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Charlson age comorbidity index, delirium

Panya Luksanapruksa, Jacob M Buchowski, Lukas P Zebala, Christopher K Kepler, Weerasak Singhatanadgige, David B Bumpass
The incidence of symptomatic spinal metastasis has increased due to treatment improvements and longer patient survival. More patients with spinal tumors are choosing operative treatment with an associated increased rate of perioperative complications. Operative metastatic disease treatment complication rates have also increased with overall rates ranging from 5.3% to 76.20%. The common surgical-related complications are iatrogenic dural injury and wound complications. The most common postoperative medical complications are delirium, pneumonia, and deep vein thrombosis...
February 2017: Clinical Spine Surgery
Rikie M Scholtens, Barbara C van Munster, Dimitrios Adamis, Annemarieke de Jonghe, David J Meagher, Sophia E J A de Rooij
OBJECTIVES: To examine changes in motor subtype profile in individuals with delirium. DESIGN: Observational, longitudinal study; substudy of a multicenter, randomized controlled trial. SETTING: Departments of surgery and orthopedics, Academic Medical Center and Tergooi Hospital, the Netherlands. PARTICIPANTS: Elderly adults acutely admitted for hip fracture surgery who developed delirium according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, for 2 days or longer (n = 76, aged 86...
February 2017: Journal of the American Geriatrics Society
Julija Stelmokas, Nicolette Gabel, Jennifer M Flaherty, Katherine Rayson, Kathileen Tran, Jason R Anderson, Linas A Bieliauskas
Misdiagnosis and under-detection of delirium may occur in many medical settings. This is important to address as delirium clearly increases risk of morbidity and mortality in such settings. This study assessed whether Veterans who screened positive on a delirium severity measure (Memorial Delirium Assessment Scale; MDAS) differed from those with and without corresponding medical documentation of delirium in terms of cognitive functioning, psychiatric/medical history, and medication use. A medical record review of 266 inpatients at a VA post-acute rehabilitation unit found that 10...
2016: PloS One
Yasuhiro Ito, Yuta Abe, Kan Handa, Shintaro Shibutani, Tomohisa Egawa, Atsushi Nagashima, Minoru Kitago, Osamu Itano, Yuko Kitagawa
BACKGROUND/AIMS: Postoperative delirium (POD) is one of the most common complications after various types of surgery. The aim of this study was to investigate the incidence and risk factors for delirium after pancreaticoduodenectomy (PD). METHODS: This was a retrospective study of 146 consecutive patients who underwent PD between April 2007 and June 2015 at Saiseikai Yokohamashi Tobu Hospital. RESULTS: Twenty-nine patients (19.9%) were diagnosed with delirium...
2017: Digestive Surgery
Alex Soroceanu, Douglas C Burton, Jonathan Haim Oren, Justin S Smith, Richard Hostin, Christopher I Shaffrey, Behrooz A Akbarnia, Christopher P Ames, Thomas J Errico, Shay Bess, Munish C Gupta, Vedat Deviren, Frank J Schwab, Virginie Lafage
STUDY DESIGN: Retrospective review of a prospective multicenter database evaluating surgical adult spinal deformity (ASD) patients. OBJECTIVE: This study aims to identify risk factors for medical complications in ASD patients undergoing surgery. SUMMARY OF BACKGROUND DATA: ASD surgery is known for its high complication rate. This study examines baseline patient characteristics for predictors of medical complications in surgical ASD patients...
November 15, 2016: Spine
Christopher G Hughes, Pratik P Pandharipande, Jennifer L Thompson, Rameela Chandrasekhar, Lorraine B Ware, E Wesley Ely, Timothy D Girard
OBJECTIVES: During critical illness, impaired endothelial vascular reactivity predicts prolonged acute brain dysfunction, but relationships between endothelial activation, blood-brain barrier/neurological injury, and acute brain dysfunction, including delirium, remain unexamined. We tested the hypothesis that elevated plasma markers of endothelial activation and blood-brain barrier/neurological injury are associated with delirium duration during critical illness. DESIGN: Prospective cohort study...
