Prognostic Value and Risk Factors of Delirium in Emergency Patients With Decompensated Heart Failure

Rizzi, Miguel Alberto; Bonafonte, Olga H. Torres; Alquézar, Aitor; Herrera, Sergio; Piñera, Pascual; Puig, Mireia; Benito, S.; Ruiz, Domingo

doi:10.1016/j.jamda.2015.06.006

Cited by 20 publications

(23 citation statements)

References 33 publications

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“…Delirium, defined as an acute disturbance in attention and awareness that develops over a short period of time, is highly prevalent among older adults with acute HF. Approximately 15% of older adults presenting to the emergency department for management of acute HF have delirium (63), with approximately 17% to 23% experiencing delirium during the hospitalization (64,65). Those with delirium are more likely to have dementia and functional dependence.…”

Section: Deliriummentioning

confidence: 99%

“…Those with delirium are more likely to have dementia and functional dependence. Their outcomes are poor, with increased risk for placement in a nursing home after discharge, hospital readmission, in-patient mortality, and 30-day post-discharge mortality (63)(64)(65). Management of delirium in older adults with acute HF in the hospital setting may be challenging, but its cornerstone is a multicomponent nonpharmacological approach that includes reorientation, early mobilization, therapeutic activities, nutrition, sleep strategies, and hearing and vision adaptations (66).…”

Section: Deliriummentioning

confidence: 99%

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Domain Management Approach to Heart Failure in the Geriatric Patient

Gorodeski

Goyal

Hummel

et al. 2018

Journal of the American College of Cardiology

174

151

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Heart failure (HF) is a quintessential geriatric cardiovascular condition, with more than 50% of hospitalizations occurring in adults age 75 years or older. In older patients, HF is closely linked to processes inherent to aging, which include cellular and structural changes to the myocardium, vasculature, and skeletal muscle. In addition, HF cannot be considered in isolation of physical functioning, or without the social, psychological, and behavioral dimensions of illness. The role of frailty, depression, cognitive impairment, nutrition, and goals of care are each uniquely relevant to the implementation and success of medical therapy. In this paper, we discuss a model of caring for older adults with HF through a 4-domain framework that can address the unique multidimensional needs and vulnerabilities of this population. We believe that clinicians who embrace this approach can improve health outcomes for older adults with HF.

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Section: Deliriummentioning

confidence: 99%

Section: Deliriummentioning

confidence: 99%

Domain Management Approach to Heart Failure in the Geriatric Patient

Gorodeski

Goyal

Hummel

et al. 2018

Journal of the American College of Cardiology

174

151

View full text Add to dashboard Cite

show abstract

“…Delirium is the main manifestation of cognitive frailty and frequently appears in hospitalized elderly patients with cognitive impairment. Its presence in patients with decompensated HF has been associated with 30-day mortality [70]. The Confusion Assessment Method (CAM) is a good tool for the identification of delirium [71].…”

Section: Evaluation Of Frailty In Older Patients With Ahfmentioning

confidence: 99%

Practical approach on frail older patients attended for acute heart failure

Martín‐Sánchez

Christ

Miró

et al. 2016

International Journal of Cardiology

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Acute heart failure (AHF) is a multi-organ dysfunction syndrome. In addition to known cardiac dysfunction, non-cardiac comorbidity, frailty and disability are independent risk factors of mortality, morbidity, cognitive and functional decline, and risk of institutionalization. Frailty, a treatable and potential reversible syndrome very common in older patients with AHF, increases the risk of disability and other adverse health outcomes. This position paper highlights the need to identify frailty in order to improve prognosis, the risk–benefits of invasive diagnostic and therapeutic procedures, and the definition of older-person-centered and integrated care plans.

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“…In the ED setting , a diagnosis of delirium in elderly patients in ED was associated with an increased 6‐month mortality rate. Our group found that the presence of altered mental status, although not delirium specifically, in an oncologic ED was independently associated with increased ICU admission and hospital mortality .…”

Section: Introductionmentioning

confidence: 99%

Advance Directives, Hospitalization, and Survival Among Advanced Cancer Patients with Delirium Presenting to the Emergency Department: A Prospective Study

et al. 2017

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Delirium is a devastating condition among advanced cancer patients. Early diagnosis in the emergency department (ED) should improve management of this life-threatening condition. However, delirium is frequently missed by ED clinicians, and the outcome of patients with delirium is unknown. This study finds that delirium assessed by the Confusion Assessment Method or the Memorial Delirium Assessment Scale is associated with poor survival and more hospitalization among advanced cancer patients visiting the ED of a major cancer center, many of whom lack advance directives. Therefore, delirium in ED patients with cancer should trigger discussion about advance directives.

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Prognostic Value and Risk Factors of Delirium in Emergency Patients With Decompensated Heart Failure

Cited by 20 publications

References 33 publications

Domain Management Approach to Heart Failure in the Geriatric Patient

Domain Management Approach to Heart Failure in the Geriatric Patient

Practical approach on frail older patients attended for acute heart failure

Advance Directives, Hospitalization, and Survival Among Advanced Cancer Patients with Delirium Presenting to the Emergency Department: A Prospective Study

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