Risk factors and outcomes of delirium in hospitalized older Ghanaians.

Journal: International journal of geriatric psychiatry

Volume: 38

Issue: 4

Year of Publication: 2023

Affiliated Institutions:  Psychiatry Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana. Department of Psychiatry, World Health Organization (WHO) Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, College of Medicine, University of Ibadan, Ibadan, Nigeria. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA. Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Department of Psychiatry, University of Ghana Medical School, Legon, Ghana.

Abstract summary 

Delirium has been rarely studied in older West Africans. We sought to investigate its correlates and outcomes in hospitalized older Ghanaians.This was a one-month prospective observational study. Delirium prevalence was assessed within 24 h of admission using the Confusion Assessment Method (CAM). Incident delirium was determined with repeat CAM assessments on post-admission days 4, 7, 14, 21 and 28, after censoring participants with prevalent delirium. Multivariate logistic regression analyses were used to explore risk factors. Estimates of adjusted hazard ratios for mortality were derived with the discrete time version of the Cox regression model for time invariant explanatory variables.Among 483 participants, 250 (51.8%, 95% CI: 47.3-56.3) had prevalent delirium while 10 of the remaining 233 (4.3%, 95% CI: 2.1-7.8) developed incident delirium. Being older than 80 years (adjusted odds ratio (OR) = 2.1, 95% CI: 1.2-3.6), having no formal education (OR = 2.2, 95% CI: 1.4-3.4), stroke (OR = 1.8, 95% CI: 1.1-3.0), infection (OR = 1.9, 95% CI: 1.2-3.0), and high Triage Early Warning Score (OR = 6.9, 95% CI: 2.5-19.0) predicted delirium. Delirium (adjusted hazard ratio (HR) = 1.8, 95% CI: 1.0-3.3) and high TEWS (HR = 4.6 (95% CI: 1.7-12.7) at baseline predicted mortality. These factors also predicted longer hospital stay.Over half of hospital-treated older Ghanaians in the present study had delirium on the first day of admission. The syndrome prolonged hospitalisation and increased mortality risk. Future studies in West Africa may investigate the epidemiology of delirium in primary care and community settings.

Authors & Co-authors:  Omuojine John-Paul JP Bello Toyin T Wemakor Stephen S Mante Priscilla Kolibea PK Amponsah George Sedinam GS Kusi-Mensah Kwabena K Owusu-Antwi Ruth R Sarfo Fred S FS Ohene Sammy S Ojagbemi Akin A

Study Outcome 

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Statistics
Citations :  American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edit.; 2013.
Authors :  10
Identifiers
Doi : 10.1002/gps.5912
SSN : 1099-1166
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Africa;delirium;incident;length of stay;mortality;older adult;outcome
Study Design
Cross Sectional Study
Study Approach
Country of Study
Ghana
Publication Country
England