Abstract | OBJECTIVES: To examine the association between persistent delirium and 1-year mortality in newly admitted postacute care (PAC) facility patients with delirium who were followed regardless of residence. DESIGN: Observational cohort study. SETTING: Eight greater-Boston skilled nursing facilities specializing in PAC. PARTICIPANTS: Four hundred twelve PAC patients with delirium at admission after an acute hospitalization. MEASUREMENTS: Assessments were done at baseline and four follow-up times: 2, 4, 12, and 26 weeks. Delirium, defined using the Confusion Assessment Method, was assessed, as were factors used as covariates in analyses: age, sex, comorbidity, functional status, and dementia. The outcome was 1-year mortality determined according to the National Death Index and corroborated using medical record and proxy telephone interview. RESULTS: Nearly one-third of subjects remained delirious at 6 months. Cumulative 1-year mortality was 39%. Independent of age, sex, comorbidity, functional status, and dementia, subjects with persistent delirium were 2.9 (95% confidence interval 51.9-4.4) times as likely to die during the 1-year follow-up as subjects whose delirium resolved. This association remained strong and significant in groups with and without dementia. Additionally, when delirium resolved, the risk of death diminished thereafter. CONCLUSION: In patients who were delirious at the time of PAC admission, persistent delirium was a significant independent predictor of 1-year mortality.
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Authors | Dan K Kiely, Edward R Marcantonio, Sharon K Inouye, Michele L Shaffer, Margaret A Bergmann, Frances M Yang, Michael A Fearing, Richard N Jones |
Journal | Journal of the American Geriatrics Society
(J Am Geriatr Soc)
Vol. 57
Issue 1
Pg. 55-61
(Jan 2009)
ISSN: 1532-5415 [Electronic] United States |
PMID | 19170790
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Topics |
- Aged
- Aged, 80 and over
- Cohort Studies
- Delirium
(etiology, mortality)
- Female
- Homes for the Aged
- Hospitalization
- Humans
- Male
- Nursing Homes
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