September 2016: Critical Care Medicine
Daniel Weintraub, Claire Chiang, Hyungjin Myra Kim, Jayne Wilkinson, Connie Marras, Barbara Stanislawski, Eugenia Mamikonyan, Helen C Kales
IMPORTANCE: As many as 60% of patients with Parkinson disease (PD) experience psychosis, 80% develop dementia, and the use of antipsychotics (APs) in the population with PD is common. The use of APs by patients with dementia in the general population is associated with increased mortality, but whether this risk extends to patients with PD remains unknown. OBJECTIVE: To determine whether AP use in patients with PD is associated with increased mortality. DESIGN, SETTING, AND PARTICIPANTS: This retrospective matched-cohort study used data from a Veterans Health Administration database from fiscal years 1999 to 2010 to examine the risk associated with AP use in a cohort of patients with idiopathic PD and recent stable physical health...
May 1, 2016: JAMA Neurology
Mohammed Saji Salahudeen, Prasad S Nishtala, Stephen B Duffull
AIMS: To examine patient characteristics that predict adverse anticholinergic-type events in older people. METHODS: This retrospective population-level study included 2,248 hospitalised patients. Individual data on medicines that are commonly associated with anticholinergic events (delirium, constipation and urinary retention) were identified. Patient characteristics examined were medicines with anticholinergic effects (ACh burden), age, sex, non-anticholinergic medicines (non-ACM), Charlson comorbidity index scores and ethnicity...
September 2015: Dementia and Geriatric Cognitive Disorders Extra
Jack J Bell, Ranjeev C Pulle, Alisa M Crouch, Suzanne S Kuys, Rebecca L Ferrier, Sarah L Whitehouse
BACKGROUND: Studies investigating the relationship between malnutrition and post-discharge mortality following acute hip fracture yield conflicting results. This study aimed to determine whether malnutrition independently predicted 12-month post-fracture mortality after adjusting for clinically relevant covariates. METHODS: An ethics approved, prospective, consecutive audit was undertaken for all surgically treated hip fracture inpatients admitted to a dedicated orthogeriatric unit (November 2010-October 2011)...
March 2016: ANZ Journal of Surgery
Kyle D Severinsen, Anne Tufton, Emma Hannan, Jessica S Schwind, Dana Schmucker, Allison Cutler
BACKGROUND: Hospital-associated disability is the loss of the ability to complete one activity of daily living (ADL), with this decline occurring between the onset of acute illness and discharge from the hospital. Approximately 30% of patients who are >70 years old and admitted to hospitals are discharged with an ADL disability. Comprehensive geriatric assessment (CGA) models use a multidimensional, interdisciplinary process of diagnosis and treatment with the goal of improving outcomes and decreasing lengths of stay...
2015: Ochsner Journal
N Sánchez-Hernández, P Sáez-López, S Paniagua-Tejo, J A Valverde-García
PURPOSE: To evaluate the efficiency of a clinical pathway in the management of elderly patients with fragility hip fracture in a second level hospital in terms of length of stay time to surgery, morbidity, hospital mortality, and improved functional outcome. MATERIAL AND METHODS: A comparative and prospective study was carried out between two groups of patients with hip fracture aged 75 and older prior to 2010 (n=216), and after a quality improvement intervention in 2013 (n=196)...
January 2016: Revista Española de Cirugía Ortopédica y Traumatología
María Virtudes Regueiro-Mira, Salvador Pita-Fernández, Sonia Pértega-Díaz, Beatriz López-Calviño, Teresa Seoane-Pillado, María Fernández-Albalat-Ruiz
INTRODUCTION: Legionellosis is a multisystem bacterial disease, which causes pneumonia with high mortality in patients with comorbidity and admitted in intensive care units (ICU). OBJECTIVE: Determine predictors of mortality or ICU admission. METHODS: Retrospective follow-up of patients diagnosed with Legionella pneumophila pneumonia in Complexo Hospitalario Universitario de A Coruña. Period 2000-2013 (n=240). Analysis of multivariate logistic regression was performed...
August 2015: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Che-Sheng Chu, Chih-Kuang Liang, Ming-Yueh Chou, Yu-Te Lin, Chien-Jen Hsu, Po-Han Chou, Chin-Liang Chu
OBJECTIVE: Postoperative delirium (POD) is a major cause for concern among elderly patients undergoing surgery, often resulting in poor outcome. It is therefore important to predict and prevent POD. The aim of this study was to evaluate the Mini Nutritional Assessment Short-Form (MNA-SF) as a predictor of POD after orthopedic surgery. METHODS: Elderly patients undergoing orthopedic surgery between April 2011 and March 2013 were included in the study (n=544; mean age, 74...
