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Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction

Cognitive dysfunction commonly occurs among older patients during admission and is associated with adverse prognosis. This study evaluated clinical characteristics and outcome determinants in hospitalized older patients with cognitive disorders. The main outcomes were length of stay, readmission wit...

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Autores principales: Chao, Yi-Ting, Kuo, Fu-Hsuan, Lee, Yu-Shan, Huang, Yu-Hui, Weng, Shuo-Chun, Chou, Yin-Yi, Lin, Chu-Sheng, Lin, Shih-Yi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744733/
https://www.ncbi.nlm.nih.gov/pubmed/35010842
http://dx.doi.org/10.3390/ijerph19010584
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author Chao, Yi-Ting
Kuo, Fu-Hsuan
Lee, Yu-Shan
Huang, Yu-Hui
Weng, Shuo-Chun
Chou, Yin-Yi
Lin, Chu-Sheng
Lin, Shih-Yi
author_facet Chao, Yi-Ting
Kuo, Fu-Hsuan
Lee, Yu-Shan
Huang, Yu-Hui
Weng, Shuo-Chun
Chou, Yin-Yi
Lin, Chu-Sheng
Lin, Shih-Yi
author_sort Chao, Yi-Ting
collection PubMed
description Cognitive dysfunction commonly occurs among older patients during admission and is associated with adverse prognosis. This study evaluated clinical characteristics and outcome determinants in hospitalized older patients with cognitive disorders. The main outcomes were length of stay, readmission within 30 days, Barthel index (BI) score at discharge, BI score change (discharge BI score minus BI score), and proportion of positive BI score change to indicate change of activities of daily living (ADL) change during hospitalization. A total of 642 inpatients with a mean age of 79.47 years (76–103 years) were categorized into three groups according to the medical history of dementia, and Mini-Mental State Examination (MMSE) scores at admission. Among them, 74 had dementia diagnosis (DD), 310 had cognitive impairment (CI), and 258 had normal MMSE scores. Patients with DD and CI generally had a higher risk of many geriatric syndromes, such as multimorbidities, polypharmacy, delirium, incontinence, visual and auditory impairment, fall history, physical frailty. They had less BI score, BI score change, and proportion of positive BI score change ADL at discharge. (DD 70.0%, CI 79.0%), suggesting less ADL change during hospitalization compared with those with normal MMSE scores (92.9%; p < 0.001). Using multiple regression analysis, we found that among patients with DD and CI, age (p = 0.008) and walking speed (p = 0.023) were predictors of discharge BI score. In addition, age (p = 0.047) and education level were associated with dichotomized BI score change (positive vs. non-positive) during hospitalization. Furthermore, the number and severity of comorbidities predicted LOS (p < 0.001) and readmission (p = 0.001) in patients with cognitive disorders. It is suggested that appropriate strategies are required to improve clinical outcomes in these patients.
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spelling pubmed-87447332022-01-11 Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction Chao, Yi-Ting Kuo, Fu-Hsuan Lee, Yu-Shan Huang, Yu-Hui Weng, Shuo-Chun Chou, Yin-Yi Lin, Chu-Sheng Lin, Shih-Yi Int J Environ Res Public Health Article Cognitive dysfunction commonly occurs among older patients during admission and is associated with adverse prognosis. This study evaluated clinical characteristics and outcome determinants in hospitalized older patients with cognitive disorders. The main outcomes were length of stay, readmission within 30 days, Barthel index (BI) score at discharge, BI score change (discharge BI score minus BI score), and proportion of positive BI score change to indicate change of activities of daily living (ADL) change during hospitalization. A total of 642 inpatients with a mean age of 79.47 years (76–103 years) were categorized into three groups according to the medical history of dementia, and Mini-Mental State Examination (MMSE) scores at admission. Among them, 74 had dementia diagnosis (DD), 310 had cognitive impairment (CI), and 258 had normal MMSE scores. Patients with DD and CI generally had a higher risk of many geriatric syndromes, such as multimorbidities, polypharmacy, delirium, incontinence, visual and auditory impairment, fall history, physical frailty. They had less BI score, BI score change, and proportion of positive BI score change ADL at discharge. (DD 70.0%, CI 79.0%), suggesting less ADL change during hospitalization compared with those with normal MMSE scores (92.9%; p < 0.001). Using multiple regression analysis, we found that among patients with DD and CI, age (p = 0.008) and walking speed (p = 0.023) were predictors of discharge BI score. In addition, age (p = 0.047) and education level were associated with dichotomized BI score change (positive vs. non-positive) during hospitalization. Furthermore, the number and severity of comorbidities predicted LOS (p < 0.001) and readmission (p = 0.001) in patients with cognitive disorders. It is suggested that appropriate strategies are required to improve clinical outcomes in these patients. MDPI 2022-01-05 /pmc/articles/PMC8744733/ /pubmed/35010842 http://dx.doi.org/10.3390/ijerph19010584 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chao, Yi-Ting
Kuo, Fu-Hsuan
Lee, Yu-Shan
Huang, Yu-Hui
Weng, Shuo-Chun
Chou, Yin-Yi
Lin, Chu-Sheng
Lin, Shih-Yi
Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction
title Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction
title_full Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction
title_fullStr Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction
title_full_unstemmed Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction
title_short Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction
title_sort characteristics and outcome determinants of hospitalized older patients with cognitive dysfunction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744733/
https://www.ncbi.nlm.nih.gov/pubmed/35010842
http://dx.doi.org/10.3390/ijerph19010584
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