Marianne Giroux1,2,3, Marcel Émond1,2,3,4,5, Alexandra Nadeau1,2,3, Valérie Boucher1,2,3,6, Pierre-Hugues Carmichael3, Philippe Voyer1,2,3, Mathieu Pelletier2,7, Émilie Gouin8, Raoul Daoust9,10, Simon Berthelot1,2,4, Marie-Eve Lamontagne2,6, Michèle Morin1,2,3,5, Stéphane Lemire1,2,3, Marie-Josée Sirois1,2,3,5. 1. Centre de recherche du CHU de Québec-Université Laval, Québec, Canada. 2. Université Laval, Québec, Canada. 3. Centre d'excellence sur le vieillissement de Québec, Québec, Canada. 4. Département de médecine d'urgence, CHU de Québec-Université Laval, Québec, Canada. 5. Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Québec, Canada. 6. Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Québec, Canada. 7. Centre Intégré de Santé et de Services Sociaux de Lanaudière, Joliette, Canada. 8. Centre Hospitalier Régional de Trois-Rivières, Trois-Rivières, Canada. 9. Centre de recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Canada. 10. Université de Montréal, Montréal, Canada.
Abstract
BACKGROUND: the aim of this study was to evaluate the impact of emergency department (ED) stay-associated delirium on older patient's functional and cognitive status at 60 days post ED visit. METHODS: this study was part of the multi-centre prospective cohort INDEED study. This project took place between March 2015 and July 2016 in five participating EDs across the province of Quebec. Independent non-delirious patients aged ≥65, with an ED stay ≥8 hours, were monitored for delirium until 24 hours post ward admission. A 60-day follow-up phone assessment was conducted. Participants were screened for delirium using the Confusion Assessment Method. Functional and cognitive statuses were assessed at baseline and at the 60-day follow-up using OARS and TICS-m. RESULTS: a total of 608 patients were recruited, 393 of which completed the 60-day follow-up. The Confusion Assessment Method was positive in 69 patients (11.8%) during ED stay or within the first 24 hours following ward admission. At 60 days, delirium patients experienced an adjusted loss of -2.9/28 [95%CI: -3.9, -2.0] points on the OARS scale compared to non-delirious patients who lost -1.6 [95%CI: -1.9, -1.3] (P = 0.006). A significant adjusted difference in cognitive function was also noted at 60 days, as TICS-m scores in delirious patients decreased by -1.6 [95%CI: -3.5, 0.2] compared to non-delirious patients, who showed a minor improvement of 0.5 [95%CI: -0.1, 1.1] (P = 0.03). CONCLUSION: seniors who developed ED stay-associated delirium have lower baseline functional and cognitive status than non-delirious patients, and they will experience a more significant decline at 60 days post ED visit.
BACKGROUND: the aim of this study was to evaluate the impact of emergency department (ED) stay-associated delirium on older patient's functional and cognitive status at 60 days post ED visit. METHODS: this study was part of the multi-centre prospective cohort INDEED study. This project took place between March 2015 and July 2016 in five participating EDs across the province of Quebec. Independent non-deliriouspatients aged ≥65, with an ED stay ≥8 hours, were monitored for delirium until 24 hours post ward admission. A 60-day follow-up phone assessment was conducted. Participants were screened for delirium using the Confusion Assessment Method. Functional and cognitive statuses were assessed at baseline and at the 60-day follow-up using OARS and TICS-m. RESULTS: a total of 608 patients were recruited, 393 of which completed the 60-day follow-up. The Confusion Assessment Method was positive in 69 patients (11.8%) during ED stay or within the first 24 hours following ward admission. At 60 days, deliriumpatients experienced an adjusted loss of -2.9/28 [95%CI: -3.9, -2.0] points on the OARS scale compared to non-deliriouspatients who lost -1.6 [95%CI: -1.9, -1.3] (P = 0.006). A significant adjusted difference in cognitive function was also noted at 60 days, as TICS-m scores in delirious patients decreased by -1.6 [95%CI: -3.5, 0.2] compared to non-deliriouspatients, who showed a minor improvement of 0.5 [95%CI: -0.1, 1.1] (P = 0.03). CONCLUSION: seniors who developed ED stay-associated delirium have lower baseline functional and cognitive status than non-deliriouspatients, and they will experience a more significant decline at 60 days post ED visit.
Authors: Gwen C Jacobsohn; Courtney M C Jones; Rebecca K Green; Amy L Cochran; Thomas V Caprio; Jeremy T Cushman; Amy J H Kind; Michael Lohmeier; Ranran Mi; Manish N Shah Journal: Acad Emerg Med Date: 2021-08-20 Impact factor: 3.451
Authors: Sangil Lee; Hao Chen; Seikei Hibino; Daniel Miller; Heather Healy; Jacques S Lee; Glenn Arendts; Jin Ho Han; Maura Kennedy; Christopher R Carpenter Journal: J Am Geriatr Soc Date: 2022-03-11 Impact factor: 7.538