Journal of Geriatric Psychiatry and Neurology

 

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Journal of Geriatric Psychiatry and Neurology, Vol. 3, No. 4, 198-202 (1990)
DOI: 10.1177/089198879000300404

Prevalence of Delirium and Urinary Tract Infection in a Psychogeriatric Unit

Jothika Manepalli, MD

Division of Geriatric Psychiatry, Department of Psychiatry and Human Behavior, St Louis University School of Medicine, St Louis, MO.

George T. Grossberg, MD

Division of Geriatric Psychiatry, Department of Psychiatry and Human Behavior, St Louis University School of Medicine, St Louis, MO.

Cindy Mueller, MS

Division of Geriatric Psychiatry, Department of Psychiatry and Human Behavior, St Louis University School of Medicine, St Louis, MO.

A retrospective study involving 407 patients discharged over a 2-year period from a psychogeriatric unit found that 83 (20.4%) had urinary tract infection (UTI) and 54 (13.3%) had delirium diagnoses at admission. Of the 54 with delirium, 14 (25.9%) had UTI. Of these 14 patients, delirium cleared in nine (64.3%) after appropriate treatment of UTI, two (14.3%) improved with treatment of concomitant medical disorders, and three (21.4%) did not improve.

Only six of the 14 (42.8%) showed symptoms of UTI, with only one of the 14 (7.1%) showing fever and leukocytosis. Urine analyses were abnormal in all cases with 13/14 (92.8%) having positive cultures. Dementia was an associated risk factor in 71.4% of the 14 patients with UTI and delirium.

Clinicians need to have a high index of suspicion relative to the presence of UTI in the elderly, especially with pre- existing cognitive impairment, since it can precipitate delirium. Early recognition and appropriate treatment decreases morbidity. (J Geriatr Psychiatry Neurol 1990;3:198-202).


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