BACKGROUND: although frailty and delirium are among the most frequent and burdensome geriatric syndromes, little is known about their association and impact on short-term mortality.OBJECTIVE: to examine, in hospitalized older persons, whether frailty is associated with delirium, and whether these two conditions, alone or in combination, affect these patients' 30-day survival.DESIGN: observational study nested in the Delirium Day project, with 30-day follow-up.SETTING: acute medical wards (n=118) and rehabilitation wards (n=46) in Italy.SUBJECTS: a total of 2,065 individuals aged 65+ years hospitalized in acute medical (1,484 patients, 71.9%) or rehabilitation (581 patients, 28.1%) wards.METHODS: a 25-item Frailty Index (FI) was created. Delirium was assessed using the 4AT test. Vital status was ascertained at 30days.RESULTS: overall, 469 (22.7%) patients experienced delirium on the index day and 82 (4.0%) died during follow-up. After adjustment for potential confounders, each FI score increase of 0.1 significantly increased the odds of delirium (odds ratio, OR: 1.66 [95% CI: 1.45-1.90]), with no difference between the acute (OR: 1.65 [95% CI: 1.41-1.93]) and rehabilitation ward patients (OR: 1.71 [95% CI: 1.27-2.30]). The risk of dying during follow-up also increased significantly for every FI increase of 0.1 in the overall population (OR: 1.65 [95% CI: 1.33-2.05]) and in the acute medical ward patients (OR: 1.61 [95% CI: 1.28-2.04]), but not in the rehabilitation patients. Delirium was not significantly associated with 30-day mortality in either hospital setting.CONCLUSIONS: in hospitalized older patients, frailty is associated with delirium and with an increased risk of short-term mortality.

Mazzola, P., Tassistro, E., Di Santo, S., Rossi, E., Andreano, A., Valsecchi, M., et al. (2021). The relationship between frailty and delirium: insights from the 2017 Delirium Day study. AGE AND AGEING, 50(5), 1593-1599 [10.1093/ageing/afab042].

The relationship between frailty and delirium: insights from the 2017 Delirium Day study

Mazzola, Paolo
Primo
;
Tassistro, Elena
Secondo
;
Rossi, Emanuela;Andreano, Anita;Valsecchi, Maria Grazia;Bellelli, Giuseppe
Ultimo
2021

Abstract

BACKGROUND: although frailty and delirium are among the most frequent and burdensome geriatric syndromes, little is known about their association and impact on short-term mortality.OBJECTIVE: to examine, in hospitalized older persons, whether frailty is associated with delirium, and whether these two conditions, alone or in combination, affect these patients' 30-day survival.DESIGN: observational study nested in the Delirium Day project, with 30-day follow-up.SETTING: acute medical wards (n=118) and rehabilitation wards (n=46) in Italy.SUBJECTS: a total of 2,065 individuals aged 65+ years hospitalized in acute medical (1,484 patients, 71.9%) or rehabilitation (581 patients, 28.1%) wards.METHODS: a 25-item Frailty Index (FI) was created. Delirium was assessed using the 4AT test. Vital status was ascertained at 30days.RESULTS: overall, 469 (22.7%) patients experienced delirium on the index day and 82 (4.0%) died during follow-up. After adjustment for potential confounders, each FI score increase of 0.1 significantly increased the odds of delirium (odds ratio, OR: 1.66 [95% CI: 1.45-1.90]), with no difference between the acute (OR: 1.65 [95% CI: 1.41-1.93]) and rehabilitation ward patients (OR: 1.71 [95% CI: 1.27-2.30]). The risk of dying during follow-up also increased significantly for every FI increase of 0.1 in the overall population (OR: 1.65 [95% CI: 1.33-2.05]) and in the acute medical ward patients (OR: 1.61 [95% CI: 1.28-2.04]), but not in the rehabilitation patients. Delirium was not significantly associated with 30-day mortality in either hospital setting.CONCLUSIONS: in hospitalized older patients, frailty is associated with delirium and with an increased risk of short-term mortality.
Articolo in rivista - Articolo scientifico
delirium; Delirium Day; frailty; mortality; older people;
English
31-mar-2021
2021
50
5
1593
1599
none
Mazzola, P., Tassistro, E., Di Santo, S., Rossi, E., Andreano, A., Valsecchi, M., et al. (2021). The relationship between frailty and delirium: insights from the 2017 Delirium Day study. AGE AND AGEING, 50(5), 1593-1599 [10.1093/ageing/afab042].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/310103
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