The In-Hospital Length of Stay after Hip Fracture in Octogenarians: Do Delirium and Dementia Shape a New Care Process?

Fiammetta Monacelli, Monica Pizzonia, Alessio Signori, Alessio Nencioni, Chiara Gianotti, Cecilia Minaglia, Tommaso Granello di Casaleto, Silvia Podestà, Federico Santolini, Patrizio Odetti

Research output: Contribution to journalArticle

Abstract

RESULTS: Prevalent delirium at hospital admission was of 3.1%. 35% of patients developed incident delirium. 56.4% were affected by dementia of Alzheimer-type. In addition, 52% of patients developed delirium superimposed to dementia. Mean LOS was 13.5±4.99 days. Namely, delirium, time to surgery, and complication rate disproportionally affected LOS. The analysis with 3 months mortality, based on cognitive vulnerability profiles, showed how delirium mainly affect short-term mortality in patients with dementia.

CONCLUSION: Our exploratory study originally pointed out the high incidence of delirium superimposed to dementia in orthogeriatric wards and how delirium turns to be a moderator of LOS. The results meet the need for additional research by virtue of a deeper understanding of the impact of delirium and dementia on orthogeriatric clinical management and outcomes.

BACKGROUND: Hip fracture is a major health problem and a patient's biological age, comorbidity, and cognitive vulnerability have an impact on its related outcomes. Length of stay (LOS) for these highly vulnerable patients is rather long and the possible causes have not been clearly identified yet.

OBJECTIVE: We aimed to assess the main clinical factors associated with protracted LOS, focusing on delirium with or without dementia in older age hip fractured patients.

METHODS: 218 subjects (mean age 86.70±6.18 years), admitted to the Orthogeriatric Unit of the Ospedale Policlinico San Martino (Italy), were recruited. All patients received physical and comprehensive geriatric assessment. Days to surgery, days from surgery to rehabilitation, and LOS were recorded. In-hospital and three months' mortality were reported.

Original languageEnglish
Pages (from-to)281-288
Number of pages8
JournalJournal of Alzheimer's disease : JAD
Volume66
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

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Keywords

  • Cognitive vulnerability
  • dedicated orthogeriatric pathway
  • hip fracture
  • length of stay

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Monacelli, F., Pizzonia, M., Signori, A., Nencioni, A., Gianotti, C., Minaglia, C., Granello di Casaleto, T., Podestà, S., Santolini, F., & Odetti, P. (2018). The In-Hospital Length of Stay after Hip Fracture in Octogenarians: Do Delirium and Dementia Shape a New Care Process? Journal of Alzheimer's disease : JAD, 66(1), 281-288. https://doi.org/10.3233/JAD-180153