دورية أكاديمية
أعرض في EDS

Epidemiology and outcomes of people with dementia, delirium, and unspecified cognitive impairment in the general hospital: prospective cohort study of 10,014 admissions.

التفاصيل البيبلوغرافية
العنوان: Epidemiology and outcomes of people with dementia, delirium, and unspecified cognitive impairment in the general hospital: prospective cohort study of 10,014 admissions.
المؤلفون: Reynish EL; Dementia and Ageing Research Group, Faculty of Social Science, University of Stirling, Stirling, FK9 4LA, UK. emma.reynish@stir.ac.uk., Hapca SM; Population Health Sciences Division, University of Dundee, Dundee, DD2 4BF, UK., De Souza N; Population Health Sciences Division, University of Dundee, Dundee, DD2 4BF, UK., Cvoro V; NHS Fife, Fife, Kirkcaldy, KY2 5AH, UK., Donnan PT; Epidemiology and Biostatistics, Population Health Sciences Division, University of Dundee, Dundee, DD2 4BF, UK., Guthrie B; Primary Care Medicine, Population Health Sciences Division, University of Dundee, Dundee, DD2 4BF, UK.
المصدر: BMC medicine [BMC Med] 2017 Jul 27; Vol. 15 (1), pp. 140. Date of Electronic Publication: 2017 Jul 27.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101190723 Publication Model: Electronic Cited Medium: Internet ISSN: 1741-7015 (Electronic) Linking ISSN: 17417015 NLM ISO Abbreviation: BMC Med Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central, 2003-
مواضيع طبية MeSH: Hospitals, General*, Cognitive Dysfunction/*epidemiology , Delirium/*epidemiology , Dementia/*epidemiology, Aged ; Cognitive Dysfunction/therapy ; Cohort Studies ; Delirium/complications ; Delirium/therapy ; Dementia/therapy ; Female ; Hospitalization ; Humans ; Inpatients ; Length of Stay ; Male ; Prevalence ; Prospective Studies ; Treatment Outcome
مستخلص: Background: Cognitive impairment of various kinds is common in older people admitted to hospital, but previous research has usually focused on single conditions in highly-selected groups and has rarely examined associations with outcomes. This study examined prevalence and outcomes of cognitive impairment in a large unselected cohort of people aged 65+ with an emergency medical admission.
Methods: Between January 1, 2012, and June 30, 2013, admissions to a single general hospital acute medical unit aged 65+ underwent a structured specialist nurse assessment (n = 10,014). We defined 'cognitive spectrum disorder' (CSD) as any combination of delirium, known dementia, or Abbreviated Mental Test (AMT) score < 8/10. Routine data for length of stay (LOS), mortality, and readmission were linked to examine associations with outcomes.
Results: A CSD was present in 38.5% of all patients admitted aged over 65, and in more than half of those aged over 85. Overall, 16.7% of older people admitted had delirium alone, 7.9% delirium superimposed on known dementia, 9.4% known dementia alone, and 4.5% unspecified cognitive impairment (AMT score < 8/10, no delirium, no known dementia). Of those with known dementia, 45.8% had delirium superimposed. Outcomes were worse in those with CSD compared to those without - LOS 25.0 vs. 11.8 days, 30-day mortality 13.6% vs. 9.0%, 1-year mortality 40.0% vs. 26.0%, 1-year death or readmission 62.4% vs. 51.5% (all P < 0.01). There was relatively little difference by CSD type, although people with delirium superimposed on dementia had the longest LOS, and people with dementia the worst mortality at 1 year.
Conclusions: CSD is common in older inpatients and associated with considerably worse outcomes, with little variation between different types of CSD. Healthcare systems should systematically identify and develop care pathways for older people with CSD admitted as medical emergencies, and avoid only focusing on condition-specific pathways such as those for dementia or delirium alone.
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معلومات مُعتمدة: HS&DR/13/54/55 United Kingdom DH_ Department of Health
فهرسة مساهمة: Keywords: Cognitive impairment; Delirium; Dementia; Length of stay; Mortality; Readmission
تواريخ الأحداث: Date Created: 20170728 Date Completed: 20171129 Latest Revision: 20220410
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC5530485
DOI: 10.1186/s12916-017-0899-0
PMID: 28747225
قاعدة البيانات: MEDLINE
الوصف
تدمد:1741-7015
DOI:10.1186/s12916-017-0899-0