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Delirium in older COVID‐19 patients: Evaluating risk factors and outcomes

OBJECTIVES: A high incidence of delirium has been reported in older patients with Coronavirus disease 2019 (COVID‐19). We aimed to identify determinants of delirium, including the Clinical Frailty Scale, in hospitalized older patients with COVID‐19. Furthermore, we aimed to study the association of...

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Autores principales: Kroon, Bart, Beishuizen, Sara J. E., van Rensen, Inge H. T., Barten, Dennis G., Mehagnoul‐Schipper, Jannet J., van der Bol, Jessica M., Ellerbroek, Jacobien L. J., Festen, Jan, van de Glind, Esther M. M., Hempenius, Liesbeth, van der Jagt, Mathieu, Jansen, Steffy W. M., van der Linden, Carolien J. M., Mooijaart, Simon P., van Munster, Barbara C., Oosterwijk, Leanne L. E., Smit, Lisa, Urlings‐Strop, Louise C., Willems, Hanna C., Mattace‐Raso, Francesco U. S., Polinder‐Bos, Harmke A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9538581/
https://www.ncbi.nlm.nih.gov/pubmed/36052424
http://dx.doi.org/10.1002/gps.5810
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author Kroon, Bart
Beishuizen, Sara J. E.
van Rensen, Inge H. T.
Barten, Dennis G.
Mehagnoul‐Schipper, Jannet J.
van der Bol, Jessica M.
Ellerbroek, Jacobien L. J.
Festen, Jan
van de Glind, Esther M. M.
Hempenius, Liesbeth
van der Jagt, Mathieu
Jansen, Steffy W. M.
van der Linden, Carolien J. M.
Mooijaart, Simon P.
van Munster, Barbara C.
Oosterwijk, Leanne L. E.
Smit, Lisa
Urlings‐Strop, Louise C.
Willems, Hanna C.
Mattace‐Raso, Francesco U. S.
Polinder‐Bos, Harmke A.
author_facet Kroon, Bart
Beishuizen, Sara J. E.
van Rensen, Inge H. T.
Barten, Dennis G.
Mehagnoul‐Schipper, Jannet J.
van der Bol, Jessica M.
Ellerbroek, Jacobien L. J.
Festen, Jan
van de Glind, Esther M. M.
Hempenius, Liesbeth
van der Jagt, Mathieu
Jansen, Steffy W. M.
van der Linden, Carolien J. M.
Mooijaart, Simon P.
van Munster, Barbara C.
Oosterwijk, Leanne L. E.
Smit, Lisa
Urlings‐Strop, Louise C.
Willems, Hanna C.
Mattace‐Raso, Francesco U. S.
Polinder‐Bos, Harmke A.
author_sort Kroon, Bart
collection PubMed
description OBJECTIVES: A high incidence of delirium has been reported in older patients with Coronavirus disease 2019 (COVID‐19). We aimed to identify determinants of delirium, including the Clinical Frailty Scale, in hospitalized older patients with COVID‐19. Furthermore, we aimed to study the association of delirium independent of frailty with in‐hospital outcomes in older COVID‐19 patients. METHODS: This study was performed within the framework of the multi‐center COVID‐OLD cohort study and included patients aged ≥60 years who were admitted to the general ward because of COVID‐19 in the Netherlands between February and May 2020. Data were collected on demographics, co‐morbidity, disease severity, and geriatric parameters. Prevalence of delirium during hospital admission was recorded based on delirium screening using the Delirium Observation Screening Scale (DOSS) which was scored three times daily. A DOSS score ≥3 was followed by a delirium assessment by the ward physician In‐hospital outcomes included length of stay, discharge destination, and mortality. RESULTS: A total of 412 patients were included (median age 76, 58% male). Delirium was present in 82 patients. In multivariable analysis, previous episode of delirium (Odds ratio [OR] 8.9 [95% CI 2.3–33.6] p = 0.001), and pre‐existent memory problems (OR 7.6 [95% CI 3.1–22.5] p < 0.001) were associated with increased delirium risk. Clinical Frailty Scale was associated with increased delirium risk (OR 1.63 [95%CI 1.40–1.90] p < 0.001) in univariable analysis, but not in multivariable analysis. Patients who developed delirium had a shorter symptom duration and lower levels of C‐reactive protein upon presentation, whereas vital parameters did not differ. Patients who developed a delirium had a longer hospital stay and were more often discharged to a nursing home. Delirium was associated with mortality (OR 2.84 [95% CI1.71–4.72] p < 0.001), but not in multivariable analyses. CONCLUSIONS: A previous delirium and pre‐existent memory problems were associated with delirium risk in COVID‐19. Delirium was not an independent predictor of mortality after adjustment for frailty.
