The short IQCODE as a predictor for delirium in hospitalized geriatric patients
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ORIGINAL ARTICLE
The short IQCODE as a predictor for delirium in hospitalized geriatric patients S. Blandfort1 · M. Gregersen1 · K. Rahbek1 · S. Juul2 · E. M. Damsgaard1 Received: 10 October 2019 / Accepted: 2 November 2019 © Springer Nature Switzerland AG 2019
Abstract Background Delirium is a serious complication, which occurs frequently in older patients with pre-existing cognitive impairment. There is a need for a simple tool to assess chronic cognitive impairment and the associated risk of delirium during hospitalization. Aims To assess the usefulness of the short IQCODE questionnaire in predicting delirium during hospitalization in older patients in a geriatric ward. Methods A prognostic study in the Geriatric Department at Aarhus University Hospital, Aarhus Denmark. Consecutive patients were enrolled during March to December, 2017. After consent of the patient, the staff interviewed the relatives by phone using the short IQCODE questionnaire. Delirium was assessed morning and evening until discharge by the Confusion Assessment Method. The ability of short IQCODE to predict delirium was examined. Results Three hundred and fifty-three patients were eligible, and 306 completed the IQCODE. Delirium occurred among 19% of the patients during hospitalization. The IQCODE score was associated with the risk of delirium with a receiver operating characteristic (ROC) area of 0.72. A cut-point of 3.3 could separate the patients in a larger group with a risk of approximately 26% to develop delirium and a smaller group having a risk of approximately 6%. Conclusion The IQCODE is a useful tool to predict delirium among older inpatients, but it may not stand alone. It can be a useful supplement to other clinical information and observations in detecting patients needing dementia-friendly treatment and care. Keywords IQCODE · Delirium predictor · Older patient · Geriatrics
Background Delirium is an acute state of confusion characterized by inattention and cognitive dysfunction. It is estimated that delirium is present in up to 56% of older inpatients [1]. Delirium affects health adversely in terms of increased morbidity and mortality, poor rehabilitation outcomes, prolonged hospitalization, and increased institutionalization [2–9]. Delirium is most prevalent in older patients with preexisting cognitive impairment [2, 10, 11]. The cause of delirium is thought to be multifactorial, dependent on a * S. Blandfort [email protected] 1
Department of Geriatrics, Aarhus University Hospital, Palle Juul‑Jensens Boulevard 99, 8200 Aarhus N, Denmark
Department of Public Health, Aarhus University, Aarhus, Denmark
2
complex interplay of predisposing and precipitating factors [12]. Predisposing factors are in particular high age and dementia [11, 13, 14]. In a meta-analysis of older medical patients, Ahmed et al. found that higher age is associated with delirium and that dementia increases the probability of delirium nearly seven times [14]. In Denmark, 6% of persons aged 75 years or older have a dementia-related diagnosis [
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