J.E. MENDEZ REYES1, T.J. Miles1, M. Hoffman1, J. Ward1, C.P. Seger1, M.D. Zielinski1, C. Wilson1 1Baylor College Of Medicine, Surgery, Houston, TX, USA
Introduction:
Delirium is a common and serious condition among hospitalized elderly patients, associated with adverse outcomes. Understanding its risk factors is crucial for effective prevention and management in trauma.
Methods:
We queried the National Trauma Data Bank for 2021 and 2022 and restricted the cohort to patients 65 years old and above. Descriptive statistics were used to characterize the study population and assess crude associations. Logistic regression was performed to assess the association between various patient characteristics and the risk of delirium.
Results:
A total of 822,591 patients were included in the analysis. The prevalence of delirium was 2.3% (18,134 / 804,457). On multivariate regression, our analysis revealed several significant risk factors associated with delirium among elderly patients, notably previous history of dementia (OR [95% CI]: 1.67 [1.59-1.75]), functionally dependent health status (OR [95% CI]: 1.61 [1.55-1.68]), history of a bleeding disorder (OR [95% CI]: 1.60 [1.42-1.80]), and male sex (OR [95% CI]: 1.49 [1.44-1.55]) had increased odds of developing delirium. Being of Hispanic ethnicity was associated with lower odds of developing delirium compared to non-Hispanics (OR [95% CI]: 0.53 [0.48-0.59]). Being transferred from another facility was significant on unadjusted analysis (p < 0.001) but not significant after multivariate analysis (OR [95% CI]: 1.00 [0.96-1.05]).
Conclusion:
Our study shows a low, potentially underreported, rate of delirium yet still highlights several risk factors associated with delirium among elderly trauma patients. Sex and ethnicity have significant association with delirium, but could indicate potential disparities in delirium diagnosis, rather than actual variation in incidence of delirium (i.e. language barriers or other social bias). Awareness of risk factors and early targeted interventions for these groups may be able to reduce incidence and severity of delirium, improving outcomes and quality of care.