the risk of death diminished thereafter.

Conclusion: In patients who were delirious at the time of PAC admission, persistent delirium was a significant independent predictor of 1-year mortality.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Delirium / etiology
  • Delirium / mortality*
  • Female
  • Homes for the Aged*
  • Hospitalization
  • Humans
  • Male
  • Nursing Homes*