Delirium Diagnosis Timing Among Trauma and Acute Care Surgery Ward Patients.

BACKGROUND

Delirium is common among hospitalized trauma and acute care surgery patients and may be under-recognized on surgical wards. Understanding which patient factors are associated with earlier versus later documented delirium diagnosis may inform targeted surveillance and prompt recognition.

OBJECTIVE

To identify factors associated with the timing of documented delirium diagnosis among adult trauma and acute care surgery patients admitted to a surgical ward.

METHODS

This single-center, retrospective cohort study included adults admitted to a trauma and acute care surgery ward (January 2020-December 2024) who developed delirium during hospitalization. The primary outcome was the hospital day of first documented delirium diagnosis. Univariate comparisons used nonparametric testing for dichotomous predictors. Multivariable linear regression evaluated independent associations with delirium diagnosis timing. Results should be interpreted with caution due to non-normality in regression residuals.

RESULTS

A total of 182 patients were included (mean age 83.0 years). The mean day of documented delirium diagnosis was 4.7 days. Older age was associated with earlier documented delirium diagnosis (r = -0.31, p < .0001). In multivariable regression, age remained an independent predictor of documented delirium diagnosis timing (β = -0.085, p = .0004; R 2 = 0.114), while injury severity and sex were not independent predictors.

CONCLUSIONS

Age was an independent predictor of earlier documented delirium diagnosis among trauma and acute care surgery ward patients. These findings suggest that early and consistent delirium monitoring in older patients and heightened vigilance may help avoid delayed recognition. Further research is needed to determine whether targeted surveillance strategies improve outcomes.