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Survival of Hospitalized Elderly Patients With Delirium

A Prospective Study

Received April 2, 2000; accepted July 20, 2000. From the Section on Geriatric Psychiatry, University of Pennsylvania, Philadelphia, PA. Address correspondence to Dr. Katz, Section of Geriatric Psychiatry, University of Pennsylvania, 3600 Market Street, Room 758, Philadelphia, PA 19104.

The authors tested the relationship between clinically diagnosed delirium during hospitalization and increased mortality after accounting for pre-hospital measures of global cognition, physical functioning, and medical comorbidity. Patients (N=102), 53 of which were hospitalized during the course of a year, received the Mini-Mental State Exam, Physical Self-Maintenance Scale, Cumulative Illness Rating Scale, and 15-item Geriatric Depression Scale. Mortality rates were determined at discharge and after 3 years. Patients who developed delirium did not differ on pre-hospitalization levels of depression, global cognitive performance, physical functioning, or medical comorbidity. Three-year mortality in the hospitalized subjects was 75% for delirium patients vs. 51% for control patients (risk ratio=2.24). Delirium occurring during hospitalization places elderly subjects at long-term risk of mortality. This effect is not accounted for by earlier measures of cognitive, functional, or health status.

Key Words: Delirium • Syndromes Secondary to General Medical Disorders • Long-Term Survival • Longitudinal Studies

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