Investigators Propose Link Between Asthma, Obstructive Disease and Delirium

A new Polish study calls for greater focus on asthma and the link to delirium in older patients, who may face greater mortality risk.

A recent study out of Poland estimated that elderly patients with asthma have an increased risk of delirium episodes during hospitalizations. No known link in delirium and asthma had been made prior to the study.

The correlation between delirium and asthma were assessed by Prof. Andrzej Bozek and fellow colleagues from Dermatology and Allergology in Zabrze at the Medical University of Silesia Katowice in Poland.

“Analyzing patients with asthma draws attention to the problem of the high rate of morbidity caused by delirium in elderly patients with asthma,” the team wrote.

The team also noted the predisposing factors for delirium such as advanced age, hypertension, smoking, and other genetic factors in an attempt to find commonality between delirium and obstructive diseases.

The participants for the study consisted of 1417 patients with asthma, 1882 with chronic obstructive pulmonary disease (COPD), and 2187 without obstructive disease. The ages of the participants ranged from 65-95 years old, and all hospitalizations were recorded between 2006 and 2015.

The common cause for hospitalization among most patients were cardiac disease, sepsis, surgery, asthmatic condition, and trauma.

Diagnosis for both asthma and COPD were made according to the International Classification of Disease (ICD)-10 code and later verified by a clinical professional.

The team admitted difficulty in observing the exact cause of delirium in patients, especially considering the lack of literature on the subject. Limitations included a small sample group, a lack of study on the impact of drugs on patients with delirium, and the nonrecognition of delirium that occurs in hospitals.

However, the study did find that incidents of delirium were more common in patients with an obstructive pulmonary disease.

All episodes of delirium that occurred during the 9-year span were independently associated with asthma. Additionally, death from a delirium episode was also associated with asthma. However, no connection was made between delirium and COPD regarding patient deaths.

Despite a myriad of causes of hospitalization among patients, the study found that asthma played a significant role in the development of delirium. The team recommended a stronger focus on the implications of asthmatic conditions in older patients, noting an increased risk of death caused by a delirium episode.

The study did note that evidence of improvement in mental functions and the treatment of asthma were confirmed in previous studies, and urged for greater care for patients suffering from obstructive conditions.

“Such patients require adequate preparation and caution during surgical procedures and other hospitalizations.” the team wrote.

The study, “Asthma and delirium episodes during hospitalization,” was published online in Aging Medicine.