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Differences in Characteristics and Outcome of Delirium as Based on Referral Patterns

Received January 12, 2005; revised September 25, 2005; accepted October 17, 2005. From the HSR&D Center for Mental Healthcare and Outcomes Research and Central Arkansas Veterans Healthcare System, Little Rock, AR; the South Central Mental Illness Research, Education and Clinical Center (MIRECC); the Dept. of Psychiatry and Behavioral Sciences, Univ. of Arkansas Medical Sciences, Little Rock, AR; G.V. "Sonny" Montgomery Veterans Affairs Hospital, Jackson, MS; the Dept. of Psychiatry, VA Commonwealth Univ., Richmond, VA; and the Dept. of Psychology, Univ. of Tulsa; Tulsa, OK. Send correspondence and reprint requests to Dr. Mittal, HSR&D Center for Mental Healthcare and Outcomes Research and Central Arkansas Veterans Healthcare System, Little Rock, AR, 2200 Fort Roots Dr. (152/NLR), North Little Rock, AR 72114. e-mail: dinesh.mittal{at}med.va.gov

The authors studied factors associated with referral of delirium patients to psychiatry consultation and its outcome implications. Characteristics and treatment outcomes of delirium patients referred to psychiatry were compared with those not referred. Referred patients were younger, had a more hyperactive subtype, greater substance abuse, less comorbid dementia, were more likely to be recognized as having delirium, and be prescribed medications. Improvement in referred patients was indicated by lower readmission rate postdischarge. No differences were noted in length of stay, discharge status, or mortality within 1 year of the index episode. Psychiatric interventions were moderately helpful. Patients’ characteristics and delirium subtypes may influence referral and should inform future liaison efforts.

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