Association between contact precautions and delirium at a tertiary care center

Hannah R Day; Eli N Perencevich; Anthony D Harris; Ann L Gruber-Baldini; Seth S Himelhoch; Clayton H Brown; Emily Dotter; Daniel J Morgan

doi:10.1086/663340

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Association between contact precautions and delirium at a tertiary care center

Journal article

Peer reviewed

Association between contact precautions and delirium at a tertiary care center

Hannah R Day, Eli N Perencevich, Anthony D Harris, Ann L Gruber-Baldini, Seth S Himelhoch, Clayton H Brown, Emily Dotter and Daniel J Morgan

Infection control and hospital epidemiology, Vol.33(1), pp.34-39

01/2012

DOI: 10.1086/663340

PMCID: PMC3544005

PMID: 22173520

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Abstract

To investigate the relationship between contact precautions and delirium among inpatients, adjusting for other factors. Retrospective cohort study. A 662-bed tertiary care center. All nonpyschiatric adult patients admitted to a tertiary care center from 2007 through 2009. Generalized estimating equations were used to estimate the association between contact precautions and delirium in a retrospective cohort of 2 years of admissions to a tertiary care center. During the 2-year period, 60,151 admissions occurred in 45,266 unique nonpsychiatric patients. After adjusting for comorbid conditions, age, sex, intensive care unit status, and length of hospitalization, contact precautions were significantly associated with delirium (as defined by International Classification of Diseases, Ninth Revision), medication, or restraint exposure (adjusted odds ratio [OR], 1.40 [95% confidence interval {CI}, 1.24-1.51]). The association between contact precautions and delirium was seen only in patients who were newly placed under contact precautions during the course of their stay (adjusted OR, 1.75 [95% CI, 1.60-1.92]; P < .01) and was not seen in patients who were already under contact precautions at admission (adjusted OR, 0.97 [95% CI, 0.86-1.09]; P = .06). Although delirium was more common in patients who were newly placed under contact precautions during the course of their hospital admission, delirium was not associated with contact precautions started at hospital admission. Patients newly placed under contact precautions after admission but during hospitalization appear to be at a higher risk and may benefit from proven delirium-prevention strategies.

Surgical Attire

Delirium - epidemiology

Delirium - etiology

Cross Infection - prevention & control

Humans

Middle Aged

Infection Control

Male

Hospitalization

Drug Resistance, Multiple, Bacterial

Gloves, Protective

Patient Isolation - psychology

Retrospective Studies

Odds Ratio

Bacterial Infections - microbiology

Details

Title: Subtitle: Association between contact precautions and delirium at a tertiary care center
Creators: Hannah R Day - University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. hdayepi@gmail.com
Eli N Perencevich
Anthony D Harris
Ann L Gruber-Baldini
Seth S Himelhoch
Clayton H Brown
Emily Dotter
Daniel J Morgan
Resource Type: Journal article
Publication Details: Infection control and hospital epidemiology, Vol.33(1), pp.34-39
DOI: 10.1086/663340
PMID: 22173520
PMCID: PMC3544005
NLM abbreviation: Infect Control Hosp Epidemiol
ISSN: 0899-823X
eISSN: 1559-6834
Publisher: United States
Grant note: 5K24AI079040-02 / NIAID NIH HHS K24 AI079040 / NIAID NIH HHS 1 K08 HS18111-01 / AHRQ HHS K08 HS018111 / AHRQ HHS
Language: English
Date published: 01/2012
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9983779290802771

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