Investigation of metabolic problems in delirium etiology in geriatric patients

Objective: The aim of this study was to investigate delirium related metabolic markers and its association with mortality rates in elderly inpatients. Methods: The medical records of 1435 patients over 65 years old who were treated at a regional university hospital and were referred to the university's Consultation and Liaison Psychiatry Clinic for psychological evaluation were retrospectively analyzed. Patients with and without a diagnosis of delirium were compared. The National Survival Database was used to determine mortality rates. Hemoglobin, leukocyte, hematocrit, sodium, potassium, calcium, albumin, sedimentation, C-reactive protein, urea, creatinine, glucose, vitamin B12, TSH and T4 values were recorded in SPSS 20 for the metabolic evaluation of the patients. Mean ± standard deviation for descriptive results of numerical variables, frequency and percentages of categorical variables were given. Results: The prevalence of delirium was 25. 5%. Mortality rate was higher in the delirium group at 1, 2, 3, 4, and 5 years (p < .0001 for all). Albumin, sodium, potassium, calcium, creatinine, fasting blood sugar and C-reactive protein values were compared in terms of mean and percentage values in patients with and without delirium diagnosis. In patients with delirium, anemia was seen in 63%, leukocytosis in 33%, hyponatremia in 28%, hypoalbuminemia in 60%, hypocalcemia in 51% and hyperglycemia in 53%, serum creatinine and CRP elevation respectively in 90%, 47%, Conclusions: Independent of all other factors, delirium is associated with higher mortality risk. In our study, metabolic conditions such as hyponatremia, hypopotassemia, hypoalbuminemia, hypocalcemia, impaired renal function, hyperglycaemia, infection, and anemia were found to be among the accelerating factors for delirium when compared to patients with and without delirium. In delirium, psychiatry-geriatric cooperation and accurate research of important metabolic problems in etiology will be life-saving. Key Words: Delirium in the elderly, mortality, metabolic conditions