{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T13:33:42Z","timestamp":1772544822183,"version":"3.50.1"},"reference-count":29,"publisher":"Belitung Raya Foundation","issue":"2","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"This study was funded by Navamindradhiraj University Research Fund","award":[""],"award-info":[{"award-number":[""]}]}],"content-domain":{"domain":["belitungraya.org"],"crossmark-restriction":true},"short-container-title":["Belitung Nurs J"],"abstract":"<jats:p>Background: Delirium is a common but often underrecognized complication in hospitalized older adults. It is associated with poor outcomes, including longer hospital stays, increased mortality, and long-term cognitive decline. While numerous studies have explored factors contributing to delirium, there is a lack of research on the context of older adults in Bangkok, Thailand. Understanding the predictors of delirium is crucial for early detection and prevention, particularly in an urban hospital setting.\nObjective: This study aimed to determine the incidence rate of delirium and identify factors associated with its development in hospitalized older adults.\nMethods: A prospective cohort study was conducted in four internal medicine wards of a large urban hospital in Bangkok, Thailand. Data were collected from 168 hospitalized older adults (\u226560 years) over a 7-day period following admission. The Confusion Assessment Method (CAM), the Mini-Mental State Examination (TMSE), and the Systemic Inflammatory Response Syndrome (SIRS) scores were used to assess delirium and cognitive impairment. Data were collected between January 2022 and October 2022, and participants were evaluated on Day 1 (24 hours after admission), Day 3, and Day 7 or before discharge. Descriptive statistics and multivariate logistic regression were used to analyze predictors of delirium.\nResults: The incidence rate of delirium among hospitalized older adults was 20.80%, with 19.00% developing delirium within the first 24-48 hours of admission. Multivariate analysis revealed that cognitive impairment (OR_adj = 7.81, p &lt;0.001), infection (SIRS) (OR_adj = 3.80, p = 0.025), age (OR_adj = 1.09, p = 0.010), and the presence of caregivers prior to admission (OR_adj = 0.11, p = 0.008) were significant predictors of delirium. The model explained 35.30% of the variance in delirium occurrence.\nConclusion: This study highlights the high incidence of delirium among hospitalized older adults and identifies key risk factors, including cognitive impairment, infection, age, and the presence of caregivers. Early delirium screening, including the use of the CAM and TMSE, should be integrated into nursing care for delirium prevention. Infection prevention and effective management strategies should also be prioritized to reduce delirium risk.<\/jats:p>","DOI":"10.33546\/bnj.3678","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T06:47:17Z","timestamp":1744958837000},"page":"186-193","update-policy":"https:\/\/doi.org\/10.33546\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors predicting delirium among hospitalized older adults in an urban area, Thailand: A prospective cohort study"],"prefix":"10.33546","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6463-6102","authenticated-orcid":false,"given":"Duangrat","family":"Kaveenuntachai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3942-7351","authenticated-orcid":false,"given":"Naphatthorn","family":"Prueksaanantakal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7540-9323","authenticated-orcid":false,"given":"Pirunnapa","family":"Benyapad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pratin","family":"Chinpinkleaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sirichai","family":"Jiojinda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"19163","published-online":{"date-parts":[[2025,4,18]]},"reference":[{"key":"115247","doi-asserted-by":"crossref","unstructured":"American College of Chest Physicians. (1992). Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Critical Care Medicine, 20, 864-875.","DOI":"10.1097\/00003246-199206000-00025"},{"key":"115248","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association [APA]. (2013). Diagnostic and statistical manual of mental disorders (DSM-5TM) (5th ed.). Arlington, VA: American Psychiatric Association.