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Current Gerontology and Geriatrics Research
Volume 2013 (2013), Article ID 962321, 9 pages
http://dx.doi.org/10.1155/2013/962321
Clinical Study

Predicting Delirium Duration in Elderly Hip-Surgery Patients: Does Early Symptom Profile Matter?

1Department of Geriatric Medicine, Medical Center Alkmaar, P.O. Box 501, 1800 AM Alkmaar, The Netherlands
2Research and Academic Institute of Athens, 27 Themistokleous Street and Akadimias, 106 77 Athens, Greece
3University Hospital Limerick and Department of Adult Psychiatry, University of Limerick Medical School, Limerick, Ireland
4Medical Center Alkmaar, Pieter van Foreest Institute for Education and Research, 1800 AM Alkmaar, The Netherlands
5Department of Surgery, Medical Center Alkmaar, 1800 AM Alkmaar, The Netherlands
6Department of Neurology, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands

Received 9 July 2012; Revised 16 November 2012; Accepted 21 November 2012

Academic Editor: Abebaw Yohannes

Copyright © 2013 Chantal J. Slor et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Features that may allow early identification of patients at risk of prolonged delirium, and therefore of poorer outcomes, are not well understood. The aim of this study was to determine if preoperative delirium risk factors and delirium symptoms (at onset and clinical symptomatology during the course of delirium) are associated with delirium duration. Methods. This study was conducted in prospectively identified cases of incident delirium. We compared patients experiencing delirium of short duration (1 or 2 days) with patients who had more prolonged delirium (≥3 days) with regard to DRS-R-98 (Delirium Rating Scale Revised-98) symptoms on the first delirious day. Delirium symptom profile was evaluated daily during the delirium course. Results. In a homogenous population of 51 elderly hip-surgery patients, we found that the severity of individual delirium symptoms on the first day of delirium was not associated with duration of delirium. Preexisting cognitive decline was associated with prolonged delirium. Longitudinal analysis using the generalised estimating equations method (GEE) identified that more severe impairment of long-term memory across the whole delirium episode was associated with longer duration of delirium. Conclusion. Preexisting cognitive decline rather than severity of individual delirium symptoms at onset is strongly associated with delirium duration.