Delirium as a Prognostic Marker in Hospitalized Patients: Evaluation of Subsequent Quality of Life (Atena Editora)

Abstract

RESUME INTRODUCTION Delirium is a transient, acute-onset disorder marked by cognitive fluctuations and a decreased ability to focus, affecting primarily hospitalized elderly patients. It results from the interplay between individual vulnerabilities and situational stressors like medical procedures or hospital settings. The incidence of delirium is rising, driven by the growing number of elderly in the population and their increased exposure to hospital environments. Factors such as isolation and prolonged hospitalization play significant roles in its development. Diagnostically, delirium is identified through symptoms like disorganized thinking, disturbances in attention, and perceptual inaccuracies. OBJETIVE Analyze and describe the main aspects of the last years. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Delirium” AND “Intensive Medicine” AND “Geriatrics” “Palliative Care” in the last 10 years. RESULTS AND DISCUSSION Delirium significantly impacts long-term cognitive and physical health, often leading to reduced quality of life and increased dependency on healthcare resources. Recognized as a predictor of severe neurological disorders such as dementia and stroke, the persistent cognitive impairments highlight the importance of proactive management strategies. Early interventions, including pharmacological and multidisciplinary care, can mitigate symptoms and reduce long-term adverse effects. Non-pharmacological approaches like environmental modifications and cognitive therapies also play a crucial role in preventing and managing symptoms, thereby maintaining cognitive function and emotional well-being. The psychological aftermath, including anxiety, depression, and PTSD, necessitates integrated psychological support for comprehensive recovery. Despite these advancements, significant research gaps remain, particularly in understanding the pathophysiological mechanisms linked to poor outcomes, underscoring the need for targeted therapies. Additionally, delirium incurs considerable socio-economic costs, with longer hospital stays and frequent rehospitalizations, amplifying the economic burden on healthcare systems. Familial and caregiver support is essential to manage the increased care demands post-delirium, while routine screening and modern technologies like AI and telemedicine could enhance early detection and personalized care. Furthermore, patient education and international research are vital for improving global management practices and outcomes for delirium patients. CONCLUSION Delirium not only presents acute medical challenges but also leads to long-term cognitive, psychological, and physical impairments, significantly reducing quality of life. Effective management through early intervention, multidisciplinary care, and the use of modern technologies is crucial for improving patient outcomes and reducing healthcare burdens. The economic and societal impacts of delirium necessitate comprehensive healthcare policies that include caregiver support and public health initiatives focused on prevention and education. Continued research and global collaboration are essential for developing more effective treatments and understanding the complex pathophysiology of delirium.