Comorbidities associated with a clinically-recognized delirium diagnosis in the hospital using real world data

Abstract Background Delirium is a mental condition defined as fluctuating disturbances in attention, awareness, and cognition. It is often seen in older, hospitalized patients and is currently hard to predict, with long- and short-term outcomes being detrimental to patients. Methods We leveraged ele...

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Main Authors: Lay Kodama, Sarah R. Woldemariam, Alice S. Tang, Yaqiao Li, John Kornak, Isabel Elaine Allen, Eva Raphael, Tomiko T. Oskotsky, Marina Sirota
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-00986-5
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author Lay Kodama
Sarah R. Woldemariam
Alice S. Tang
Yaqiao Li
John Kornak
Isabel Elaine Allen
Eva Raphael
Tomiko T. Oskotsky
Marina Sirota
author_facet Lay Kodama
Sarah R. Woldemariam
Alice S. Tang
Yaqiao Li
John Kornak
Isabel Elaine Allen
Eva Raphael
Tomiko T. Oskotsky
Marina Sirota
author_sort Lay Kodama
collection DOAJ
description Abstract Background Delirium is a mental condition defined as fluctuating disturbances in attention, awareness, and cognition. It is often seen in older, hospitalized patients and is currently hard to predict, with long- and short-term outcomes being detrimental to patients. Methods We leveraged electronic health records (EHR) to identify 7492 UCSF patients and 19,417 UC health system patients with an inpatient delirium diagnosis and the same number of control patients without delirium. We used the Fisher’s exact test with multiple corrections for the association studies and the Cox regression model for the longitudinal analyses. Results Here we show significant associations between comorbidities or laboratory values and an inpatient delirium diagnosis, including metabolic abnormalities and psychiatric diagnoses. Some associations are sex-specific, including dementia subtypes and infections. We further explore the associations with anemia and bipolar disorder by conducting longitudinal analyses from the time of first diagnosis to development of delirium, demonstrating a significant relationship across time. Finally, we show that an inpatient delirium diagnosis leads to increased risk of mortality. Conclusions These results demonstrate the powerful application of the EHR to shed insights into prior diagnoses and laboratory values that could help predict development of inpatient delirium and the importance of sex when making these assessments.
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spelling doaj-art-ab930b80f4cf4d669af19b09a0bf95142025-08-20T03:46:29ZengNature PortfolioCommunications Medicine2730-664X2025-07-015111210.1038/s43856-025-00986-5Comorbidities associated with a clinically-recognized delirium diagnosis in the hospital using real world dataLay Kodama0Sarah R. Woldemariam1Alice S. Tang2Yaqiao Li3John Kornak4Isabel Elaine Allen5Eva Raphael6Tomiko T. Oskotsky7Marina Sirota8Bakar Computational Health Sciences Institute, University of California San FranciscoBakar Computational Health Sciences Institute, University of California San FranciscoBakar Computational Health Sciences Institute, University of California San FranciscoBakar Computational Health Sciences Institute, University of California San FranciscoDepartment of Epidemiology and Biostatistics, University of California, San FranciscoDepartment of Epidemiology and Biostatistics, University of California, San FranciscoDepartment of Epidemiology and Biostatistics, University of California, San FranciscoBakar Computational Health Sciences Institute, University of California San FranciscoBakar Computational Health Sciences Institute, University of California San FranciscoAbstract Background Delirium is a mental condition defined as fluctuating disturbances in attention, awareness, and cognition. It is often seen in older, hospitalized patients and is currently hard to predict, with long- and short-term outcomes being detrimental to patients. Methods We leveraged electronic health records (EHR) to identify 7492 UCSF patients and 19,417 UC health system patients with an inpatient delirium diagnosis and the same number of control patients without delirium. We used the Fisher’s exact test with multiple corrections for the association studies and the Cox regression model for the longitudinal analyses. Results Here we show significant associations between comorbidities or laboratory values and an inpatient delirium diagnosis, including metabolic abnormalities and psychiatric diagnoses. Some associations are sex-specific, including dementia subtypes and infections. We further explore the associations with anemia and bipolar disorder by conducting longitudinal analyses from the time of first diagnosis to development of delirium, demonstrating a significant relationship across time. Finally, we show that an inpatient delirium diagnosis leads to increased risk of mortality. Conclusions These results demonstrate the powerful application of the EHR to shed insights into prior diagnoses and laboratory values that could help predict development of inpatient delirium and the importance of sex when making these assessments.https://doi.org/10.1038/s43856-025-00986-5
spellingShingle Lay Kodama
Sarah R. Woldemariam
Alice S. Tang
Yaqiao Li
John Kornak
Isabel Elaine Allen
Eva Raphael
Tomiko T. Oskotsky
Marina Sirota
Comorbidities associated with a clinically-recognized delirium diagnosis in the hospital using real world data
Communications Medicine
title Comorbidities associated with a clinically-recognized delirium diagnosis in the hospital using real world data
title_full Comorbidities associated with a clinically-recognized delirium diagnosis in the hospital using real world data
title_fullStr Comorbidities associated with a clinically-recognized delirium diagnosis in the hospital using real world data
title_full_unstemmed Comorbidities associated with a clinically-recognized delirium diagnosis in the hospital using real world data
title_short Comorbidities associated with a clinically-recognized delirium diagnosis in the hospital using real world data
title_sort comorbidities associated with a clinically recognized delirium diagnosis in the hospital using real world data
url https://doi.org/10.1038/s43856-025-00986-5
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