The association between C-reactive protein and delirium in 710 acute elderly hospital admissions. (May 2014)

• Record Type: Journal Article
• Authors: Ritchie, C.W.; Newman, T.H.; Leurent, B.; Sampson, E.L.
• Is Part Of: International psychogeriatrics. Volume 26:Number 5(2014:May)
• Page Start: 717
• Page End: 724
• Publication Date: 2014-05
• Subjects: Geriatric psychiatry -- Periodicals; 618.9768905
• DOI: 10.1017/S1041610213002433
• Languages: English
• ISSNs: 1041-6102

Abstract

<abstract abstract-type="normal"> <title>ABSTRACT</title> <sec> <title>Background:</title> <p>Delirium is a common neuropsychiatric syndrome associated with poor outcomes. Evidence supports a neuroinflammatory etiology, but the role of the inflammatory marker C-reactive protein (C-RP) remains unclear. We investigated the relationship between C-RP and delirium and its severity as well as interaction with medical diagnosis.</p> </sec> <sec> <title>Methods:</title> <p>From an existing database (710 patients over 70 years old admitted to a Medical Acute Admissions Unit) we analyzed data which included C-RP levels, delirium (using the Confusion Assessment Method), and other clinical and demographic factors. Primary diagnoses were grouped (cardiovascular, musculoskeletal, infection, metabolic, and other).</p> </sec> <sec> <title>Results:</title> <p>There was a strong association between elevated C-RP and delirium (t = 5.09; p < 0.001), independent of other potential risk factors for delirium (odds ratio (OR) = 1.32 (95% CI: 1.10–1.58) p = 0.003). There was no significant association between C-RP and delirium severity, and between C-RP and delirium in the populations with cardiovascular disease, infection upon admission, or from the metabolic group despite an OR of 2.24 (95% CI: 0.92–5.45). There was an association in the musculoskeletal group (OR 2.19 (95% CI: 1.19–4.02)).</p> <p> <bold>Conclusions</bold>: There is an association between elevated C-RP and delirium. This is strongest in patients admitted with musculoskeletal disease but not in others, implying that C-RP is involved in the genesis of delirium in musculoskeletal disease, but that other factors or processes may be more important in those with cardiovascular disease or infection.</p> </sec> </abstract>