Muscat – Among the several research projects of the 10th National Research Award organised by the Ministry of Higher Education, Research and Innovation, ‘Delirium in Medically Hospitalised Patients: Prevalence, Recognition and Risk Factors – A Prospective Cohort Study’ by Dr Rajaa Saleh al Farsi, Internal Medicine Resident from Oman Medical Specialty Board, won in the Health and Social Services field in the Young Researcher’s category.
According to Dr Rajaa, delirium is defined as a sudden and fluctuating disturbance in mental function, characterised by an inability to pay attention, disorientation, an inability to think clearly, and fluctuations in the level of alertness (awareness). It is usually the result of an organic disease, in addition to the presence of risk factors that increase the chance of having delirium.
She described the study as the first in the sultanate on delirium in elderly people hospitalised in internal medicine wards and one of the few studies done in the Middle East discussing this topic.
The research project aimed to assess the prevalence of delirium among elderly people hospitalised at Sultan Qaboos University Hospital as well as assess the risk factors that may increase the likelihood of its occurrence and evaluate its impact on short- and long-term health outcomes.
Dr Rajaa and her team included 327 patients aged 65 years or older, admitted in wards at Sultan Qaboos University. Patients were screened for delirium using Three-Minute Diagnostic Assessment for Delirium using the Confusion Assessment Method (3D-CAM). Risk factors and clinical outcomes were assessed by interviewing patients, reviewing their medical records and following up by phone calls 90 days and one year after hospital discharge.
Dr Rajaa stated that the study showed prevalence of delirium among elderly patients admitted to medical wards was more than 55%, with hypoactive delirium being the most common type.
There are several actors that increase the risk of delirium, including the presence of prior cognitive impairment, poor functional status, an increase in the number of medications the patient takes, the presence of a urinary catheter, dehydration, and electrolyte imbalance. Moreover, delirium has a significant impact on short- and long-term health outcomes. It associated with increase mortality (all-cause mortality at 90 days – 25.4% vs 8.4% – and one year – 35.9% vs 16%) after hospital discharge, prolonged hospital admission and increased incidence of complications acquired from the patient’s presence in the hospital, including infection, bed sores and upper gastrointestinal bleeding.
Through the study, Dr Rajaa concluded that delirium is common among elderly patients hospitalised in general hospital wards and it is associated with serious clinical consequences. Early recognition, implementing effective preventive strategies for delirium, and developing geriatric wards are crucial. Further research is necessary to explore effective management strategies for delirium in general medical wards and to optimise patient care.
The research project was published in the ‘Journal of Clinical Medicine’ and the research team included Dr Abdullah Mohammed al Alawi, Juhaina Salim al Maqbali, Dr Aisha Ramadhan al Huraizi, Dr Taif al Saadi, Dr Noof al Hamadani and Dr Khalfan al Zeedy, besides Dr Rajaa.
Regarding her National Research Award win, Dr Rajaa said, “Winning it is a tremendous achievement for me and my research group members. It is a validation of our hard work, dedication and passion for research. This award not only boosts our confidence as researchers but also opens new opportunities for collaboration and funding. It serves as a motivation for us to continue making significant contributions in our field. Overall, winning the National Research Award is a significant milestone in my career, and I am truly honoured and grateful for this recognition.”