Aims: The incidence and management of delirium amongst hospitalised elderly patients with COVID-19 infections in Australia has not been well-described. Infection control measures required for COVID-19 creates challenges for delirium management. This study aims to report the incidence and outcomes of delirium in hospitalised elderly COVID-19 inpatients and compares our management practices to the Delirium Clinical Care Standard.
Methods: In this single-centre retrospective descriptive study, we reviewed the electronic medical records for patients aged 80 years and older who were admitted with COVID-19 infections between January 2022 to June 2022. Baseline characteristics, delirium management and outcome measures including length of stay, hospital-acquired complications and mortality were examined.
Results: Of 265 patients, 116(43.8%) developed delirium either prior to or during admission. Delirious patients had longer lengths of stay (17.5 vs 8.6 days;p<0.01), higher mortality (25.9% vs 6%;p<0.01), and hospital-acquired complications including falls (14.7% vs 4.7%;p<0.01), infections (12.9% vs 4.7%;p=0.029) and pressure injuries (12.1% vs 2.7%;p<0.01). The management of delirium was variable. There was comprehensive communication between staff, patients and families, as well as assessment of behaviour, mobility, nutrition, and pressure areas. However, use of delirium screening tools, documentation of non-pharmacological strategies, diagnoses and follow-up plans in discharge summaries were suboptimal.
Conclusions: Delirium is common amongst elderly patients admitted with COVID-19 and was associated with poorer outcomes. Future interventions could target staff education to improve awareness and adherence with clinical care standards.