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The Prevalence of Delirium in An Older Acute Surgical Population and Its Effect on Outcome

Background: With an ageing population, an increasing number of older adults are admitted for assessment to acute surgical units. Older adults have specific factors that may influence outcomes, one of which is delirium (acute cognitive impairment). Objectives: To establish the prevalence of delirium...

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Autores principales: Hewitt, Jonathan, Owen, Stephanie, Carter, Ben R., Stechman, Michael J., Tay, Hui Sian, Greig, Matthew, McCormack, Caroline, Pearce, Lyndsay, McCarthy, Kathryn, Myint, Phyo K., Moug, Susan J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6960557/
https://www.ncbi.nlm.nih.gov/pubmed/31623269
http://dx.doi.org/10.3390/geriatrics4040057
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author Hewitt, Jonathan
Owen, Stephanie
Carter, Ben R.
Stechman, Michael J.
Tay, Hui Sian
Greig, Matthew
McCormack, Caroline
Pearce, Lyndsay
McCarthy, Kathryn
Myint, Phyo K.
Moug, Susan J.
author_facet Hewitt, Jonathan
Owen, Stephanie
Carter, Ben R.
Stechman, Michael J.
Tay, Hui Sian
Greig, Matthew
McCormack, Caroline
Pearce, Lyndsay
McCarthy, Kathryn
Myint, Phyo K.
Moug, Susan J.
author_sort Hewitt, Jonathan
collection PubMed
description Background: With an ageing population, an increasing number of older adults are admitted for assessment to acute surgical units. Older adults have specific factors that may influence outcomes, one of which is delirium (acute cognitive impairment). Objectives: To establish the prevalence of delirium on admission in an older acute surgical population and its effect on mortality. Secondary outcomes investigated include hospital readmission and length of hospital stay. Method: This observational multi-centre study investigated consecutive patients, ≥65 years, admitted to the acute surgical units of five UK hospitals during an eight-week period. On admission the Confusion Assessment Method (CAM) score was performed to detect delirium. The effect of delirium on important clinical outcomes was investigated using tests of association and logistic regression models. Results: The cohort consisted of 411 patients with a mean age of 77.3 years (SD 8.1). The prevalence of admission delirium was 8.8% (95% CI 6.2–11.9%) and cognitive impairment was 70.3% (95% CI 65.6–74.7%). The delirious group were not more likely to die at 30 or 90 days (OR 1.1, 95% CI 0.2 to 5.1, p = 0.67; OR 1.4, 95% CI 0.4 to 4.1. p = 0.82) or to be readmitted within 30 days of discharge (OR 0.9, 95% CI 0.4 to 2.2, p = 0.89). Length of hospital stay was significantly longer in the delirious group (median 8 vs. 5 days respectively, p = 0.009). Conclusion: Admission delirium occurs in just under 10% of older people admitted to acute surgical units, resulting in significantly longer hospital stays.
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spelling pubmed-69605572020-01-23 The Prevalence of Delirium in An Older Acute Surgical Population and Its Effect on Outcome Hewitt, Jonathan Owen, Stephanie Carter, Ben R. Stechman, Michael J. Tay, Hui Sian Greig, Matthew McCormack, Caroline Pearce, Lyndsay McCarthy, Kathryn Myint, Phyo K. Moug, Susan J. Geriatrics (Basel) Article Background: With an ageing population, an increasing number of older adults are admitted for assessment to acute surgical units. Older adults have specific factors that may influence outcomes, one of which is delirium (acute cognitive impairment). Objectives: To establish the prevalence of delirium on admission in an older acute surgical population and its effect on mortality. Secondary outcomes investigated include hospital readmission and length of hospital stay. Method: This observational multi-centre study investigated consecutive patients, ≥65 years, admitted to the acute surgical units of five UK hospitals during an eight-week period. On admission the Confusion Assessment Method (CAM) score was performed to detect delirium. The effect of delirium on important clinical outcomes was investigated using tests of association and logistic regression models. Results: The cohort consisted of 411 patients with a mean age of 77.3 years (SD 8.1). The prevalence of admission delirium was 8.8% (95% CI 6.2–11.9%) and cognitive impairment was 70.3% (95% CI 65.6–74.7%). The delirious group were not more likely to die at 30 or 90 days (OR 1.1, 95% CI 0.2 to 5.1, p = 0.67; OR 1.4, 95% CI 0.4 to 4.1. p = 0.82) or to be readmitted within 30 days of discharge (OR 0.9, 95% CI 0.4 to 2.2, p = 0.89). Length of hospital stay was significantly longer in the delirious group (median 8 vs. 5 days respectively, p = 0.009). Conclusion: Admission delirium occurs in just under 10% of older people admitted to acute surgical units, resulting in significantly longer hospital stays. MDPI 2019-10-16 /pmc/articles/PMC6960557/ /pubmed/31623269 http://dx.doi.org/10.3390/geriatrics4040057 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hewitt, Jonathan
Owen, Stephanie
Carter, Ben R.
Stechman, Michael J.
Tay, Hui Sian
Greig, Matthew
McCormack, Caroline
Pearce, Lyndsay
McCarthy, Kathryn
Myint, Phyo K.
Moug, Susan J.
The Prevalence of Delirium in An Older Acute Surgical Population and Its Effect on Outcome
title The Prevalence of Delirium in An Older Acute Surgical Population and Its Effect on Outcome
title_full The Prevalence of Delirium in An Older Acute Surgical Population and Its Effect on Outcome
title_fullStr The Prevalence of Delirium in An Older Acute Surgical Population and Its Effect on Outcome
title_full_unstemmed The Prevalence of Delirium in An Older Acute Surgical Population and Its Effect on Outcome
title_short The Prevalence of Delirium in An Older Acute Surgical Population and Its Effect on Outcome
title_sort prevalence of delirium in an older acute surgical population and its effect on outcome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6960557/
https://www.ncbi.nlm.nih.gov/pubmed/31623269
http://dx.doi.org/10.3390/geriatrics4040057
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