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Subtypes of Delirium Linked to Shorter Survival in Terminally Ill

Hypoactive and mixed subtypes linked to shorter period of survival; significant interaction with age

MONDAY, Sept. 28, 2015 (HealthDay News) — For terminally ill patients, hypoactive and mixed subtypes of delirium are associated with shorter survival periods, according to a study published online Sept. 18 in Psychosomatic Medicine.

Seon-Young Kim, M.D., Ph.D., from Chonnam National University Medical School in Gwangju, South Korea, and colleagues conducted a prospective cohort study involving 322 terminally ill patients. The authors examined the differential associations between delirium and mortality in terminally ill patients, according to delirium subtype and age.

The researchers found that 30.4 percent of the patients were diagnosed as having delirium. The median number of survival days after admission was 17.0 and 28.0 days for patients with and without delirium, respectively (P = 0.002). Compared to patients without delirium, shorter survival was seen for patients with hypoactive (hazard ratio [HR]: 1.65; 95 percent confidence interval [CI], 1.05 to 2.59; P = 0.029) and mixed subtypes of delirium (HR: 2.30, 95 percent CI, 1.44 to 3.69; P = 0.001). Significant interactions were seen for hypoactive and mixed delirium subtypes with age: younger age correlated with shorter periods of survival in patients with hypoactive (HR, 0.95; 95 percent CI, 0.93 to 0.98; P < 0.001) and mixed subtypes of delirium (HR, 0.97; 95 percent CI, 0.93 to 1.00; P = 0.038).

“These findings support the clinical and academic value of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition specifiers that differentiate the diagnoses of delirium subtypes,” the authors write.

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