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MMSE items that predict incident delirium and hypoactive subtype in older medical inpatients.
Gabriel Franco, José; Santesteban, Olga; Trzepacz, Paula; Bernal, Carolina; Valencia, Camila; Ocampo, María Victoria; Pablo, Joan de; Gaviria, Ana Milena; Vilella, Elisabet.
Afiliación
  • Gabriel Franco J; Faculty of Medicine, Universidad Pontificia Bolivariana, Medellín, Antioquia, Colombia; Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, CIBERSAM, IISPV, Carretera del Pere Mata, unnumbered, Reus (Tarragona) 43206, Spain. Electronic address: josefranco11@hotmail.com.
  • Santesteban O; Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, CIBERSAM, IISPV, Carretera del Pere Mata, unnumbered, Reus (Tarragona) 43206, Spain.
  • Trzepacz P; Lilly Research Laboratories, Indianapolis, IN, USA; University of Mississippi Medical School, Jackson, MS, USA; Tufts University School of Medicine, Boston, MA, USA; Indiana University School of Medicine, Indianapolis, IN, USA.
  • Bernal C; Faculty of Medicine, Universidad Pontificia Bolivariana, Medellín, Antioquia, Colombia.
  • Valencia C; Faculty of Medicine, Universidad Pontificia Bolivariana, Medellín, Antioquia, Colombia.
  • Ocampo MV; Faculty of Medicine, Universidad Pontificia Bolivariana, Medellín, Antioquia, Colombia.
  • Pablo Jd; Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, CIBERSAM, IISPV, Carretera del Pere Mata, unnumbered, Reus (Tarragona) 43206, Spain.
  • Gaviria AM; Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, CIBERSAM, IISPV, Carretera del Pere Mata, unnumbered, Reus (Tarragona) 43206, Spain.
  • Vilella E; Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, CIBERSAM, IISPV, Carretera del Pere Mata, unnumbered, Reus (Tarragona) 43206, Spain.
Psychiatry Res ; 220(3): 975-81, 2014 Dec 30.
Article en En | MEDLINE | ID: mdl-25307690
Because hypoactive delirium is especially under-recognized, we analyzed which Mini-Mental State Examination (MMSE) items predicted incident delirium and its hypoactive motor presentation. Over a 1-year period, older medical inpatients (n=291) were consecutively screened on admission with the Confusion Assessment Method-Spanish (CAM-S) to exclude prevalent delirium. Nondelirious patients were evaluated the same day with the MMSE, followed by daily ratings with the CAM-S. Those who became CAM-S positive were rated using the Delirium Rating Scale-Revised-98 to assess severity and motor subtype. Disorientation to time (OR 4.4, 95% CI 1.7-11.1) and place (OR 3.8, 95% CI 1.7-8.2) at admission were risk factors for delirium at follow-up and together correctly classified 88.3% of subjects as to delirium status. Disorientation to time and place, and visuoconstructional impairment were each associated with either hypoactive or mixed subtype (p<0.05 χ(2) test). Simple bedside evaluation of cognitive function in nondelirious patients revealed deficits that detected patients at risk for developing incident delirium at follow-up (especially hypoactive or mixed). We recommend patients with orientation deficits be monitored closely for emergence of delirium. A separate evaluation for possible dementia or other causes of cognitive impairment at admission should be considered too.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Escalas de Valoración Psiquiátrica Breve / Evaluación Geriátrica / Delirio / Pacientes Internos Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Psychiatry Res Año: 2014 Tipo del documento: Article Pais de publicación: Irlanda
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Escalas de Valoración Psiquiátrica Breve / Evaluación Geriátrica / Delirio / Pacientes Internos Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Psychiatry Res Año: 2014 Tipo del documento: Article Pais de publicación: Irlanda