The Prevalence, Risk Factors, and Short-Term Health Outcomes of Delirium in Patients Admitted to a Nephrology Ward in Eastern Europe: An Observational Prospective Cohort Study

<b>Background/Objectives:</b> To date, delirium is considered one of the most frequent acute neuropsychiatric syndromes among hospitalized populations, although there is a lack of data regarding its frequency and predictors in nephrological patients. The aims of this study were to investigate the prevalence of and the risk factors for delirium and to evaluate the association between delirium and short-term clinical outcomes, including the length of stay (LOS) and in-hospital mortality rate among patients from the nephrology unit of a tertiary university hospital in Eastern Europe. <b>Method:</b> A cohort of 942 patients admitted between January 2023 and December 2023 were enrolled in a prospective observational study. Delirium was diagnosed by a psychiatrist during hospitalization. The endpoint was defined as hospital death or hospital discharge. <b>Results:</b> In the studied group, the median age was 65 years, and 519 (55.09%) patients were males. The prevalence of delirium was 5.41% (51/942 patients). The patients with delirium had a significantly longer LOS (11.96 days vs. 8.86 days, <i>p</i> = 0.007) and a significantly higher in-hospital mortality rate (47.05% vs. 14.36%, <i>p</i> < 0.001) compared to the patients without delirium. The independent predictors of delirium were as follows: age (OR = 1.029; 95%CI: 1.002-1.056; <i>p</i> = 0.034), history of stroke (OR = 3.493; 95%CI: 1.849-6.598; <i>p</i> < 0.001), alcohol abuse (OR = 4.728; 95%CI: 1.968-11.359; <i>p</i> = 0.001), and AKI stages 2 and 3 (OR = 2.175; 95%CI: 1.152-4.105; <i>p</i> = 0.017). From a time-to-event analysis, delirium was associated with increased mortality (HR = 2.77; 95%CI: [1.79 to 4.29]; <i>p</i> < 0.001). Moreover, delirium was independently associated with increased in-hospital mortality (OR = 1.666; 95%CI: 1.069-2.597; <i>p</i> =0.024). <b>Conclusions:</b> Among nephrological patients, age, alcohol abuse, history of stroke, and AKI stages 2 and 3 were independent risk factors for delirium. Delirium significantly increased the LOS and in-hospital mortality.