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"115249","doi-asserted-by":"crossref","unstructured":"Arbabi, M., Ziaei, E., Amini, B., Ghadimi, H., Rashidi, F., Shohanizad, N., Moradi, S., Beikmarzehei, A., Hasanzadeh, A., & Parsaei, A. (2022). Delirium risk factors in hospitalized patient: A comprehensive evaluation of underlying diseases and medications in different wards of a large Urban Hospital Center in Iran. BMC Anesthesiology, 22(1), 147. https:\/\/doi.org\/10.1186\/s12871-022-01690-w","DOI":"10.1186\/s12871-022-01690-w"},{"key":"115250","doi-asserted-by":"crossref","unstructured":"Ballweg, T., White, M., Parker, M., Casey, C., Bo, A., Farahbakhsh, Z., Kayser, A., Blair, A., Lindroth, H., & Pearce, R. A. (2021). Association between plasma tau and postoperative delirium incidence and severity: A prospective observational study. British Journal of Anaesthesia, 126(2), 458-466. https:\/\/doi.org\/10.1016\/j.bja.2020.08.061","DOI":"10.1016\/j.bja.2020.08.061"},{"key":"115251","doi-asserted-by":"crossref","unstructured":"Banerdt, J. K., Mateyo, K., Wang, L., Lindsell, C. J., Riviello, E. D., Saylor, D., Heimburger, D. C., & Ely, E. W. (2021). Delirium as a predictor of mortality and disability among hospitalized patients in Zambia. PloS One, 16(2), e0246330. https:\/\/doi.org\/10.1371\/journal.pone.0246330","DOI":"10.1371\/journal.pone.0246330"},{"key":"115252","doi-asserted-by":"crossref","unstructured":"Bo, M., Porrino, P., Di Santo, S. G., Mazzone, A., Cherubini, A., Mossello, E., Bianchetti, A., Musicco, M., Ferrari, A., & Ferrara, N. (2019). The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: An explorative analysis from the \u201cDelirium Day 2015\u201d. Aging Clinical and Experimental Research, 31, 411-420. https:\/\/doi.org\/10.1007\/s40520-018-0974-1","DOI":"10.1007\/s40520-018-0974-1"},{"key":"115253","doi-asserted-by":"crossref","unstructured":"Chaiwat, O., Chanidnuan, M., Pancharoen, W., Vijitmala, K., Danpornprasert, P., Toadithep, P., & Thanakiattiwibun, C. (2019). Postoperative delirium in critically ill surgical patients: Incidence, risk factors, and predictive scores. BMC Anesthesiology, 19, 39. https:\/\/doi.org\/10.1186\/s12871-019-0694-x","DOI":"10.1186\/s12871-019-0732-8"},{"key":"115254","doi-asserted-by":"crossref","unstructured":"Chang, H. C., Neal, K., Traynor, V., Ho, M.-H., & Kankom, W. (2020). Delirium among hospitalized older adults in Thailand: An integrative review. Journal of Gerontological Nursing, 46(6), 43-52. https:\/\/doi.org\/10.3928\/00989134-20200504-01","DOI":"10.3928\/00989134-20200504-01"},{"key":"115255","doi-asserted-by":"crossref","unstructured":"Elder, N. M., Mumma, B. E., Maeda, M. Y., Tancredi, D. J., & Tyler, K. R. (2023). Emergency department length of stay is associated with delirium in older adults. Western Journal of Emergency Medicine, 24(3), 532\u2013537. https:\/\/doi.org\/10.5811\/westjem.59383","DOI":"10.5811\/WESTJEM.59383"},{"key":"115256","doi-asserted-by":"crossref","unstructured":"Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149-1160. https:\/\/doi.org\/10.3758\/BRM.41.4.1149","DOI":"10.3758\/BRM.41.4.1149"},{"key":"115257","doi-asserted-by":"crossref","unstructured":"Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). \u201cMini-mental state\u201d: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198. https:\/\/doi.org\/10.1016\/0022-3956(75)90026-6","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"115258","doi-asserted-by":"crossref","unstructured":"Fortini, A., Morettini, A., Tavernese, G., Facchini, S., Tofani, L., & Pazzi, M. (2014). Delirium in elderly patients hospitalized in internal medicine wards. Internal and Emergency Medicine, 9, 435-441. https:\/\/doi.org\/10.1007\/s11739-013-0968-0","DOI":"10.1007\/s11739-013-0968-0"},{"key":"115259","unstructured":"Iamrod, N., Sindhu, S., Danaidutsadeekul, S., & Tantowongkosri, K. (2016). Predictors of delirium in the elderly patients undergone open heart surgery in the first 72 hours after surgery [in Thai]. Journal of The Royal Thai Army Nurses, 17(2), 34-42."