Prevalence and predictors of delirium among medical inpatients admitted through accident and emergency unit of Jos University Teaching Hospital

Abstract

Background: Delirium is a complex neuropsychiatric syndrome, commonly encountered across all healthcare settings. However, little is known about its magnitude and determining factors in medical inpatients especially at the Accident and Emergency (A&E) setting of tertiary institutions in low income countries.

Objectives: This study was conducted to evaluate the prevalence of delirium among medical inpatients admitted through the A&E unit as well as to assess its predictors.

Method: This was a cross-sectional study that employed a consecutive sampling technique to select 290 eligible subjects from medical inpatients that presented to A&E unit of Jos University Teaching Hospital (JUTH). Confusion Assessment Method (CAM) was used to assess for delirium.

Results: The results showed that 35.9% of the respondents had delirium. The predictive variables for delirium were: Age groups 18-34 years and 35-64 years (P=0.014 and P = 0.003), prior cognitive impairment (P = 0.020), having estimated monthly income belowN50,000 (P<0.001 and P=0.008) , use of alcohol (P=0.026) and having rare/other medical diagnosis (P = 0.0016).

Conclusion: Delirium is very common in medical inpatients and highly predictable especially in high risk patients. Consultation-Liaison Psychiatry services need to be integrated into the A&E unit management team particularly in the areas of prevention and management of identified cases.

Keywords: Delirium, Medical Inpatients, Prevalence, Predictors, Accident and Emergency Unit