Aims: To profile common risk factors and precipitants of delirium in the American Geriatric Society CoCare Hospital Elder Life Program (HELP), in relation to the acute length of stay in a regional Australian hospital.
Methods: Retrospective descriptive analysis of all acute patients enrolled into the HELP programme at Ballarat Base Hospital over 6 months period. Data were collected from a novel pilot Advanced Trainee-designed assessment protocol.
Results: 986 patients’ data were analysed. Median age was 77 years old, with 98% of patients residing at home, 62% patients in Acute and Speciality Medicine and median acute length of stay of 6 days. Risk factors found included polypharmacy (79%), malnutrition (14%), hearing impaired (16%), visual impairment (60%), and cognitive impairment (4%). Univariate analyses demonstrated presence of each of these risk factors were associated with 1.6-5.2 days longer acute length of stay, and statistically significant. Common delirium precipitants included hospital acquired disability (60%) metabolic derangement (49%), infection (39%), physiological instability (15%), constipation (10%), dehydration (15%), and catheterisation (60%). All precipitants described were associated with 1.9-5.3 days longer acute length of stay, and statistically significant.
Conclusions: This is the first known profiling of risk factors and precipitants for delirium, in context of acute regional hospital within Australasia. These factors were strongly associated with increased length of stay. There was likely under-reporting of delirium incidence during the study period. This helps to inform targeted delirium prevention strategies in the acute setting.