},{"key":"115260","doi-asserted-by":"crossref","unstructured":"Inouye, S. K., van Dyck, C. H., Alessi, C. A., Balkin, S., Siegal, A. P., & Horwitz, R. I. (1990). Clarifying confusion: The confusion assessment method: a new method for detection of delirium. Annals of Internal Medicine, 113(12), 941-948. https:\/\/doi.org\/10.7326\/0003-4819-113-12-941","DOI":"10.7326\/0003-4819-113-12-941"},{"key":"115261","doi-asserted-by":"crossref","unstructured":"Inouye, S. K., Westendorp, R. G. J., & Saczynski, J. S. (2014). Delirium in elderly people. The Lancet, 383(9920), 911-922. https:\/\/doi.org\/10.1016\/S0140-6736(13)60688-1","DOI":"10.1016\/S0140-6736(13)60688-1"},{"key":"115262","unstructured":"Kaewsin, S., & Sasat, S. (2024). Predictive factors of delirium in older persons at emergency department [in Thai]. Journal of Nursing Research, Innovation, and Health, 36(1), 26-38."},{"key":"115263","doi-asserted-by":"crossref","unstructured":"Kotfis, K., Williams Roberson, S., Wilson, J. E., Dabrowski, W., Pun, B. T., & Ely, E. W. (2020). COVID-19: ICU delirium management during SARS-CoV-2 pandemic. Critical Care, 24, 176. https:\/\/doi.org\/10.1186\/s13054-020-02882-x","DOI":"10.1186\/s13054-020-02882-x"},{"key":"115264","doi-asserted-by":"crossref","unstructured":"Lach, H. W., Leach, K. M., & Butcher, H. K. (2016). Evidence-based practice guideline: Changing the practice of physical restraint use in acute care. Journal of Gerontological Nursing, 42(2), 17-26. https:\/\/doi.org\/10.3928\/00989134-20160113-04","DOI":"10.3928\/00989134-20160113-04"},{"key":"115265","doi-asserted-by":"crossref","unstructured":"Lewis, E. G., Banks, J., Paddick, S.-M., Duinmaijer, A., Tucker, L., Kisoli, A., Cletus, J., Lissu, C., Kilonzo, K., & Cosker, G. (2017). Risk factors for delirium in older medical inpatients in Tanzania. Dementia and Geriatric Cognitive Disorders, 44(3-4), 160-170. https:\/\/doi.org\/10.1159\/000479058","DOI":"10.1159\/000479058"},{"key":"115266","unstructured":"Muangpaisan, W., Assantachai, P., Sitthichai, K., Richardson, K., & Brayne, C. (2015). The distribution of Thai Mental State Examination Scores among non-demented elderly in suburban Bangkok metropolitan and associated factors. Journal of the Medical Association of Thailand, 98(9), 916-924."},{"key":"115267","unstructured":"Ngamkala, T., Malathum, P., & Krairit, O. (2018). Incidence and risk factors of acute confusional state in hospitalized older patients. Nursing Research and Innovation Journal, 24(2), 137-149."},{"key":"115268","doi-asserted-by":"crossref","unstructured":"Nguyen, P. V.-Q., Pelletier, L., Payot, I., & Latour, J. (2018). The Delirium Drug Scale is associated to delirium incidence in the emergency department. International Psychogeriatrics, 30(4), 503-510. https:\/\/doi.org\/10.1017\/S1041610217002538","DOI":"10.1017\/S1041610217002538"},{"key":"115269","doi-asserted-by":"crossref","unstructured":"ORegan, N. A., Fitzgerald, J., Adamis, D., Molloy, D. W., Meagher, D., & Timmons, S. (2018). Predictors of delirium development in older medical inpatients: Readily identifiable factors at admission. 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BMC Family Practice, 12, 65. https:\/\/doi.org\/10.1186\/1471-2296-12-65","DOI":"10.1186\/1471-2296-12-65"}],"container-title":["Belitung Nursing Journal"],"original-title":[],"link":[{"URL":"https:\/\/www.belitungraya.org\/BRP\/index.php\/bnj\/article\/download\/3678\/1132","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.belitungraya.org\/BRP\/index.php\/bnj\/article\/download\/3678\/1150","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.belitungraya.org\/BRP\/index.php\/bnj\/article\/download\/3678\/1132","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T06:54:36Z","timestamp":1744959276000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.belitungraya.org\/BRP\/index.php\/bnj\/article\/view\/3678"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,18]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,4,18]]}},"URL":"https:\/\/doi.org\/10.33546\/bnj.3678","relation":{},"ISSN":["2477-4073"],"issn-type":[{"value":"2477-4073","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,18]]},"assertion":[{"value":"2024-10-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-10","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}