دورية أكاديمية
Delirium, Frailty, and Mortality: Interactions in a Prospective Study of Hospitalized Older People.
| العنوان: | Delirium, Frailty, and Mortality: Interactions in a Prospective Study of Hospitalized Older People. |
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| المؤلفون: | Dani M; Department of Medicine for the Elderly, Hammersmith Hospital, London, UK., Owen LH; University College London Hospitals NHS Foundation Trust, London, UK., Jackson TA; Institute of Inflammation and Ageing, University of Birmingham, UK., Rockwood K; Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada., Sampson EL; Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK., Davis D; MRC Unit for Lifelong Health and Ageing at UCL, London, UK. |
| المصدر: | The journals of gerontology. Series A, Biological sciences and medical sciences [J Gerontol A Biol Sci Med Sci] 2018 Mar 02; Vol. 73 (3), pp. 415-418. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: published on behalf of the Gerontological Society of America by Oxford University Press Country of Publication: United States NLM ID: 9502837 Publication Model: Print Cited Medium: Internet ISSN: 1758-535X (Electronic) Linking ISSN: 10795006 NLM ISO Abbreviation: J Gerontol A Biol Sci Med Sci Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Washington, DC : published on behalf of the Gerontological Society of America by Oxford University Press Original Publication: Washington, DC : Gerontological Society of America, c1995- |
| مواضيع طبية MeSH: | Cause of Death* , Frail Elderly*, Delirium/*mortality , Hospital Mortality/*trends, Aged ; Delirium/diagnosis ; Female ; Geriatric Assessment ; Hospitalization ; Humans ; Male ; Prospective Studies ; Risk Factors |
| مستخلص: | Background: It is unknown whether the association between delirium and mortality is consistent for individuals across the whole range of health states. A bimodal relationship has been proposed, where delirium is particularly adverse for those with underlying frailty, but may have a smaller effect (perhaps even protective) if it is an early indicator of acute illness in fitter people. We investigated the impact of delirium on mortality in a cohort simultaneously evaluated for frailty. Methods: We undertook an exploratory analysis of a cohort of consecutive acute medical admissions aged ≥70. Delirium on admission was ascertained by psychiatrists. A frailty index (FI) was derived according to a standard approach. Deaths were notified from linked national mortality statistics. Cox regression was used to estimate associations between delirium, frailty, and their interactions on mortality. Results: The sample consisted of 710 individuals. Both delirium and frailty were independently associated with increased mortality rates (delirium: HR 2.4, 95% CI 1.8-3.3, p < .01; frailty (per SD): HR 3.5, 95% CI 1.2-9.9, p = .02). Estimating the effect of delirium in tertiles of FI, mortality was greatest in the lowest tertile: tertile 1 HR 3.4 (95% CI 2.1-5.6); tertile 2 HR 2.7 (95% CI 1.5-4.6); tertile 3 HR 1.9 (95% CI 1.2-3.0). Conclusion: Although delirium and frailty contribute to mortality, the overall impact of delirium on admission appears to be greater at lower levels of frailty. In contrast to the hypothesis that there is a bimodal distribution for mortality, delirium appears to be particularly adverse when precipitated in fitter individuals. (© The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America.) |
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| معلومات مُعتمدة: | 107467/Z/15/Z United Kingdom WT_ Wellcome Trust; MCCC-FCO-11-U United Kingdom MCCC_ Marie Curie; MC_UU_12019/1 United Kingdom MRC_ Medical Research Council; WT107467 United Kingdom WT_ Wellcome Trust |
| تواريخ الأحداث: | Date Created: 20171104 Date Completed: 20190307 Latest Revision: 20220409 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC5861945 |
| DOI: | 10.1093/gerona/glx214 |
| PMID: | 29099916 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1758-535X |
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| DOI: | 10.1093/gerona/glx214 |