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Room transfers and the risk of delirium incidence amongst hospitalized elderly medical patients: a case-control study.

Goldberg A, Straus SE, Hamid JS, Wong CL - BMC Geriatr (2015)

Bottom Line: Using a multivariable logistic regression model which controlled for age, gender, cognitive impairment, vision impairment, dehydration, and severe illness, room transfers per patient days were associated with delirium incidence (OR: 9.69, 95 % CI (6.20 to15.16), P < 0.0001).An increased number of room transfers per patient days is associated with an increased incidence of delirium amongst hospitalized elderly medical patients.This is an exploratory analysis and needs confirmation with larger studies.

View Article: PubMed Central - PubMed

Affiliation: Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, 7th Floor East Building, Toronto, ON, M5B 1T8, Canada. amanda.goldberg@mail.utoronto.ca.

ABSTRACT

Background: Room transfers are suspected to promote the development of delirium in hospitalized elderly patients, but no studies have systematically examined the relationship between room transfers and delirium incidence. We used a case-control study to determine if the number of room transfers per patient days is associated with an increased incidence of delirium amongst hospitalized elderly medical patients, controlling for baseline risk factors.

Methods: We included patients 70 years of age or older who were admitted to the internal medicine or geriatric medicine services at St. Michael's Hospital between October 2009 and September 2010 for more than 24 h. The cases consisted of patients who developed delirium during the first week of hospital stay. The controls consisted of patients who did not develop delirium during the first week of hospital stay. Patients with evidence of delirium at admission were excluded from the analysis. A multivariable logistic regression model was used to determine the relationship between room transfers and delirium development within the first week of hospital stay.

Results: 994 patients were included in the study, of which 126 developed delirium during the first week of hospital stay. Using a multivariable logistic regression model which controlled for age, gender, cognitive impairment, vision impairment, dehydration, and severe illness, room transfers per patient days were associated with delirium incidence (OR: 9.69, 95 % CI (6.20 to15.16), P < 0.0001).

Conclusions: An increased number of room transfers per patient days is associated with an increased incidence of delirium amongst hospitalized elderly medical patients. This is an exploratory analysis and needs confirmation with larger studies.

No MeSH data available.


Related in: MedlinePlus

Log odds ratio of incident delirium associated with room transfers per patient days. The 6 subgroups shown represent the log odds ratio of incidence delirium within the first, second, third, fourth, fifth and sixth days after hospital admission
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Fig1: Log odds ratio of incident delirium associated with room transfers per patient days. The 6 subgroups shown represent the log odds ratio of incidence delirium within the first, second, third, fourth, fifth and sixth days after hospital admission

Mentions: We explored heterogeneity among the OR estimates for the six subgroups using meta-analytic approaches and provided pooled estimates of OR (Fig. 1), as an alternative to the multiple logistic regression approach for increasing the power to detect effect of room transfer. The number of room transfers within the first week of admission led to a significant increase in incident delirium (pooled OR = 3.35, 95 % CI: [1.86, 6.05], p-value < 0.0001) (Fig. 1). Heterogeneity (among estimates in a log scale) was estimated to be I2 = 0.00 %, 95 % CI: [0.00 %, 96.73 %], indicating that the estimates were relatively homogeneous across the different subgroups (strata). However, the wide confidence interval indicates that the heterogeneity estimate was not reliable, as is the case for meta-analysis involving small number of studies.Fig. 1


Room transfers and the risk of delirium incidence amongst hospitalized elderly medical patients: a case-control study.

Goldberg A, Straus SE, Hamid JS, Wong CL - BMC Geriatr (2015)

Log odds ratio of incident delirium associated with room transfers per patient days. The 6 subgroups shown represent the log odds ratio of incidence delirium within the first, second, third, fourth, fifth and sixth days after hospital admission
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4478641&req=5

Fig1: Log odds ratio of incident delirium associated with room transfers per patient days. The 6 subgroups shown represent the log odds ratio of incidence delirium within the first, second, third, fourth, fifth and sixth days after hospital admission
Mentions: We explored heterogeneity among the OR estimates for the six subgroups using meta-analytic approaches and provided pooled estimates of OR (Fig. 1), as an alternative to the multiple logistic regression approach for increasing the power to detect effect of room transfer. The number of room transfers within the first week of admission led to a significant increase in incident delirium (pooled OR = 3.35, 95 % CI: [1.86, 6.05], p-value < 0.0001) (Fig. 1). Heterogeneity (among estimates in a log scale) was estimated to be I2 = 0.00 %, 95 % CI: [0.00 %, 96.73 %], indicating that the estimates were relatively homogeneous across the different subgroups (strata). However, the wide confidence interval indicates that the heterogeneity estimate was not reliable, as is the case for meta-analysis involving small number of studies.Fig. 1

Bottom Line: Using a multivariable logistic regression model which controlled for age, gender, cognitive impairment, vision impairment, dehydration, and severe illness, room transfers per patient days were associated with delirium incidence (OR: 9.69, 95 % CI (6.20 to15.16), P < 0.0001).An increased number of room transfers per patient days is associated with an increased incidence of delirium amongst hospitalized elderly medical patients.This is an exploratory analysis and needs confirmation with larger studies.

View Article: PubMed Central - PubMed

Affiliation: Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, 7th Floor East Building, Toronto, ON, M5B 1T8, Canada. amanda.goldberg@mail.utoronto.ca.

ABSTRACT

Background: Room transfers are suspected to promote the development of delirium in hospitalized elderly patients, but no studies have systematically examined the relationship between room transfers and delirium incidence. We used a case-control study to determine if the number of room transfers per patient days is associated with an increased incidence of delirium amongst hospitalized elderly medical patients, controlling for baseline risk factors.

Methods: We included patients 70 years of age or older who were admitted to the internal medicine or geriatric medicine services at St. Michael's Hospital between October 2009 and September 2010 for more than 24 h. The cases consisted of patients who developed delirium during the first week of hospital stay. The controls consisted of patients who did not develop delirium during the first week of hospital stay. Patients with evidence of delirium at admission were excluded from the analysis. A multivariable logistic regression model was used to determine the relationship between room transfers and delirium development within the first week of hospital stay.

Results: 994 patients were included in the study, of which 126 developed delirium during the first week of hospital stay. Using a multivariable logistic regression model which controlled for age, gender, cognitive impairment, vision impairment, dehydration, and severe illness, room transfers per patient days were associated with delirium incidence (OR: 9.69, 95 % CI (6.20 to15.16), P < 0.0001).

Conclusions: An increased number of room transfers per patient days is associated with an increased incidence of delirium amongst hospitalized elderly medical patients. This is an exploratory analysis and needs confirmation with larger studies.

No MeSH data available.


Related in: MedlinePlus