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October 1988

A Prospective Study of Delirium and Prolonged Hospital StayExploratory Study

Author Affiliations

From the Department of Community Medicine, Mount Sinai School of Medicine (Drs Thomas and Fahs), and Department of Medicine, Beth Israel Hospital (Dr Cameron), New York.

Arch Gen Psychiatry. 1988;45(10):937-940. doi:10.1001/archpsyc.1988.01800340065009

• Using explicit criteria, delirium was diagnosed in 15% of a cohort of 133 hospitalized patients. Following each patient's discharge or death, the length of stay was compared with the diagnosis related group—predicted length of hospitalization. An analysis of stay variations disclosed that delirious patients exceeded their predicted stay by an average of 13 days, while nondelirious patients exceeded theirs by 3.3 days. The mean (±SD) length of hospitalization for patients with delirium was significantly longer than for their nondelirious counterparts (21.6 ±23.7 days vs 10.6 ±10.1 days, respectively). Hospitals treating high proportions of patients with delirium as a comorbidity to a principal somatic diagnosis should institute measures for the early detection of and appropriate intervention in patients with this condition. These steps may help reduce prolonged hospitalizations and minimize financial risk under the current diagnosis related group reimbursement system.