Delirium Bibliography

Reference Information

Title

Clinical and prognostic implications of delirium in elderly patients with non–ST-segment elevation acute coronary syndromes.

Authors

Vives-Borrás, M. Martínez-Sellés, M. Ariza-Solé, A. Vidán, M. T. Formiga, F. Bueno, H. Sanchís, J. Alegre, O. Durán-Cambra, A. López-Palop, R. Abu-Assi, E. Sionis, A.

Year

2019

Journal

Journal of Geriatric Cardiology

Abstract

Background Elderly patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) may present delirium but its clinical relevance is unknown. This study aimed at determining the clinical associated factors, and prognostic implications of delirium in old-aged patients admitted for NSTE-ACS. Methods LONGEVO-SCA is a prospective multicenter registry including unselected patients with NSTE-ACS aged 80 years. Clinical variables and a complete geriatric evaluation were assessed during hospitalization. The association between delirium and 6-month mortality was assessed by a Cox regression model weighted for a propensity score including the potential confounding variables. We also analysed its association with 6-month bleeding and cognitive or functional decline. Results Among 527 patients included, thirty-seven (7%) patients presented delirium during the hospitalization. Delirium was more frequent in patients with dementia or depression and in those from nursing homes (27.0% vs. 3.1%, 24.3% vs. 11.6%, and 11.1% vs. 2.2%, respectively; all P < 0.05). Delirium was significantly associated with in-hospital infections (27.0% vs. 5.3%, P < 0.001) and usage of diuretics (70.3% vs. 49.8%, P = 0.02). Patients with delirium had longer hospitalizations [median 8.5 (5.5-14) vs. 6.0 (4.0-10) days, P = 0.02] and higher incidence of 6-month bleeding and mortality (32.3% vs. 10.0% and 24.3% vs. 10.8%, respectively; both P < 0.05) but similar cognitive or functional decline. Delirium was independently associated with 6-month mortality (HR = 1.47, 95% CI: 1.02-2.13, P = 0.04) and 6-month bleeding events (OR = 2.87; 95% CI: 1.98-4.16, P < 0.01). Conclusions In-hospital delirium in elderly patients with NSTE-ACS is associated with some preventable risk factors and it is an independent predictor of 6-month mortality.

PMID

30923543

Keywords

aged
article
bleeding
cognitive defect
confounding variable
controlled study
female
hospital infection
hospitalization
human
incidence
major clinical study
male
mortality
multicenter study
non st segment elevation acute coronary syndrome
nursing home
prognosis
propensity score
prospective study
risk factor
very elderly
diuretic agent

Page(s)

121-8

Volume

16

Issue

2