Examining the risk of delirium in patients hospitalized with COVID-19: Insights from the homeless population

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(1), P. e0313242 - e0313242

Published: Jan. 9, 2025

For patients hospitalized with COVID-19, delirium is a serious and under-recognized complication, people experiencing homelessness (PEH) may be at greater risk. This retrospective cohort study compared delirium-associated risk factors clinical outcomes between PEH non-PEH. used patient records from 154 hospitals discharged 2020-2021 the Texas Inpatient Public Use Data file. Study subjects (n = 878) were patients, aged 18-69 years, who COVID-19 identified as homeless. The baseline group included 176,518) years not Logistic regression models to identify for delirium. Relevant chronic comorbidities, substance use disorders, traumatic brain injury (TBI). Seven of more prevalent among baseline. had higher rates TBI, alcohol, cannabis, opioid disorders. significantly (10.6% vs. 8.1%; P<0.01). However, fewer respiratory complications, including pneumonia (48.5% 81.9%; P<0.001) failure (28.7% 61.9%; P<0.001), lower in-hospital mortality (3.3% 9.5%; P<0.001). anti-viral Remdesivir protective effect against (AOR 0.63; CI: 0.60, 0.66). Mean hospital length stay (LOS) was than twice long delirious non-delirious (18.4 days 7.7 days; Delirium greatly increased 3.8; 3.6, 4.0). 29) died present in half (52%) cases. Hospitals should screen adopt nursing protocols prevent reduce its severity.

Language: Английский

Delirium prevalence and management in general wards, emergency departments, rehabilitation centres and nursing homes in Germany, Austria and Switzerland (DACH countries): A secondary analysis of a worldwide point prevalence study

International Journal of Nursing Studies Advances, Journal Year: 2025, Volume and Issue: 8, P. 100309 - 100309

Published: Feb. 10, 2025

Delirium is a common neuropsychiatric syndrome associated with an increased risk of mortality and length stay. Current delirium prevalence, assessments management practices in DACH countries are unknown. To examine the point assessment, general wards, emergency departments, rehabilitation centres nursing homes countries. Secondary data analysis from prospective, cross-sectional, worldwide one-day prevalence study (registered German Registry for Clinical Trials, DRKS00030002). General hospital excluding operating rooms, ambulatory, high acuity, intermediate care intensive units. In total, 172 wards (majority were wards; 91.3 %, n = 157) Germany, Austria Switzerland participated. Descriptive 39-questions online survey aggregated routine patient facility completed by healthcare professionals, administrators, researchers on World Awareness Day, March 15th, 2023. Data collected at 8:00 A.M. P.M. (± 4 h). Use assessments, awareness structures, presence protocols, barriers to structures reported. Overall was 7.1 % (n 143/2,028) 7.2 133/1,842) There no statistically significant difference between assessed valid (p .770) or non-valid assessment .643). The most frequent Nursing Screening Scale (16.3 28/172), Confusion Assessment Method (15.7 27/172) Observation (9.3 16/172). reported interventions provide education "delirium mentioned handovers" (53.5 92/172), "availability experts" (51.2 88/172) during last year" (48.3 83/172). An existing protocol present 76.7 132/172) participating wards. frequently "shortage staff" (45.3 78/172), "patients who difficult assess" (32.6 56/172), "communication gaps professions" (29.1 50/172). As non-pharmacological interventions, "mobilization" (92.4 159/172), "pain management" (87.8 151/172), "adequate fluids" (83.7 144/172) mostly complication patients More than three quarter suggesting published guidelines best practice recommendations. Improved staffing, interprofessional communication could be helpful improve usage addressing management.

Language: Английский

Delirium management in 2024: A status check and evolution in clinical practice since 2016

Intensive and Critical Care Nursing, Journal Year: 2025, Volume and Issue: 89, P. 103995 - 103995

Published: March 8, 2025

Delirium in patients on intensive care units (ICU) can lead to prolonged length of stay, cognitive decline and higher mortality. Implementing delirium management is a challenge for healthcare workers. Between 2016 2024, several quality improvement projects were performed German speaking countries. These included founding society, distributing related curricula, awards, surveys, webinars, public materials, others. The aim was assess the current state 2024 identify changes prevention, detection, treatment since 2016. Repetition comparison survey from 2024. Questions items hospital ICU characteristics, present structures, processes, assessment routines, barriers, distributed snowball system Data analysed statistically. Participating both surveys (2016: n = 559, 2024: 447) had similar basic characteristics enabled comparison. Use validated tools slightly increased 56.8 % (n 398) 74.4 438) Significant rates identified use assessments (56.8 vs. 72.8 %), prevention programs (34.6 44.7 information materials families (18.9 33.8 Conversely, there decreased implementation dementia screening (23.7 14.8), restraints (68.3 58.4 top barrier, lack time staff, remained first place. two large indicate cultural shift Open might increase awareness contribute an ongoing change. Improvement addressing barriers delirium-specific are essential improve sustain practices settings.

Language: Английский