Table 1.
Clinical characteristics, cognitive and functional outcomes in GMU patients (n = 228) at baseline
| Total (n = 228) | Hyperactive (n = 117) | Hypoactive (n = 42) | Mixed (n = 69) | |
|---|---|---|---|---|
| Demographics | ||||
| Age (mean ± SD) | 84.2 (7.4) | 83.6 (7.5) | 84.9 (7.8) | 84.7 (6.9) |
| Gender (male %) | 43.4 | 42.7 | 47.6 | 42.0 |
| Race (Chinese %) | 88.2 | 93.2 | 80.9 | 84.1 |
| Comorbidities | ||||
| Charlson Comorbidity Index score35 | 2.3 (1.6) | 1.9 (1.3)+ | 2.9 (2.20) | 2.5 (1.6)* |
| Severity of Illness Index score36 | 2.0 (0.3) | 2.1 (0.2) | 2.0 (0.3) | 2.0 (0.4) |
| Days of delirium | 6.7 (4.6) | 5.8 (3.1) | 7.3 (6.0) | 7.9 (5.6)*,# |
| Length of stay | 15.1 (9.3) | 13.9 (7.1) | 15.0 (10.4) | 16.6 (11.4) |
| Precipitating causes of delirium | ||||
| Number of precipitating causes, n (%) | ||||
| Single precipitating cause | 67 (29.4%) | 34 (29.1%) | 9 (21.4%) | 24 (34.8%) |
| Two precipitating causes | 72 (31.6%) | 38 (32.5%) | 13 (31.0%) | 21 (30.4%) |
| More than two precipitating causes | 89 (39.0%) | 45 (38.5%) | 20 (47.6%) | 24 (34.8%) |
| Type of precipitating cause, n (%) | ||||
| Sepsis | 155 (68.0%) | 75 (64.1%) | 29 (69.0%) | 51 (73.9%) |
| Other medical cause | 48 (21.1%) | 28 (23.9%) | 8 (19.0%) | 12 (17.4%) |
| Postoperative | 7 (3.1%) | 4 (3.4%) | 1 (2.4%) | 2 (2.9%) |
| Other surgical cause | 18 (7.9%) | 10 (8.5%) | 4 (9.5%) | 4 (5.8%) |
| Cognitive status | ||||
| Prior dementia diagnosis (%) | 46.1 | 44.4 | 45.2 | 49.3 |
| Newly diagnosed dementia during admission (%) | 30.3 | 33.3 | 33.3 | 23.1 |
| Prior behavioral issues before admission (%) | 25.1 | 27.4 | 9.8 | 30.4* |
| Initial CMMSE37 (/28) | 5.8 (5.5) | 6.9 (5.9)+ | 4.3 (5.3) | 4.9 (4.4)* |
| Last CMMSE (/28) | 9.2 (6.6) | 10.5 (6.4) | 7.8 (7.2)++ | 7.9 (6.0)* |
| Change in CMMSE (/28) | 3.4 (5.5) | 3.6 (5.2) | 3.5 (6.6) | 3.0 (5.3) |
| Initial CAM33 | 5.1 (2.0) | 5.2 (2.5) | 5.3 (1.2) | 5.0 (1.2) |
| Last CAM | 2.2 (1.2) | 1.9 (0.9) | 2.3 (1.3) | 2.5 (1.4) |
| Change in CAM | −2.9 (2.3) | −3.2 (2.7) | −3.0 (1.4) | −2.4 (1.8) |
| Initial DRS severity34 (/39) | 22.5 (5.8) | 21.6 (6.3) | 23.1 (5.6) | 23.6 (4.7) |
| Last DRS severity (/39) | 14.6 (6.1) | 13.5 (95.5) | 16.0 (7.0) | 15.4 (6.3)* |
| Change in DRS severity (/39) | −6.2 (6.3) | −6.4 (5.8) | −5.3 (6.2) | −6.2 (7.1) |
| Initial DRS total (/46) | 26.2 (6.1) | 25.3 (6.5) | 26.9 (5.7) | 27.3 (5.4) |
| Last DRS total (/46) | 16.3 (6.7) | 15.2 (5.9) | 17.8 (7.7) | 17.2 (7.2) |
| Change in DRS total (/46) | −11.6 (6.1) | −11.7 (5.9) | −10.9 (5.7) | −11.8 (6.9) |
| Initial DRS subitem sleep–wake disturbance (/3) | 1.9 (0.8) | 1.8 (0.8) | 1.9 (0.9) | 1.9 (0.6) |
| Last DRS subitem sleep–wake disturbance (/3) | 0.7 (0.8) | 0.7 (0.8) | 0.6 (0.7) | 0.6 (0.9) |
| Change in DRS subitem sleep–wake disturbance (/3) | −1.2 (1.1)** | −1.1 (1.1)** | −1.3 (0.9)** | −1.4 (1.3)** |
| Functional scores | ||||
| MBI38 admission (/100) | 29.1 (24.1) | 36.8 (25.9) | 16.9 (18.7) | 23.4 (19.2)* |
| MBI discharge (/100) | 47.4 (26.1) | 56.4 (22.5) | 30.9 (26.3) | 42.3 (25.7)* |
| Improvement in MBI scores | 18.4 (18.1)** | 19.6 (18.6)** | 14.0 (2.5)** | 19.0 (18.4)** |
| Pharmacological agent use | ||||
| Chemical restraints (%) | 39.5 | 47.9 | 9.5 | 43.5* |
| Total antipsychotic use (CPZ equivalent) | 0.9 (1.6) | 1.2 (1.6) | 0 (0) | 1.0 (1.7) |
| Benzodiazepine usage (%) | 24.6 | 26.5 | 9.5 | 30.4 |
Notes:
ANOVA P < 0.05 across delirium subtypes;
paired sample t-test P < 0.05 for GMU cohort and specific delirium subtypes;
post hoc results (with Bonferroni correction) between hyperactive delirium and hypoactive delirium (P < 0.05);
post hoc results (with Bonferroni correction) between hypoactive delirium and mixed delirium (P < 0.05);
post hoc results (with Bonferroni correction) between hyperactive delirium and mixed delirium (P < 0.05).
Abbreviations: ANOVA, analysis of variance; CAM, Confusion Assessment Method; CMMSE, Chinese Mini−Mental State Examination; CPZ, chlorpromazine; DRS, Delirium Rating Scale; GMU, Geriatric Monitoring Unit; MBI, modified Barthel Index; SD, standard deviation.