Деменция и злоупотребление алкоголем являются независимыми факторами риска делирия у госпитализированных пациентов

Dementia, prior delirium, and heavy alcohol use independently predict consultation-confirmed delirium among hospitalized patients, whereas age of at least 70 years and having surgery under general anesthesia are not independent predictors. These study findings were published in Psychiatry and Clinical Neurosciences Report. Researchers conducted a retrospective observational study to examine demographic and clinical factors that are associated with consultation-confirmed, referral-based delirium. Eligible participants were hospitalized at Nara Medical University Hospital from June 2022 through November 2023. Within 3 days of admission, patients underwent standardized screening for predefined risk factors for delirium based on the Japanese national prevention framework, including age 70 years and older, organic brain disorders, dementia, heavy alcohol use, prior delirium, medications associated with delirium risk, and surgery under general anesthesia. Delirium diagnosis was assessed using International Classification of Diseases, Tenth Edition (ICD-10), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision ( DSM-5-TR ) criteria, whereas heavy alcohol use was defined as habitual, documented alcohol consumption requiring clinical attention. In this large cohort[…]consultation-confirmed delirium was independently associated with baseline neurocognitive vulnerability […] and heavy alcohol use, rather than chronological age alone, supporting vulnerability-focused risk stratification[…]. A total of 20,980 patients (mean age, 67.09±16.96 years; 55.0% men) were selected for final analysis. Study participants were separated into 3 groups: those who received consultation with delirium (n=209), without delirium (n=300), and no consultation (n=20,470).  Researchers found that predefined risk factors in the study participants included the following factors:  Aged at least 70 years (56.4%); Organic brain disorders (5.9%);  Dementia (3.3%); Heavy alcohol use (6.2%);  Prior delirium (1.5%);  Delirium-associated medication use (8.7%); and  Surgery under general anesthesia (25.3%). Of the study participants, 21.2% had no identified risk factors. Delirium prevalence increased with age, from 0% among patients aged younger than 40 years to 1.57% among those aged older than 80 years ( P <.001). Patients with consultation-confirmed delirium vs without delirium and no consultation were older (71.85±11.63 years vs 60.93±17.84 years and 67.16±16.90, respectively) and more frequently had dementia (16.75% vs 8.67% and 3.11%, respectively) or prior delirium (8.61% vs 4.33% and 1.38%, respectively; all P <.001). In unadjusted analysis, increasing age was associated with delirium (odds ratio [OR], 1.032 per year; 95% CI, 1.020-1.043; P <.001). However, in the fully adjusted model, dementia (OR, 3.995; 95% CI, 2.647-6.029; P <.001), history of delirium (OR, 3.649; 95% CI, 2.158-6.170; P <.001), and heavy alcohol use (OR, 1.648; 95% CI, 1.002-2.710; P =.049) remained independently associated with consultation-confirmed delirium.  In contrast, age 70 years and older (OR, 1.034; 95% CI, 0.582-1.838; P =.91), organic brain disorders (OR, 1.099; 95% CI, 0.665–1.817; P =.71), delirium-associated medications (OR, 1.538; 95% CI, 0.976–2.425]; P =.06), and surgery under general anesthesia (OR, 0.732; 95% CI, 0.497–1.080; P =.67) were not independently associated with delirium. Study limitations include consultation-based ascertainment of delirium without uniform use of validated bedside screening tools; the single-center tertiary hospital design, which may limit generalizability; and a lack of adjustment for important confounders. The study authors concluded, “In this large cohort[…]consultation-confirmed delirium was independently associated with baseline neurocognitive vulnerability […] and heavy alcohol use, rather than chronological age alone, supporting vulnerability-focused risk stratification[…].” References: Matsuda M, Yamamuro K, Ikeuchi M, et al. Clinical characteristics and risk factors associated with consultation-confirmed delirium in hospitalized patients.  PCN Rep. 2026;5(3):e70385. doi:10.1002/pcn5.70385