These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Usefulness of acute delirium as a predictor of adverse outcomes in patients >65 years of age with acute decompensated heart failure.
    Author: Uthamalingam S, Gurm GS, Daley M, Flynn J, Capodilupo R.
    Journal: Am J Cardiol; 2011 Aug 01; 108(3):402-8. PubMed ID: 21757045.
    Abstract:
    Delirium is an acute confusional state that is very prevalent in older patients hospitalized with acute decompensated heart failure (ADHF). The association between delirium and ADHF outcome has not been well described. We analyzed 883 consecutive patients >65 years of age admitted with ADHF. Acute delirium was diagnosed based on the Confusion Assessment Method. Delirious patients (total n = 151) had an increased in-hospital all-cause death compared to nondelirious patients (n = 17, 11%, vs n = 45, 6%; adjusted odds ratio [OR] 1.93, 95% confidence interval [CI] 1.07 to 3.48, p = 0.02). Of those surviving to discharge (n = 821), on multivariable logistic regression analysis, delirium was independently associated with increased risk of 30-day (adjusted OR 4.24, 95% CI 2.77 to 6.47, p <0.001) and 90-day (adjusted OR 3.72, 95% CI 2.51 to 5.54, p <0.001) rehospitalizations for ADHF and higher nursing home placement (adjusted OR 2.70, 95% CI 1.59 to 5.30, p <0.001) after adjusting for age, gender, cardiac risk factors, dementia, activities of daily living, instrumental activities of daily living, coronary artery disease, atrial fibrillation, left ventricular ejection fraction, angiotensin-converting enzyme inhibitor and/or angiotensin receptor blocker, β blockers, Charlson co-morbidity index, and other potential confounders. Furthermore, delirium was strongly associated with 90-day all-cause mortality in patients discharged from the hospital (adjusted hazard ratio 2.10, CI 1.53 to 2.88, p <0.0001). In conclusion, acute delirium serves as an important prognostic determinant of in-hospital and posthospital discharge outcomes including increased ADHF readmission risk in older hospitalized patients with ADHF. Thus, delirium plays an important role in the risk stratification and prognosis of patients with ADHF.
    [Abstract] [Full Text] [Related] [New Search]