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The Delirium Drug Scale is associated to delirium incidence in the emergency department

Published online by Cambridge University Press:  06 December 2017

Patrick Viet-Quoc Nguyen Open the ORCID record for Patrick Viet-Quoc Nguyen [Opens in a new window] ,
Lucie Pelletier ,
Isabelle Payot  and
Judith Latour
Patrick Viet-Quoc Nguyen*
Affiliation:
Department of Pharmacy, Montreal University Hospital Centers (CHUM), Montreal, Quebec, Canada CHUM Research Center, Montreal, Quebec, Canada Réseau Québécois de Recherche en Vieillissement
Lucie Pelletier
Affiliation:
Department of Pharmacy, Montreal University Hospital Centers (CHUM), Montreal, Quebec, Canada
Isabelle Payot
Affiliation:
Department of Geriatrics, Montreal University Hospital Centers (CHUM), Montreal, Quebec, Canada
Judith Latour
Affiliation:
Department of Geriatrics, Montreal University Hospital Centers (CHUM), Montreal, Quebec, Canada
*
Correspondence should be addressed to: Patrick Viet-Quoc Nguyen, Department of Pharmacy, Study conducted at Montreal University Hospital Centers (CHUM), 900 Rue Saint-Denis, Montreal, Quebec, H2X 0A9, Canada. Phone: (+1) 438-876-5074. Email: patrick.nguyen@umontreal.ca.
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Abstract

Background:

The Delirium Drug Scale (DDS) is an evaluation scale developed to assess a patient's drug burden for delirium. The primary goal is to validate the association between the DDS score and the incidence of delirium.

Methods:

This study was an observational retrospective cross-sectional chart review study in patients aged 75 years and older. It was carried out in three emergency departments of a tertiary care university health center. Patients were included if a medication list was available. Delirium present upon admission was assessed during the first five days of admission.

Results:

A total of 1,205 subjects were included in the analysis. The mean age was of 83.4 years, and 62.4% were female. The prevalence of delirium was 19.1%. A total of 745 patients (62%) were exposed to DDS medication. The relative risk for the low (1–2) and high (>2) exposure group according to the DDS score was of 1.26 (CI: 0.95; 1.66) and 2.18 (CI: 1.61; 2.96) compared to a score of 0. In the multivariate analysis, dementia, anxiety, insomnia, history of delirium, infection, and acute kidney failure were significantly associated to delirium. When adjusted for confounding variables, the DDS score was associated with the incidence of delirium with an odd ratio (OR) of 1.29 (CI: 1.16; 1.44).

Conclusions:

This study found that DDS score was associated with delirium incidence. The association persisted in the multivariate analysis adjusted for 26 known risks and precipitating factors for delirium.

Keywords

deliriumagedanticholinergic agentsemergency department
Type
Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 4: Issue Theme: Delirium , April 2018 , pp. 503 - 510
Copyright
Copyright © International Psychogeriatric Association 2017 

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