Risk factors associated with the development of delirium in hospitalized older adults with cardiopathy

Jesús A. Gómez-García, Department of Geriatrics, Unidad Médica de Alta Especialidad Hospital de Cardiología No. 34 Dr. Alfonso J. Treviño Treviño, Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Nuevo Leon, Monterrey, Mexico
Manuel A. Bustillos-Cuevas, Department of Geriatrics, Unidad Médica de Alta Especialidad Hospital de Cardiología No. 34 Dr. Alfonso J. Treviño Treviño, Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Nuevo Leon, Monterrey, Mexico
María J. Bojórquez-Lopez, Department of Geriatrics, Unidad Médica de Alta Especialidad Hospital de Cardiología No. 34 Dr. Alfonso J. Treviño Treviño, Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Nuevo Leon, Monterrey, Mexico
Itzel Reyes-Salcedo, Department of Geriatrics, Unidad Médica de Alta Especialidad Hospital de Cardiología No. 34 Dr. Alfonso J. Treviño Treviño, Centro Médico Nacional del Noreste, Instituto Mexicano del Seguro Social, Nuevo Leon, Monterrey, Mexico

Background: Delirium is a frequent and serious neuropsychiatric complication in hospitalized older adults and is associated with poor outcomes. Its incidence varies widely, but it is estimated to affect between 11% and 42% of hospitalized patients worldwide. Identifying the risk factors in this population is crucial for optimizing preventive strategies. Objective: To evaluate the risk factors associated with the development of delirium in older adults hospitalized for cardiac pathologies. Material and methods: A retrospective cohort study was conducted that included adults aged ≥ 70 years who were hospitalized for heart disease between January 2022 and December 2023. From the total population included in the study, two groups were defined: patients admitted under a delirium prevention protocol and patients with delirium present at hospital admission, who were designated as the delirium follow-up program group. All patients included underwent a comprehensive geriatric assessment. The associated risk factors were analyzed using multivariate logistic regression. Results: A total of 847 patients were included; 52.5% were men, with a mean age of 78 ± 6.4 years. The overall frequency of delirium was 48%. In the prevention group, 17% developed delirium during hospitalization. The risk factors for delirium in the multivariate analysis were male sex (Relative risk [RR] = 1.45), prior history of delirium (RR = 2.78), admission to the intensive care unit (RR = 5.58), and history of recent non-cardiac surgery (RR = 4.80). Conclusion: The identified risk factors could be used as inclusion criteria for preventive protocols.

Keywords: Delirium. Heart disease. Predisposing factors. Precipitating factors.