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Survival of Frail Elderly with Delirium

Author

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  • Guillermo Cano-Escalera

    (Department of Computer Science and Artificial Intelligence, University of the Basque Country (UPV/EHU), Paseo Manuel de Lardizabal, 1, 20018 Donostia-San Sebastian, Spain
    Computational Intelligence Group, University of the Basque Country (UPV/EHU), 20018 Donostia-San Sebastian, Spain)

  • Manuel Graña

    (Department of Computer Science and Artificial Intelligence, University of the Basque Country (UPV/EHU), Paseo Manuel de Lardizabal, 1, 20018 Donostia-San Sebastian, Spain
    Computational Intelligence Group, University of the Basque Country (UPV/EHU), 20018 Donostia-San Sebastian, Spain)

  • Jon Irazusta

    (Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48013 Bilbao, Spain
    BioCruces Health Research Institute, 48903 Barakaldo, Spain)

  • Idoia Labayen

    (Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, 31006 Pamplona, Spain)

  • Ariadna Besga

    (BioAraba, Health Research Institute, Hospital Universitario de Araba, Department of Medicine, 01004 Vitoria, Spain
    Biomedical Research Centre in Mental Health Network (CIBERSAM) G10, Spain)

Abstract

This study aims to determine when frailty increases the risks of delirium mortality. Hospital patients falling into the elderly frail or pre-frail category were recruited, some without delirium, some with delirium at admission, and some who developed delirium during admission. We screened for frailty, cognitive status, and co-morbidities whenever possible and extracted drug information and mortality data from electronic health records. Kaplan–Meier estimates of survival probability functions were computed at four times, comparing delirium versus non delirium patients. Differences in survival were assessed by a log-rank test. Independent Cox’s regression was carried out to identify significant hazard risks (HR) at 1 month, 6 months, 1 year, and 2 years. Delirium predicted mortality (log-rank test, p < 0.0001) at all four censoring points. Variables with significant HRs were frailty indicators, comorbidities, polypharmacy, and the use of specific drugs. For the delirium cohort, variables with the most significant 2-year hazard risks (HR(95%CI)) were: male gender (0.43 20 (0.26,0.69)), weight loss (0.45 (0.26,0.74)), sit and stand up test (0.67 (0.49,0.92)), readmission within 30 days of discharge (0.50 (0.30,0.80)), cerebrovascular disease (0.45 (0.27,0.76)), head trauma (0.54 22 (0.29,0.98)), number of prescribed drugs (1.10 (1.03,1.18)), and the use of diuretics (0.57 (0.34,0.96)). These results suggest that polypharmacy and the use of diuretics increase mortality in frail elderly patients with delirium.

Suggested Citation

  • Guillermo Cano-Escalera & Manuel Graña & Jon Irazusta & Idoia Labayen & Ariadna Besga, 2022. "Survival of Frail Elderly with Delirium," IJERPH, MDPI, vol. 19(4), pages 1-18, February.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:4:p:2247-:d:750988
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    References listed on IDEAS

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    1. Honoria Ocagli & Daniele Bottigliengo & Giulia Lorenzoni & Danila Azzolina & Aslihan S. Acar & Silvia Sorgato & Lucia Stivanello & Mario Degan & Dario Gregori, 2021. "A Machine Learning Approach for Investigating Delirium as a Multifactorial Syndrome," IJERPH, MDPI, vol. 18(13), pages 1-13, July.
    2. Marcelina Czok & Michał P. Pluta & Zbigniew Putowski & Łukasz J. Krzych, 2021. "Postoperative Neurocognitive Disorders in Cardiac Surgery: Investigating the Role of Intraoperative Hypotension. A Systematic Review," IJERPH, MDPI, vol. 18(2), pages 1-15, January.
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