Trends and Mortality Predictors of Delirium Among Hospitalized Older Adults: A National 5-Year Retrospective Study in Thailand

TL;DR

This study examines delirium trends and mortality factors in hospitalized older adults in Thailand over five years.

Contribution

The study provides new national data on delirium prevalence and mortality predictors in Thai geriatric patients.

Findings

Delirium prevalence and mortality rates increased over the 5-year study period.

Respiratory disease was the most common primary diagnosis among delirium patients.

Older age, female gender, and specific diagnoses like respiratory disease and malignancy were linked to higher mortality.

Abstract

Background: Delirium frequently manifests in hospitalized geriatric patients and is associated with negative health outcomes. Available large-scale data regarding its prevalence rate and impact on older Thai patients are limited. This study aimed to analyze trends in the prevalence rate, its consequences, and the factors contributing to death at discharge among this population. Methods: A retrospective study of inpatients over the age of 60 who received a diagnosis of delirium was conducted, utilizing inpatient medical expense documentation for the fiscal years 2019–2023. The identification of delirium was conducted by the National Health Security Office using the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification (ICD-10-TM) code F05. Results: The 5-year prevalence rate and mortality rate of delirium were 215.1 and 18.7/100,000 population, respectively, and tended to rise over the studied periods. The average hospitalization was 10 days, and the average healthcare expenditure was about 1470 USD/visit. Respiratory disease emerged as the most common primary diagnosis in delirious patients (23.5%). Factors associated with mortality were individuals aged >80 years when juxtaposed with the cohort aged 61–70 years (adjusted odds ratio [AOD] 1.07), being female (AOR 1.13), and a primary diagnosis of respiratory disease (AOR 2.72), cardiovascular disease (AOR 1.68), musculoskeletal disease (AOR 0.61), systemic infection/septicemia (AOR 2.08); or malignancy (AOR 2.97). Conclusions: There was an upward trend in rates of both prevalence and mortality associated with delirium among hospitalized geriatric patients. Advancing age, gender, and particular primary diagnoses were associated with mortality at hospital discharge.

Figures