Incidence and Risk Factors of Acute Confusional State in Hospitalized Older Patients

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Tipanetr Ngamkala
Porntip Malathum
Orapichaya Krairit


Acute confusional state is a common phenomenon associated with acute
illness in hospitalized older patients. It independently predicts undesirable hospital
outcomes, higher costs of care, prolonged hospital stays, higher mortality, and greater
discharge to nursing homes. The purpose of this study was to explore the incidence rate
and risk factors of acute confusional state at Ramathibodi Hospital, Thailand.
This prospective descriptive study was conducted between January and April 2016 in
179 patients, aged 60 years and older, admitted to general medical wards. The Confusion
Assessment Method and the Risk Factor of Acute Confusional State Checklist were daily
used to assess acute confusional state and its risk factors, respectively. The average age
of the sample ranged from 64 to 89 years (M = 80.52). Most presenting signs and
symptoms found on admission were related to the respiratory problem (39.13%).
The incidence of acute confusional state was 12.85%. The acute confusional state was
found on Day1 to Day4 and its duration was from 2 to 12 days. Common risk factors
for acute confusional state were multifactorial, including infection, dehydration,
electrolyte imbalance, pain, and hypoxemia, respectively. All of the sample had more
than two risk factors. This study can be used as baseline data for prevention and
management of acute confusional state in hospitalized older patients.

Keywords: Incidence rate, Risk factors, Acute confusional state, Hospitalized older


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Ngamkala T, Malathum P, Krairit O. Incidence and Risk Factors of Acute Confusional State in Hospitalized Older Patients. Rama Nurs J [Internet]. 2018 Oct. 4 [cited 2022 Aug. 19];24(2):137-49. Available from:


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