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Factors associated with delirium in a real-world acute-care setting: analysis considering the interdependence of clinical variables with the frailty syndrome.
Ticinesi, Andrea; Parise, Alberto; Delmonte, Davide; Coppi, Chiara; Prati, Beatrice; Cerundolo, Nicoletta; Guerra, Angela; Nouvenne, Antonio; Meschi, Tiziana.
Afiliación
  • Ticinesi A; Department of Medicine and Surgery, University of Parma, Via Antonio Gramsci 14, 43126, Parma, Italy. andrea.ticinesi@unipr.it.
  • Parise A; Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126, Parma, Italy. andrea.ticinesi@unipr.it.
  • Delmonte D; Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126, Parma, Italy.
  • Coppi C; Institute of Materials for Electronics and Magnetism, National Research Council (CNR), Parco Area delle Scienze 7/A, 43124, Parma, Italy.
  • Prati B; Doctoral School in Material Science, Department of Chemistry, Life Science and Environmental Sustainability, University of Parma, Parco Area delle Scienze 7/A, 43124, Parma, Italy.
  • Cerundolo N; Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126, Parma, Italy.
  • Guerra A; Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126, Parma, Italy.
  • Nouvenne A; Department of Medicine and Surgery, University of Parma, Via Antonio Gramsci 14, 43126, Parma, Italy.
  • Meschi T; Geriatric-Rehabilitation Department, Azienda Ospedaliero-Universitaria di Parma, Via Antonio Gramsci 14, 43126, Parma, Italy.
Eur Geriatr Med ; 15(2): 411-421, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38329618
ABSTRACT

PURPOSE:

Delirium risk assessment in the acute-care setting generally does not account for frailty. The objective of this retrospective study was to identify factors associated with delirium, considering the interdependency of clinical variables with frailty syndrome in complex older patients.

METHODS:

The clinical records of 587 participants (248 M, median age 84) were reviewed, collecting clinical, anamnestic and pharmacological data. Frailty syndrome was assessed with the Clinical Frailty Scale (CFS). Delirium was the main study endpoint. The correlations of the considered anamnestic and clinical variables with delirium and its subtypes were investigated selecting only those variables not showing a high overlap with frailty. Correlations associated with a 25% excess of frequency of delirium in comparison with the average of the population were considered as statistically significant.

RESULTS:

Delirium was detected in 117 (20%) participants. The presence of one among age > 85 years old, CFS > 4 and invasive devices explained 95% of delirium cases. The main factors maximizing delirium incidence at the individual level were dementia, other psychiatric illness, chronic antipsychotic treatment, and invasive devices. The coexistence of three of these parameters was associated with a peak frequency of delirium, ranging from 57 to 61%, mostly hypoactive forms.

CONCLUSIONS:

In acute-care wards, frailty exhibited a strong association with delirium during hospitalization, while at the individual level, dementia and the use of antipsychotics remained important risk factors. Modern clinical prediction tools for delirium should account for frailty syndrome.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Delirio / Demencia / Fragilidad Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Humans Idioma: En Revista: Eur Geriatr Med Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Delirio / Demencia / Fragilidad Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Humans Idioma: En Revista: Eur Geriatr Med Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza