Renal function and delirium in older fracture patients: different information from different formulas?

Mossello, Enrico; Rivasi, Giulia; Tortù, Virginia; Giordano, A.; Iacomelli, Iacopo; Cavallini, Maria Chiara; Rafanelli, Martina; Ceccofiglio, Alice; Cartei, Alessandro; Rostagno, Carlo; Bari, Mauro Di; Ungar, Andrea

doi:10.1016/j.ejim.2019.10.022

Cited by 9 publications

(8 citation statements)

References 50 publications

(58 reference statements)

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“…In line with our results, Mitchell et al (2017) showed that delirium in hospital had an as-sociation with all-cause one-year mortality following hip fracture in older cases with no dementia (31). Also, similar to previous studies, the other underlying factors can affect mortality rate including cancer (32), hepatic (33), renal (34), and hematologic diseases (35,36).…”

Section: Discussionsupporting

confidence: 90%

Cognitive Dysfunction and Survival in Hospitalized Patients with Delirium: A 12-Month Prospective Cohort Study

et al. 2021

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Background: The effect of delirium of hospitalized inpatients on post-discharge cognitive status and survival of older patients remains unclear, and little is known about the related risk factors of cognitive impairment after delirium. Objectives: To determine one-year survival of patients with delirium and cognitive dysfunction in elderly inpatients after initial hospital admission. Methods: This prospective cohort study was conducted on 100 patients with delirium admitted to a general hospital from October 2018 to November 2019. Cognitive dysfunction and death were the primary outcomes. The mini-mental state examination (MMSE) was used to measure cognitive function. Results: In this study, 12 patients died in hospital and cumulative three-month mortality was 40%. Finally, 60 patients were followed for one year. The one-year survival rate through the Kaplan-Meyer approach was 31%. The rate of one-year mortality was found with a significant association with underlying parameters, such as cancer (P = 0.008), cirrhosis (P = 0.04), trauma (P = 0.001), BUN ≥ 50 mg/dL (P = 0.02), Cr ≥ 1.2 mg/dL (P = 0.04), hypocalcemia (P = 0.0), and thrombocytopenia (P = 0.002). According to the MMSE scores, participants had normal cognition (46.7%), mild dementia (6.7%), moderate dementia (33.3%), and severe dementia (3.3%). The cognitive impairment showed a significant association with underlying parameters, such as pulmonary infections (P = 0.02), trauma (P = 0.02), and renal failure (P = 0.04). Conclusions: Assessment and screening for delirium is necessary in all older hospitalized inpatients. Cognitive measurement is effective to identify delirium, accelerate proper control, and decrease its negative effects. Family members should be trained and involved in care, particularly for monitoring of risk factors upon discharge.

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Section: Discussionsupporting

confidence: 90%

Cognitive Dysfunction and Survival in Hospitalized Patients with Delirium: A 12-Month Prospective Cohort Study

et al. 2021

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“…64 Longer LOS increased the risk of opportunistic infections, diminished effective treatment, and increased risk of mortality. 65 In addition, cost of an increased LOS by 1 day due to DSD amounts to at least $21 million a year. 1 Hence, early identification and treatment of DSD is important.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, Risk Factors, and Impact of Delirium on Hospitalized Older Adults With Dementia: A Systematic Review and Meta-Analysis

Han

Rodrigues

Klainin‐Yobas

et al. 2022

Journal of the American Medical Directors Association

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“…As a routine indicator of renal function, the measurement of GFR is often affected by muscle mass. Due to physical weakness, GFR in elderly patients has difficulty in reflecting the real renal function before operation and even overestimates renal metabolic function, while Cystatin C is not affected by age, sex, weight, and inflammatory reaction, so Cystatin C can more sensitively capture the changes of renal function [ 26 ]. The kidney is the main pathway of perioperative metabolism of some drugs, especially anesthesia-related drugs.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors and a Nomogram Model Establishment for Postoperative Delirium in Elderly Patients Undergoing Arthroplasty Surgery: A Single-Center Retrospective Study

Chen

Liu

et al. 2021

BioMed Research International

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Objective. To explore the related risk factors of postoperative delirium (POD) after hip or knee arthroplasty in elderly orthopedic patients and the predictive value of related risk factors. Material and Methods. In total, 309 patients (≥60 years) who received knee and hip arthroplasty between January 2017 and May 2020 were consecutively selected into the POD and nonpostoperative delirium (NPOD) groups. Group bias was eliminated through propensity score matching. Univariate and multivariable logistic analysis was used to determine the risk factors for POD. The nomogram was made by R. Results. 58 patients were included in each group after propensity score matching; multivariable analysis demonstrated that LDH ( OR = 4.364 , P = 0.017 ), CHE ( OR = 4.640 , P = 0.004 ), Cystatin C ( OR = 5.283 , P = 0.006 ), arrhythmia ( OR = 5.253 , P = 0.002 ), and operation duration ( OR = 1.017 , P = 0.050 ) were independent risk factors of POD. LDH, CHE, Cystatin C, and arrhythmia were used to construct a nomogram to predict the POD. The nomogram was well calibrated and had moderate discriminative ability ( AUC = 0.821 , 95% CI: 0.760~0.883). Decision curve analysis demonstrated that the nomogram was clinically useful. Conclusions. Our study revealed that arrhythmia, operation duration, the increase of lactate dehydrogenase and Cystatin C, and the decrease of cholinesterase were reliable factors for predicting postoperative delirium after elderly hip and knee arthroplasty. Meanwhile, the nomogram we developed can assist the clinician to filtrate potential patients with postoperative delirium.

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Renal function and delirium in older fracture patients: different information from different formulas?

Cited by 9 publications

References 50 publications

Cognitive Dysfunction and Survival in Hospitalized Patients with Delirium: A 12-Month Prospective Cohort Study

Cognitive Dysfunction and Survival in Hospitalized Patients with Delirium: A 12-Month Prospective Cohort Study

Prevalence, Risk Factors, and Impact of Delirium on Hospitalized Older Adults With Dementia: A Systematic Review and Meta-Analysis

Risk Factors and a Nomogram Model Establishment for Postoperative Delirium in Elderly Patients Undergoing Arthroplasty Surgery: A Single-Center Retrospective Study

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