Delirium markers in older fallers: a case-control study

Delirium markers in older fallers: a case-control study

Kelly Doherty,1 Elizabeth Archambault,1 Brittany Kelly,1,2 James L Rudolph1,3,4 1Geriatric Research, Education, and Clinical Center, VA Boston Healthcare System, Boston, MA, USA; 2School of Nursing, Science & Health Professions, Regis College, Boston, MA, USA; 3Division of Aging, Brigham an...

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Autores principales: Doherty K, Archambault E, Kelly B, Rudolph JL
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2014
Materias:
Delirium
Geriatrics
Patient Safety
Patient Centered Outcomes Research
RC952-954.6
Acceso en línea:https://doaj.org/article/026f384fbec74a08bca23a8dc8ffaada
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spelling oai:doaj.org-article:026f384fbec74a08bca23a8dc8ffaada2021-12-02T02:32:56ZDelirium markers in older fallers: a case-control study1178-1998https://doaj.org/article/026f384fbec74a08bca23a8dc8ffaada2014-11-01T00:00:00Zhttps://www.dovepress.com/delirium-markers-in-older-fallers-a-case-controlnbspstudy-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Kelly Doherty,1 Elizabeth Archambault,1 Brittany Kelly,1,2 James L Rudolph1,3,4 1Geriatric Research, Education, and Clinical Center, VA Boston Healthcare System, Boston, MA, USA; 2School of Nursing, Science & Health Professions, Regis College, Boston, MA, USA; 3Division of Aging, Brigham and Women’s Hospital, Boston, MA, USA; 4Harvard Medical School, Boston, MA, USA Background: When a hospitalized older patient falls or develops delirium, there are significant consequences for the patient and the health care system. Assessments of inattention and altered consciousness, markers for delirium, were analyzed to determine if they were also associated with falls. Methods: This retrospective case-control study from a regional tertiary Veterans Affairs referral center identified falls and delirium risk factors from quality databases from 2010 to 2012. Older fallers with complete delirium risk assessments prior to falling were identified. As a control, non-fallers were matched at a 3:1 ratio. Admission risk factors that were compared in fallers and non-fallers included altered consciousness, cognitive performance, attention, sensory deficits, and dehydration. Odds ratio (OR) was reported (95% confidence interval [CI]). Results: After identifying 67 fallers, the control population (n=201) was matched on age (74.4±9.8 years) and ward (83.6% medical; 16.4% intensive care unit). Inattention as assessed by the Months of the Year Backward test was more common in fallers (67.2% versus 50.8%, OR=2.0; 95% CI: 1.1–3.7). Fallers tended to have altered consciousness prior to falling (28.4% versus 12.4%, OR=2.8; 95% CI: 1.3–5.8). Conclusion: In this case-control study, alterations in consciousness and inattention, assessed prior to falling, were more common in patients who fell. Brief assessments of consciousness and attention should be considered for inclusion in fall prediction. Keywords: geriatrics, patient centered outcomes research, patient safetyDoherty KArchambault EKelly BRudolph JLDove Medical PressarticleDeliriumGeriatricsPatient SafetyPatient Centered Outcomes ResearchGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 2013-2018 (2014)
institution DOAJ
collection DOAJ
language EN
topic Delirium
Geriatrics
Patient Safety
Patient Centered Outcomes Research
Geriatrics
RC952-954.6
spellingShingle Delirium
Geriatrics
Patient Safety
Patient Centered Outcomes Research
Geriatrics
RC952-954.6
Doherty K
Archambault E
Kelly B
Rudolph JL
Delirium markers in older fallers: a case-control study
description Kelly Doherty,1 Elizabeth Archambault,1 Brittany Kelly,1,2 James L Rudolph1,3,4 1Geriatric Research, Education, and Clinical Center, VA Boston Healthcare System, Boston, MA, USA; 2School of Nursing, Science & Health Professions, Regis College, Boston, MA, USA; 3Division of Aging, Brigham and Women’s Hospital, Boston, MA, USA; 4Harvard Medical School, Boston, MA, USA Background: When a hospitalized older patient falls or develops delirium, there are significant consequences for the patient and the health care system. Assessments of inattention and altered consciousness, markers for delirium, were analyzed to determine if they were also associated with falls. Methods: This retrospective case-control study from a regional tertiary Veterans Affairs referral center identified falls and delirium risk factors from quality databases from 2010 to 2012. Older fallers with complete delirium risk assessments prior to falling were identified. As a control, non-fallers were matched at a 3:1 ratio. Admission risk factors that were compared in fallers and non-fallers included altered consciousness, cognitive performance, attention, sensory deficits, and dehydration. Odds ratio (OR) was reported (95% confidence interval [CI]). Results: After identifying 67 fallers, the control population (n=201) was matched on age (74.4±9.8 years) and ward (83.6% medical; 16.4% intensive care unit). Inattention as assessed by the Months of the Year Backward test was more common in fallers (67.2% versus 50.8%, OR=2.0; 95% CI: 1.1–3.7). Fallers tended to have altered consciousness prior to falling (28.4% versus 12.4%, OR=2.8; 95% CI: 1.3–5.8). Conclusion: In this case-control study, alterations in consciousness and inattention, assessed prior to falling, were more common in patients who fell. Brief assessments of consciousness and attention should be considered for inclusion in fall prediction. Keywords: geriatrics, patient centered outcomes research, patient safety
format article
author Doherty K
Archambault E
Kelly B
Rudolph JL
author_facet Doherty K
Archambault E
Kelly B
Rudolph JL
author_sort Doherty K
title Delirium markers in older fallers: a case-control study
title_short Delirium markers in older fallers: a case-control study
title_full Delirium markers in older fallers: a case-control study
title_fullStr Delirium markers in older fallers: a case-control study
title_full_unstemmed Delirium markers in older fallers: a case-control study
title_sort delirium markers in older fallers: a case-control study
publisher Dove Medical Press
publishDate 2014
url https://doaj.org/article/026f384fbec74a08bca23a8dc8ffaada
work_keys_str_mv AT dohertyk deliriummarkersinolderfallersacasecontrolnbspstudy
AT archambaulte deliriummarkersinolderfallersacasecontrolnbspstudy
AT kellyb deliriummarkersinolderfallersacasecontrolnbspstudy
AT rudolphjl deliriummarkersinolderfallersacasecontrolnbspstudy
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