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.
The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the “Delirium Day 2015” / 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; Porrino, P; 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; Isaia, G; 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; Cavallini, Mc; 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; Bellelli, G; Morandi, A; Di Santo, S; Mazzone, A; Rozzini, R; Zanetti, E; Bianchetti, A; Bo, M; Mossello, E; Cherubini, A; Ferrara, N; Ferrari, A; Musicco, M; Trabucchi, M.. - In: AGING CLINICAL AND EXPERIMENTAL RESEARCH. - ISSN 1594-0667. - STAMPA. - 31:3(2019), pp. 411-420. [10.1007/s40520-018-0974-1]
The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the “Delirium Day 2015”
Cherubini A;
2019-01-01
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
