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Delirium in COVID-19 and post-liver transplant patients: an observational study.

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Title: Delirium in COVID-19 and post-liver transplant patients: an observational study.
Authors: Fiore, Gianluca, Ferrari, Silvia, Cutino, Anna, Giorgino, Claudia, Valeo, Laura, Galeazzi, Gian M., Marchi, Mattia
Source: International Journal of Psychiatry in Clinical Practice. Nov2022, Vol. 26 Issue 4, p343-351. 9p.
Subjects: COVID-19, Scientific observation, T-test (Statistics), Delirium, Liver transplantation, Sociodemographic factors
Abstract: Delirium is a major complication in hospitalised patients. This study aimed to compare the mortality trends of patients with delirium according to the underlying physical condition. Hospitalised patients diagnosed with delirium by the Modena Consultation-Liaison Psychiatry Service (Italy) during 2020 were enrolled. Three groups were identified: COVID; after orthotopic liver transplant (OLT); other conditions. The full medical records were screened to retrieve socio-demographic and clinical data. INTERMED score and Delirium Rating Scale were used to retrospectively rate bio-social-complexity and delirium severity. Early (20 days) and end of study (31st January 2021) mortality were ascertained for each subject. A total of 103 patients were enrolled. Patients hospitalised for COVID showed higher INTERMED scores (two-tailed t-test, p = 0.019) and higher 20-day mortality (HR = 3.68, p = 0.014). When considering a 1-year follow-up, the main predictor of mortality was patients' age in all three subgroups (HR = 1.06; p = 0.003). Our results suggest that patients hospitalised for COVID-19 with delirium showed higher bio-psycho-social complexity and higher short-term mortality, regardless of the severity of delirium. OLT patients showed lower mortality and bio-psycho-social complexity, despite being still considered as 'complex', according to the INTERMED score. Future research should focus on understanding the underlying mechanisms in the relationship between delirium and mortality. Patients hospitalised for COVID-19 with delirium were found at risk of higher short-term mortality and higher bio-psycho-social complexity. OLT patients showed lower overall mortality and lower bio-psycho-social complexity than the other two groups, despite being still in the 'complex' range according to the INTERMED score. Future research should assess the areas of impact of delirium in patients affected by COVID-19, considering short- and long-term outcomes. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Psychiatry in Clinical Practice is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Delirium in COVID-19 and post-liver transplant patients: an observational study.
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  Data: <searchLink fieldCode="AR" term="%22Fiore%2C+Gianluca%22">Fiore, Gianluca</searchLink><br /><searchLink fieldCode="AR" term="%22Ferrari%2C+Silvia%22">Ferrari, Silvia</searchLink><br /><searchLink fieldCode="AR" term="%22Cutino%2C+Anna%22">Cutino, Anna</searchLink><br /><searchLink fieldCode="AR" term="%22Giorgino%2C+Claudia%22">Giorgino, Claudia</searchLink><br /><searchLink fieldCode="AR" term="%22Valeo%2C+Laura%22">Valeo, Laura</searchLink><br /><searchLink fieldCode="AR" term="%22Galeazzi%2C+Gian+M%2E%22">Galeazzi, Gian M.</searchLink><br /><searchLink fieldCode="AR" term="%22Marchi%2C+Mattia%22">Marchi, Mattia</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Psychiatry+in+Clinical+Practice%22">International Journal of Psychiatry in Clinical Practice</searchLink>. Nov2022, Vol. 26 Issue 4, p343-351. 9p.
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  Data: <searchLink fieldCode="DE" term="%22COVID-19%22">COVID-19</searchLink><br /><searchLink fieldCode="DE" term="%22Scientific+observation%22">Scientific observation</searchLink><br /><searchLink fieldCode="DE" term="%22T-test+%28Statistics%29%22">T-test (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Delirium%22">Delirium</searchLink><br /><searchLink fieldCode="DE" term="%22Liver+transplantation%22">Liver transplantation</searchLink><br /><searchLink fieldCode="DE" term="%22Sociodemographic+factors%22">Sociodemographic factors</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Delirium is a major complication in hospitalised patients. This study aimed to compare the mortality trends of patients with delirium according to the underlying physical condition. Hospitalised patients diagnosed with delirium by the Modena Consultation-Liaison Psychiatry Service (Italy) during 2020 were enrolled. Three groups were identified: COVID; after orthotopic liver transplant (OLT); other conditions. The full medical records were screened to retrieve socio-demographic and clinical data. INTERMED score and Delirium Rating Scale were used to retrospectively rate bio-social-complexity and delirium severity. Early (20 days) and end of study (31st January 2021) mortality were ascertained for each subject. A total of 103 patients were enrolled. Patients hospitalised for COVID showed higher INTERMED scores (two-tailed t-test, p = 0.019) and higher 20-day mortality (HR = 3.68, p = 0.014). When considering a 1-year follow-up, the main predictor of mortality was patients' age in all three subgroups (HR = 1.06; p = 0.003). Our results suggest that patients hospitalised for COVID-19 with delirium showed higher bio-psycho-social complexity and higher short-term mortality, regardless of the severity of delirium. OLT patients showed lower mortality and bio-psycho-social complexity, despite being still considered as 'complex', according to the INTERMED score. Future research should focus on understanding the underlying mechanisms in the relationship between delirium and mortality. Patients hospitalised for COVID-19 with delirium were found at risk of higher short-term mortality and higher bio-psycho-social complexity. OLT patients showed lower overall mortality and lower bio-psycho-social complexity than the other two groups, despite being still in the 'complex' range according to the INTERMED score. Future research should assess the areas of impact of delirium in patients affected by COVID-19, considering short- and long-term outcomes. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of International Journal of Psychiatry in Clinical Practice is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1080/13651501.2022.2026403
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        Text: English
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        PageCount: 9
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      – SubjectFull: COVID-19
        Type: general
      – SubjectFull: Scientific observation
        Type: general
      – SubjectFull: T-test (Statistics)
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      – SubjectFull: Delirium
        Type: general
      – SubjectFull: Liver transplantation
        Type: general
      – SubjectFull: Sociodemographic factors
        Type: general
    Titles:
      – TitleFull: Delirium in COVID-19 and post-liver transplant patients: an observational study.
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              Text: Nov2022
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              Y: 2022
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