(29) Characteristics of Patients with Incident Delirium During Inpatient Rehabilitation: A Descriptive Study

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 703

Presenting Author(s)

Marco G. Ceppi
– Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland, Allenwinden, Zug, Switzerland

Co-Author(s)

Marlene Rauch
– Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Switzerland
Christoph Meier, Prof Dr
– Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland, Switzerland
Peter Sandor
– Neurorehabilitation and Research Department, ZURZACH Care, Bad Zurzach, Switzerland, Switzerland

Background: Delirium is an etiologically non-specific organic brain syndrome that leads to poor outcomes in rehabilitation. Characterizing patients with delirium during rehabilitation is important to identify factors that are potentially associated with delirium occurrence.

Objectives: To characterize patients with incident delirium episodes during rehabilitation.

Methods: We conducted a retrospective descriptive study, based on the electronic database of ZURZACH Care, a Swiss group of rehabilitation centers. Database records comprise medical notes suggestive of delirium occurrence (validated in a previous study), patient and rehabilitation characteristics such as age, sex, length of stay and rehabilitation disciplines, as well as routinely recorded clinical data such as diagnoses, administered drugs, degree of disability and disease burden. The study base comprised all rehabilitation stays of all patients who were admitted to inpatient rehabilitation at ZURZACH Care, Rehaklinik Bad Zurzach, Switzerland, between 1 January 2015 and 31 December 2018. Incident delirium episodes were defined as those rehabilitation stays during which incident delirium took place. We calculated the cumulative incidence of delirium during rehabilitation. Within the study base and separately within incident delirium episodes, we summarized continuous variables as means with standard deviations, and categorical variables as absolute and relative frequencies.

Results: Within the study base comprising 10’503 rehabilitation stays, we identified 125 validated incident delirium episodes (cumulative incidence: 1.2%). Patients with incident delirium episodes were more often male (56.0% vs. 44.6%), on average older (mean age: 77.2 vs. 66.8 years), had a longer mean rehabilitation stay (33.1 vs. 25.3 days), a higher disease burden (Cumulative Illness Rating Scale [CIRS]: 18.8 vs. 14.7), and a higher average number of administered drugs (9.0 vs. 6.9) than those of the study base. The average degree of disability of patients with incident delirium episodes was higher at admission (Functional Independence Measure [FIM] 45.6 vs. 75.9) and improved less during rehabilitation (+16.1% vs. +21.0%) than in the study base. Rehabilitation most frequently took place in neurology discipline (32.9%) and also, most incident delirium episodes (71.2%) occurred in this discipline.

Conclusions: Our findings identified key characteristics of patients with incident delirium during inpatient rehabilitation. Further observational studies are needed to identify risk factors of developing delirium during rehabilitation.