ArticleTrauma surgery & acute care open2021
Older trauma patients are at high risk of delirium, especially those with underlying dementia or baseline frailty.
Article in Trauma surgery & acute care open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 24 citations in OpenAlex.
- Two Decades of Burns in Queensland (2003-2023): A Retrospective Analysis of Prospectively Collected Data.ANZ journal of surgery · 2026Article
- Prediction of postoperative delirium in older adults from preoperative cognition and occipital alpha power from resting-state electroencephalogram.Age and ageing · 2025Observational
- Factors involved in the development of hospital-acquired conditions in older patients in acute care settings: a scoping review.BMC health services research · 2025Article
- Chest trauma clinical practice guideline protects against delirium in patients with rib fractures.Trauma surgery & acute care open · 2024Article
- PROTOCOL: The effectiveness of sensory interventions targeted at improving occupational outcomes, quality of life, well-being and behavioural and psychological symptoms for older adults living with dementia: A systematic review and meta-analysis.Campbell systematic reviews · 2023Article
- Frailty Screening Practice in Specialized Burn Care-A Retrospective Multicentre Cohort Study.European burn journal · 2023Article
- Implementation of a novel nursing assessment tool in geriatric trauma patients with proximal femur fractures.PloS one · 2023Article
- Delirium in the intensive care unit and its importance in the post-operative context: A review.Frontiers in medicine · 2023Review
- Potential effects of regular use of antihypertensive drugs for in-hospital delirium in geriatric patients with trauma.Scientific reports · 2022Article
- Establishment of a teaching hospital-based dementia consultation service for rurally-based regional district general hospitals.Frontiers in public health · 2022Article
- Development of a delirium predictive model for adult trauma patients in an emergency and critical care center: a retrospective study.Trauma surgery & acute care open · 2021Article
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGiven the increasing numbers of older patients presenting with trauma, and the potential influence of delirium on outcomes, we sought to investigate the proportion of such patients who were diagnosed with delirium during their stay-and patient factors associated therewith-and the potential associations between delirium and hospital length of stay (LOS). We hypothesized that delirium would be common, associated with certain patient characteristics, and associated with long hospital LOS (highest quartile).
methodsWe conducted a retrospective observational cohort study of all trauma patients aged ≥65 years presenting in September to October 2019, interrogating medical records and the institutional trauma database. The primary outcome measure was occurrence of delirium.
resultsAmong 99 eligible patients, delirium was common, documented in 23% (23 of 99). On multivariable analysis, adjusting for age, frailty and history of dementia, frailty (OR 4.09, 95% CI 1.08 to 15.53, p=0.04) and dementia (OR 5.23, 95% CI 1.38 to 19.90, p=0.02) were independently associated with likelihood of delirium. Standardized assessment tools were underused, with only 34% (34 of 99) screened within 4 hours of arrival. On univariate logistic regression analysis, having an episode of delirium was associated with long LOS (highest quartile), OR of 5.29 (95% CI 1.92 to 14.56, p<0.001). In the final multivariable model, adjusting for any (non-delirium) in-hospital complication, delirium was independently associated with long LOS (≥16 days; OR 4.81, p=0.005). DISCUSSION: In this study, delirium was common. History of dementia and baseline frailty were associated with increased risk. Delirium was independently associated with long LOS. However, many patients did not undergo standardized screening at admission. Early identification and targeted management of older patients at risk of delirium may reduce incidence and improve care of this vulnerable cohort. These data are hypothesis generating, but support the need for initiatives which improve delirium care, acknowledging the complex interplay between frailty and other geriatric syndromes in the older trauma patients. LEVEL OF EVIDENCE: III.
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