TY - JOUR
T1 - Delirium, dementia and in-hospital mortality
T2 - the results from the Italian Delirium Day 2016, a national multicenter study
AU - Italian Study Group on Delirium (ISGoD)
AU - Morandi, Alessandro
AU - Di Santo, Simona G
AU - Zambon, Antonella
AU - Mazzone, Andrea
AU - Cherubini, Antonio
AU - Mossello, Enrico
AU - Bo, Mario
AU - Marengoni, Alessandra
AU - Bianchetti, Angelo
AU - Cappa, Stefano
AU - Fimognari, Filippo
AU - Antonelli Incalzi, Raffaele
AU - Gareri, Pietro
AU - Perticone, Francesco
AU - Campanini, Mauro
AU - Penco, Italo
AU - Montorsi, Marco
AU - Di Bari, Mauro
AU - Trabucchi, Marco
AU - Bellelli, Giuseppe
PY - 2018/7/4
Y1 - 2018/7/4
N2 - Background: There is little evidence about the prevalence of cognitive disorders and their effect on in-hospital mortality in large multicenter studies. The objectives of the 2016th edition of the "Italian Delirium Day", a large multicenter study on in-hospital older patients, were to assess: 1) the point-prevalence of cognitive impairment/no dementia, dementia, delirium and delirium superimposed on dementia, DSD; and 2) the effect of these conditions on in-hospital mortality.Methods: This multicenter study and included 2037 older patients (aged ≥65 years) admitted to acute medical and surgical wards across 205 acute hospitals. The four cognitive disorders groups were defined with a structured approach including the 4 AT and the presence of a documented diagnosis of dementia. The outcome measure was in hospital mortality, as reported by the researchers involved in the study in each center.Results: The mean age was 81.17±7.7 years. Overall, 893 patients (43.8%) had neither delirium, nor dementia nor cognitive impairment, 483 (23.7%) had cognitive impairment/no dementia, 230 (11.3%) dementia alone, 187 (9.2%) delirium alone and 244 (12.0%) DSD. Overall, 99 (4.8%) patients died. Participants with delirium alone (Odds Ratio, O.R. 2.56, 95% Confidence interval, C.I. 1.29-5.09) and those with DSD (OR. 2.60, 95% C.I. 1.39-4.85) had higher mortality risk compared to the reference group of patients with "no cognitive impairment".Conclusions: Delirium and DSD were highly prevalent among older hospitalized patients and significantly increased in-hospital mortality. Clinicians should systematically assess these conditions and recognize them as markers of critical conditions and predictors of imminent death.
AB - Background: There is little evidence about the prevalence of cognitive disorders and their effect on in-hospital mortality in large multicenter studies. The objectives of the 2016th edition of the "Italian Delirium Day", a large multicenter study on in-hospital older patients, were to assess: 1) the point-prevalence of cognitive impairment/no dementia, dementia, delirium and delirium superimposed on dementia, DSD; and 2) the effect of these conditions on in-hospital mortality.Methods: This multicenter study and included 2037 older patients (aged ≥65 years) admitted to acute medical and surgical wards across 205 acute hospitals. The four cognitive disorders groups were defined with a structured approach including the 4 AT and the presence of a documented diagnosis of dementia. The outcome measure was in hospital mortality, as reported by the researchers involved in the study in each center.Results: The mean age was 81.17±7.7 years. Overall, 893 patients (43.8%) had neither delirium, nor dementia nor cognitive impairment, 483 (23.7%) had cognitive impairment/no dementia, 230 (11.3%) dementia alone, 187 (9.2%) delirium alone and 244 (12.0%) DSD. Overall, 99 (4.8%) patients died. Participants with delirium alone (Odds Ratio, O.R. 2.56, 95% Confidence interval, C.I. 1.29-5.09) and those with DSD (OR. 2.60, 95% C.I. 1.39-4.85) had higher mortality risk compared to the reference group of patients with "no cognitive impairment".Conclusions: Delirium and DSD were highly prevalent among older hospitalized patients and significantly increased in-hospital mortality. Clinicians should systematically assess these conditions and recognize them as markers of critical conditions and predictors of imminent death.
U2 - 10.1093/gerona/gly154
DO - 10.1093/gerona/gly154
M3 - Article
C2 - 29982365
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
SN - 1079-5006
ER -