January 2016: General Hospital Psychiatry
Parijat S Joy, Gagan Kumar
OBJECTIVES: The mortality rate for patients with delirium tremens (DT) is 5%. As these patients present with elevated cardiac indices, coexisting DT in acute coronary syndrome (ACS) likely worsens outcomes. Our aim was to examine the outcomes of alcohol withdrawal syndrome (AWS) and DT in patients with ACS. METHODS: We used the Nationwide Inpatient Sample (2000-2009) for our study. A multivariable logistic regression model was used to examine the independent association of AWS on inhospital mortality and a multivariable linear regression was used to examine the effect of AWS on inpatient length of stay (LOS)...
2015: Cardiology
Doris Ka Ying Miu, Ching Wai Chan, Ching Kok
AIM: To investigate the prevalence and risk factors of delirium in an extended care unit, the persistence of delirium and 3-month outcome. METHOD: Patients aged >65 years were recruited. Basic demographic data, medical comorbidity using the Charlson Comorbidity Index, pre-existing cognitive impairment using the informant questionnaire on cognitive decline in the elderly, place of residence and physical function as measured by the modified Barthel Index were recorded...
May 2016: Geriatrics & Gerontology International
M P Mesa-Lampré, V Canales-Cortés, M E Castro-Vilela, M Clerencia-Sierra
OBJECTIVE: To report the design and outcomes obtained during the first operational years of the Orthogeriatric Unit (OGU) established in the Zaragoza-1 (Spain) Health-Sector. MATERIAL AND METHODS: A total of 494 patients >70 years old treated in the OGU from February 2009 to December 2012. An analysis was performed using the following variables: demography, previous functional level, comorbidities, surgical delay, fracture type and surgical technique, complications, hospital stay, functional outcomes, destination after hospital discharge, and short and long term mortality...
November 2015: Revista Española de Cirugía Ortopédica y Traumatología
Laurie R Archbald-Pannone, Timothy L McMurry, Richard L Guerrant, Cirle A Warren
BACKGROUND: Clostridium difficile infection (CDI) severity has increased, especially among hospitalized older adults. We evaluated clinical factors to predict mortality after CDI. METHODS: We collected data from inpatients diagnosed with CDI at a U.S. academic medical center (HSR-IRB#13630). We evaluated age, Charlson comorbidity index (CCI), whether patients were admitted from a long-term care facility, whether patients were in an intensive care unit (ICU) at the time of diagnosis, white blood cell count (WBC), blood urea nitrogen (BUN), low body mass index, and delirium as possible predictors...
July 1, 2015: American Journal of Infection Control
Arif Nazir, Babar Khan, Steven Counsell, Macey Henderson, Sujuan Gao, Malaz Boustani
BACKGROUND: Impact of geriatric consultative services (GCS) on hospital readmission and mortality outcomes for cognitively impaired (CI) patients is not known. OBJECTIVE: Evaluate impact of GCS on hospital readmission and mortality among CI inpatients. DESIGN: Secondary data analysis of a prospective trial of a computerized decision support system between July 1, 2006 and May 30, 2008. SETTING: Study conducted at Eskenazi hospital, Indianapolis, Indiana, a 340-bed, public hospital with over 2300 yearly admissions of patients ages 65 years or older...
May 2015: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Janet E Shu, Austin Lin, Grace Chang
BACKGROUND: Optimizing alcohol withdrawal treatment is a clinical priority, yet it is difficult to predict on presentation which patients would require benzodiazepines or in which patients withdrawal would be complicated. Detoxification studies typically exclude patients with medical comorbidities, psychiatric comorbidities, or multiple substance use disorders; therefore, it is difficult to generalize their conclusions to all types of patients. OBJECTIVE: This retrospective study with no exclusion criteria identifies the risk factors for complicated withdrawal...
September 2015: Psychosomatics
Pilar Sáez López, Natalia Sánchez Hernández, Sonsoles Paniagua Tejo, José Antonio Valverde García, Margarita Montero Díaz, Noelia Alonso García, Alfonso Freites Esteve
INTRODUCTION: Hip fracture in the elderly often occurs in patients with high co-morbidity. Effective management requires a comprehensive and multidisciplinary approach. PURPOSE: To evaluate the effect of a quality improvement intervention in the detection and treatment of complications in elderly patients admitted for hip fracture. MATERIAL AND METHODS: A comparative study was conducted between two groups of patients admitted for hip fracture prior to 2010, and after a quality improvement intervention in 2013...
July 2015: Revista Española de Geriatría y Gerontología
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