Article Figures & Data
- Figure 1
Cohort selection. bCAM, brief confusion assessment method; ED, emergency department; IHT, interhospital transfer; OBGYN, obstetrics and gynecology.
- Figure 2
Sequential model receiver operating characteristic (ROC) curves. AUC, area under the curve.
- Table 1
Demographics
ED
n=19,915Clinic
n=4214IHT
n=5971P value Age (mean±SD) 58.1±17.4 57.5±16.1 58.6±17.2 0.0008 Age group (%) <0.0001 <50 29.3 28.3 28.7 50 to <65 29.8 33.4 29.2 65 to <80 31.9 32.5 32.6 80+ 9.0 5.8 9.4 Gender (%) <0.0001 Male 48.0 49.2 54.0 Female 52.0 50.9 46.0 Race (%) <0.0001 Black 37.0 29.7 33.6 Other 3.2 3.2 4.7 White 59.9 67.1 61.7 Marital status (%) <0.0001 Married 46.6 55.1 47.9 Single 19.7 17.0 20.6 Other 33.7 27.9 31.5 Distance to MUSC (>50 miles) (%) 34.6 58.2 76.0 <0.0001 Poverty (%) 30.3 27.1 30.2 0.0002 CCI score (mean±SD) 4.1±3.2 4.1±3.1 4.3±3.1 <0.0001 CCI score (%) <0.0001 0 12.8 10.1 10.0 1–2 25.0 25.6 22.4 3–4 24.4 27.7 26.0 5+ 37.8 36.6 41.7 Medication exposure (%) Antipsychotic 30.4 33.6 29.1 <0.0001 Anticholinergic 63.3 68.9 59.6 <0.0001 Opioid 81.9 86.1 82.3 <0.0001 Benzodiazepine (anytime) 38.3 43.2 49.5 <0.0001 ICU during hospitalization (%) 18.1 11.9 40.2 <0.0001 Group of specialty (%) <0.0001 ICU 0.3 0.4 0.5 General Internal Medicine 50.5 40.4 45.1 Neurology 13.8 11.5 24.6 OBGYN 1.9 3.3 2.1 Surgery 33.5 44.4 27.7 Alcohol abuse 7.8 3.0 7.9 <0.0001 Dementia 4.9 2.4 5.0 <0.0001 Myocardial infarction 12.4 8.6 16.6 <0.0001 Congestive heart failure 19.4 16.2 23.1 <0.0001 Cerebrovascular disease 9.0 7.7 19.9 <0.0001 Chronic pulmonary disease 21.1 19.4 20.0 0.0185 Peptic ulcer disease 1.7 1.0 2.5 <0.0001 Uncomplicated diabetes 10.9 9.7 11.2 0.0347 Complicated diabetes 19.1 17.6 19.6 0.0341 Hemiplegia 3.3 1.5 9.0 <0.0001 Renal disease 20.3 20.2 19.8 0.6385 Cancer 19.5 29.3 19.1 <0.0001 AIDS/HIV 1.4 1.4 1.1 0.2560 Liver disease 7.9 7.1 9.9 <0.0001 CCI, Charlson Comorbidity Index; ED, emergency department; ICU, intensive care unit; IHT, interhospital transfer; MUSC, Medical University of South Carolina; OBGYN, obstetrics and gynecology.
- Table 2
Outcomes
ED
n=19,915Clinic
n=4214IHT
n=5971P value Primary outcome bCAM positive (%) 11.8 5.8 22.3 <0.0001 Secondary outcome Discharge to a facility (%) 13.0 5.8 22.8 <0.0001 LOS (mean±SD) 5.7±6.3 5.6±7.2 8.9±9.3 <0.0001 Mortality (%) 0.8 0.6 1.9 <0.0001 bCAM, brief confusion assessment method; ED, emergency department; IHT, interhospital transfer; LOS, length of stay.
- Table 3
Clinical variables associated with delirium used in the multivariable logistic regression model
OR 95% CI P value Admission source (ref: ED) Clinic 0.557 0.481 to 0.644 <0.0001 IHT 1.912 1.741 to 2.099 <0.0001 Group of specialty (ref: General Internal Medicine) ICU 3.164 1.900 to 5.267 <0.0001 Neurology 0.992 0.881 to 1.116 0.8903 OBGYN 0.422 0.286 to 0.624 <0.0001 Surgery 0.754 0.682 to 0.834 <0.0001 Age group (ref: 18–49) 50–64 1.438 1.287 to 1.607 <0.0001 65–79 2.018 1.799 to 2.264 <0.0001 80+ 2.8 2.405 to 3.259 <0.0001 Female 0.996 0.921 to 1.077 0.9153 Race (ref: White) Black 1.182 1.083 to 1.291 0.0002 Other 1.155 0.939 to 1.423 0.1733 Marital status (ref: Married) Other 1.151 1.042 to 1.272 0.0056 Single 1.236 1.122 to 1.362 <0.0001 Distance_MUSC≥50 0.882 0.809 to 0.962 0.0045 Poverty 1.009 0.928 to 1.096 0.8362 Antipsychotic 3.220 2.977 to 3.483 <0.0001 Anticholinergics 0.826 0.761 to 0.897 <0.0001 Opioid 1.032 0.931 to 1.145 0.5481 Benzodiazepine 2.422 2.235 to 2.625 <0.0001 Falls 2.773 2.107 to 3.648 <0.0001 Alcohol abuse 1.728 1.516 to 1.971 <0.0001 Dementia 3.922 3.431 to 4.484 <0.0001 Myocardial infarction 1.284 1.157 to 1.425 <0.0001 Congestive heart failure 1.146 1.039 to 1.265 0.0067 Cerebrovascular disease 2.377 2.132 to 2.650 <0.0001 Chronic pulmonary disease 1.020 0.930 to 1.119 0.6776 Peptic ulcer disease 1.392 1.084 to 1.789 0.0096 Uncomplicated diabetes 0.936 0.826 to 1.061 0.2998 Complicated diabetes 1.206 1.091 to 1.333 0.0002 Hemiplegia 2.494 2.144 to 2.901 <0.0001 Renal disease 1.042 0.939 to 1.155 0.4409 Cancer 0.896 0.811 to 0.989 0.0302 AIDS/HIV 1.308 0.960 to 1.783 0.089 Liver disease 1.589 1.398 to 1.807 <0.0001 ED, emergency department; ICU, intensive care unit; IHT, interhospital transfer; MUSC, Medical University of South Carolina; OBGYN, obstetrics and gynecology.
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