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Age Ageing. 2012 May;41(3):412-6. doi: 10.1093/ageing/afs021. Epub 2012 Mar 4.

The impact of frailty and delirium on mortality in older inpatients.

Author information

1
Department of Geriatric Medicine, Cardiff University, Cardiff, UK. elizabeta.mukaetova-ladinska@ncl.ac.uk

Abstract

BACKGROUND:

delirium and frailty are common among hospitalised older people but delirium is often missed and frailty considered difficult to measure in clinical practice.

OBJECTIVE:

to explore the relationship between delirium and frailty in older inpatients and determine their impact on survival.

DESIGN AND SETTING:

the prospective cohort study of 273 patients aged ≥75 years.

MEASURES:

patients were screened for delirium at presentation and on alternate days throughout their hospital stay. Frailty status was measured by an index of accumulated deficits (FI), giving a potential score from 0 (no deficits) to 1.0 (all 33 deficits), with 0.25 used as the cut-off between 'fit' and 'frail'.

RESULTS:

delirium was detected in 102 patients (mean FI: 0.33) and excluded in 171 (mean FI: 0.18) (P < 0.005); 111 patients were frail. Among patients with delirium, the median survival in fit patients was 359 days (95% CI: 118-600) compared with 88 days for those who were frail (95% CI: 5-171; P < 0.05).

CONCLUSION:

delirium was associated with higher levels of frailty: the identification of frail patients may help to target those at a greatest risk of delirium. Survival following delirium was poor with the combination of frailty and delirium conferring a particularly bleak prognosis.

PMID:
22391613
DOI:
10.1093/ageing/afs021
[Indexed for MEDLINE]

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