Citation

Kalivas B, Zhang J, Harper K, Dulin J, Heincelman M, Marsden J, Hunt KJ, Mauldin PD, Moran WP, Thomas MK. J. Healthc. Qual. 2023; 45(3): 177-190.

Copyright

(Copyright © 2023, National Association for Healthcare Quality, Publisher John Wiley and Sons)

DOI

10.1097/JHQ.0000000000000377

PMID

37141572

Abstract

INTRODUCTION: Delirium or a fall are associated with many negative outcomes including increased length of stay (LOS) and discharge to a facility; however, this relationship is incompletely understood.

METHODS: A cross-sectional study of all hospitalizations in a large, tertiary care hospital evaluated the effect of delirium and a fall on the outcomes of LOS and risk of being discharged to a facility.

RESULTS: The study included 29,655 hospital admissions. A total of 3,707 (12.5%) patients screened positive for delirium and 286 (0.96%) had a reported fall. After adjustment for covariates, relative to patients without delirium or a fall, patients with delirium only had a 1.64-fold longer LOS; patients with fall only had a 1.96-fold longer LOS; and patients who had delirium and fall had a 2.84-fold longer LOS. The adjusted odds of discharge to a facility, relative to those without delirium or a fall, was 8.98 times higher in those with delirium and a fall.

CONCLUSIONS: Delirium and falls influence LOS and likelihood of being discharged to a facility. The joint impact of falls and delirium on LOS and facility discharge was more than additive. Hospitals should consider the integrated management of delirium and falls.

Language: en