1. The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the 'Delirium Day 2015'
- Author
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Bo, M, Porrino, P, Di Santo SG, Mazzone, A, Cherubini, A, Mossello, E, Bianchetti, A, Musicco, M, Ferrari, A, Ferrara, N, Filippini, C, Trabucchi, M, Morandi, A, Bellelli, G, on behalf of the Italian Study Group on Delirium (ISGoD): Boffelli, S, Di Stefano, F, De Filippi, F, Guerini, F, Bertoletti, E, March, A, Margiotta, A, Mecocci, P, Ruggiero, C, Addesi, D, Fantò, F, Isaia, G, Dijik, B, Cotroneo, Am, Galli, G, Bruni, Ac, Bernardini, B, Corsini, C, Cagnin, A, Zurlo, G, Barbagallo, G, Lunardelli, Ml, Martini, E, Battaglia, G, Latella, R, Petritola, D, Sinforiani, E, Cester, A, Formilan, M, Carbone, P, Appollonio, I, Cereda, D, Tremolizzo, L, Bottacchi, E, Lucchetti, L, Mariani, C, Rapazzini, P, Romanelli, G, Marengoni, A, Zuliani, G, Bianchi, L, Suardi, T, Muti, E, Bottura, R, Sgrò, G, Mandas, A, Serchisu, L, Crippa, P, Ivaldi, C, Ungar, A, Villani, D, Raimondi, C, Mussi, C, Provenzano, G, Mari, D, Odetti, P, Monacelli, F, Antonelli Incalzi, R, Pluderi, A, Bellamoli, C, Terranova, L, Scarpini, E, D’Amico, F, Cavallini, Mc, Guerrini, G, Scotuzzi, Am, Chiarello, A, Pilotto, A, Tognini, S, Dell’Aquila, G, Toigo, G, Ceschia, G, Piccinini, M, Fabbo, A, Zoli, M, Forti, P, Wenter, C, Basile, G, Lasagni, A, Padovani, A, Rozzini, L, Cottino, M, Vitali, S, Tripi, G, Avanzi, S, Umidi, S, Moretti, D, Ruotolo, G, Boschi, F, Bonino, P, Marchionni, N, Fascendini, S, Noro, G, Turco, R, Ubezio, Mc, Serrati, C, Infante, M, Gentile, S, Pernigotti, Lm, Biagini, Ca, Canonico, E, Bonati, P, Gareri, P, Caffarra, P, Castagna, A, Ceretti, A, Castiglia, R, Gabelli, C, Lo Storto, M, Putzu, P, Di Santo, S, Rozzini, R, Zanetti, E, Trabucchi, M., Bo, M, Porrino, P, Di Santo, S, Mazzone, A, Cherubini, A, Mossello, E, Bianchetti, A, Musicco, M, Ferrari, A, Ferrara, N, Filippini, C, Trabucchi, M, Morandi, A, Bellelli, G, Bo, Mario, Porrino, Paola, Di Santo, Simona G., Mazzone, Andrea, Cherubini, Antonio, Mossello, Enrico, Bianchetti, Angelo, Musicco, Massimo, Ferrari, Alberto, Ferrara, Nicola, Filippini, Claudia, Trabucchi, Marco, Morandi, Alessandro, and Bellelli, Giuseppe
- Subjects
Male ,Aging ,medicine.medical_specialty ,4AT test ,Cognition ,Delirium ,Geriatric assessment ,Aged ,Aged, 80 and over ,Catheters, Indwelling ,Female ,Humans ,Logistic Models ,Urinary Catheterization ,Nursing Homes ,Catheters ,Hospitalized patients ,medicine.medical_treatment ,Logistic regression ,behavioral disciplines and activities ,Urinary catheterization ,03 medical and health sciences ,0302 clinical medicine ,Informed consent ,Internal medicine ,mental disorders ,medicine ,80 and over ,Dementia ,030212 general & internal medicine ,Coma ,business.industry ,Geriatrics and Gerontology ,medicine.disease ,Indwelling ,medicine.symptom ,Nursing homes ,business ,030217 neurology & neurosurgery - Abstract
Backround: Use of indwelling urinary catheter (IUC) in older adults has negative consequences, including delirium. Aim: This analysis, from the "Delirium Day 2015", a nationwide multicenter prevalence study, aim to evaluate the association of IUC with delirium in hospitalized and Nursing Homes (NHs) patients. Methods: Patients underwent a comprehensive geriatric assessment, including the presence of IUC; inclusion criteria were age > 65 years, being Italian speaker and providing informed consent; exclusion criteria were coma, aphasia, end-of-life status. Delirium was assessed using the 4AT test (score >= 4: possible delirium; scores 1-3: possible cognitive impairment). Results: Among 1867 hospitalized patients (mean age 82.0 ± 7.5 years, 58% female), 539 (28.9%) had IUC, 429 (22.9%) delirium and 675 (36.1%) cognitive impairment. IUC was significantly associated with cognitive impairment (OR 1.60, 95% CI 1.19-2.16) and delirium (2.45, 95% CI 1.73-3.47), this latter being significant also in the subset of patients without dementia (OR 2.28, 95% CI 1.52-3.43). Inattention and impaired alertness were also independently associated with IUC. Among 1454 NHs residents (mean age 84.4 ± 7.4 years, 70.% female), 63 (4.3%) had IUC, 535 (36.8%) a 4AT score >= 4, and 653 (44.9%) a 4AT score 1-3. The multivariate logistic regression analysis did not show a significant association between 4AT test or its specific items with IUC, neither in the subset of patients without dementia. Discussion: We confirmed a significant association between IUC and delirium in hospitalized patients but not in NHs residents. Conclusion: Environmental and clinical factors of acute setting might contribute to IUC-associated delirium occurrence.
- Published
- 2019
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