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spelling pubmed-95385812022-10-11 Delirium in older COVID‐19 patients: Evaluating risk factors and outcomes Kroon, Bart Beishuizen, Sara J. E. van Rensen, Inge H. T. Barten, Dennis G. Mehagnoul‐Schipper, Jannet J. van der Bol, Jessica M. Ellerbroek, Jacobien L. J. Festen, Jan van de Glind, Esther M. M. Hempenius, Liesbeth van der Jagt, Mathieu Jansen, Steffy W. M. van der Linden, Carolien J. M. Mooijaart, Simon P. van Munster, Barbara C. Oosterwijk, Leanne L. E. Smit, Lisa Urlings‐Strop, Louise C. Willems, Hanna C. Mattace‐Raso, Francesco U. S. Polinder‐Bos, Harmke A. Int J Geriatr Psychiatry Research Article OBJECTIVES: A high incidence of delirium has been reported in older patients with Coronavirus disease 2019 (COVID‐19). We aimed to identify determinants of delirium, including the Clinical Frailty Scale, in hospitalized older patients with COVID‐19. Furthermore, we aimed to study the association of delirium independent of frailty with in‐hospital outcomes in older COVID‐19 patients. METHODS: This study was performed within the framework of the multi‐center COVID‐OLD cohort study and included patients aged ≥60 years who were admitted to the general ward because of COVID‐19 in the Netherlands between February and May 2020. Data were collected on demographics, co‐morbidity, disease severity, and geriatric parameters. Prevalence of delirium during hospital admission was recorded based on delirium screening using the Delirium Observation Screening Scale (DOSS) which was scored three times daily. A DOSS score ≥3 was followed by a delirium assessment by the ward physician In‐hospital outcomes included length of stay, discharge destination, and mortality. RESULTS: A total of 412 patients were included (median age 76, 58% male). Delirium was present in 82 patients. In multivariable analysis, previous episode of delirium (Odds ratio [OR] 8.9 [95% CI 2.3–33.6] p = 0.001), and pre‐existent memory problems (OR 7.6 [95% CI 3.1–22.5] p < 0.001) were associated with increased delirium risk. Clinical Frailty Scale was associated with increased delirium risk (OR 1.63 [95%CI 1.40–1.90] p < 0.001) in univariable analysis, but not in multivariable analysis. Patients who developed delirium had a shorter symptom duration and lower levels of C‐reactive protein upon presentation, whereas vital parameters did not differ. Patients who developed a delirium had a longer hospital stay and were more often discharged to a nursing home. Delirium was associated with mortality (OR 2.84 [95% CI1.71–4.72] p < 0.001), but not in multivariable analyses. CONCLUSIONS: A previous delirium and pre‐existent memory problems were associated with delirium risk in COVID‐19. Delirium was not an independent predictor of mortality after adjustment for frailty. John Wiley and Sons Inc. 2022-09-01 2022-10 /pmc/articles/PMC9538581/ /pubmed/36052424 http://dx.doi.org/10.1002/gps.5810 Text en © 2022 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kroon, Bart
Beishuizen, Sara J. E.
van Rensen, Inge H. T.
Barten, Dennis G.
Mehagnoul‐Schipper, Jannet J.
van der Bol, Jessica M.
Ellerbroek, Jacobien L. J.
Festen, Jan
van de Glind, Esther M. M.
Hempenius, Liesbeth
van der Jagt, Mathieu
Jansen, Steffy W. M.
van der Linden, Carolien J. M.
Mooijaart, Simon P.
van Munster, Barbara C.
Oosterwijk, Leanne L. E.
Smit, Lisa
Urlings‐Strop, Louise C.
Willems, Hanna C.
Mattace‐Raso, Francesco U. S.
Polinder‐Bos, Harmke A.
Delirium in older COVID‐19 patients: Evaluating risk factors and outcomes
title Delirium in older COVID‐19 patients: Evaluating risk factors and outcomes
title_full Delirium in older COVID‐19 patients: Evaluating risk factors and outcomes
title_fullStr Delirium in older COVID‐19 patients: Evaluating risk factors and outcomes
title_full_unstemmed Delirium in older COVID‐19 patients: Evaluating risk factors and outcomes
title_short Delirium in older COVID‐19 patients: Evaluating risk factors and outcomes
title_sort delirium in older covid‐19 patients: evaluating risk factors and outcomes
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9538581/
https://www.ncbi.nlm.nih.gov/pubmed/36052424
http://dx.doi.org/10.1002/gps.5810
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