Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica

Background: Delirium is a prevalent problem among older patients and it is frequently underdiagnosed. Aim: To develop and validate a clinical predictive model to identify patients at high risk of delirium. Material and Methods: Two consecutive prospective cohort studies were used to develop and vali...

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Autores principales:	Carrasco G,Marcela, Villarroel D,Luis, Calderón P,Jorge, Martínez F,Gabriel, Andrade A,Maricarmen, González T,Matías
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2014
Materias:	Aged Delirium Inpatients
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872014000700002
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spelling	oai:scielo:S0034-988720140007000022014-12-10Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínicaCarrasco G,MarcelaVillarroel D,LuisCalderón P,JorgeMartínez F,GabrielAndrade A,MaricarmenGonzález T,Matías Aged Delirium Inpatients Background: Delirium is a prevalent problem among older patients and it is frequently underdiagnosed. Aim: To develop and validate a clinical predictive model to identify patients at high risk of delirium. Material and Methods: Two consecutive prospective cohort studies were used to develop and validate the model. The development cohort included 542 consecutive medical inpatients, 65 years or older. The validation cohort included 85 comparable patients. A predictive score was constructed with a multivariate analysis, using variables independently associated with delirium and subsequently tested in the new cohort. Patients were assessed within the first 48 hours of admission, and every 48 hours thereafter, using the Confusion Assessment Method to diagnose delirium, evaluating also the severity of underlying disease, comorbidities, functionality, and laboratory data. Results: Delirium occurred in 192 patients (35.4%) of the development cohort and was independently associated with age and functional status assessed using the Barthel Index. With these two variables, the predictive score for delirium was developed and tested rendering an area under the receiver operating characteristic (ROC) of 0.80 (confidence intervals 0.77-0.85). Cut-off points were chosen to establish low, intermediate, and high-risk groups for delirium. According to these cut-off points, delirium frequencies in the development cohort were 8%, 23%, and 69%, and in the validation cohort 5%, 34%, and 66%, respectively (c² p < 0.05). Conclusions: This simple predictive model based on age and functional status may be a useful tool for identifying older patients risking delirium.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.142 n.7 20142014-07-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872014000700002es10.4067/S0034-98872014000700002
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Aged Delirium Inpatients
spellingShingle	Aged Delirium Inpatients Carrasco G,Marcela Villarroel D,Luis Calderón P,Jorge Martínez F,Gabriel Andrade A,Maricarmen González T,Matías Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica
description	Background: Delirium is a prevalent problem among older patients and it is frequently underdiagnosed. Aim: To develop and validate a clinical predictive model to identify patients at high risk of delirium. Material and Methods: Two consecutive prospective cohort studies were used to develop and validate the model. The development cohort included 542 consecutive medical inpatients, 65 years or older. The validation cohort included 85 comparable patients. A predictive score was constructed with a multivariate analysis, using variables independently associated with delirium and subsequently tested in the new cohort. Patients were assessed within the first 48 hours of admission, and every 48 hours thereafter, using the Confusion Assessment Method to diagnose delirium, evaluating also the severity of underlying disease, comorbidities, functionality, and laboratory data. Results: Delirium occurred in 192 patients (35.4%) of the development cohort and was independently associated with age and functional status assessed using the Barthel Index. With these two variables, the predictive score for delirium was developed and tested rendering an area under the receiver operating characteristic (ROC) of 0.80 (confidence intervals 0.77-0.85). Cut-off points were chosen to establish low, intermediate, and high-risk groups for delirium. According to these cut-off points, delirium frequencies in the development cohort were 8%, 23%, and 69%, and in the validation cohort 5%, 34%, and 66%, respectively (c² p < 0.05). Conclusions: This simple predictive model based on age and functional status may be a useful tool for identifying older patients risking delirium.
author	Carrasco G,Marcela Villarroel D,Luis Calderón P,Jorge Martínez F,Gabriel Andrade A,Maricarmen González T,Matías
author_facet	Carrasco G,Marcela Villarroel D,Luis Calderón P,Jorge Martínez F,Gabriel Andrade A,Maricarmen González T,Matías
author_sort	Carrasco G,Marcela
title	Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica
title_short	Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica
title_full	Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica
title_fullStr	Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica
title_full_unstemmed	Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica
title_sort	riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica
publisher	Sociedad Médica de Santiago
publishDate	2014
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872014000700002
work_keys_str_mv	AT carrascogmarcela riesgodedeliriumdurantelahospitalizacionenpersonasmayoresdesarrolloyvalidaciondeunmodelodeprediccionclinica AT villarroeldluis riesgodedeliriumdurantelahospitalizacionenpersonasmayoresdesarrolloyvalidaciondeunmodelodeprediccionclinica AT calderonpjorge riesgodedeliriumdurantelahospitalizacionenpersonasmayoresdesarrolloyvalidaciondeunmodelodeprediccionclinica AT martinezfgabriel riesgodedeliriumdurantelahospitalizacionenpersonasmayoresdesarrolloyvalidaciondeunmodelodeprediccionclinica AT andradeamaricarmen riesgodedeliriumdurantelahospitalizacionenpersonasmayoresdesarrolloyvalidaciondeunmodelodeprediccionclinica AT gonzaleztmatias riesgodedeliriumdurantelahospitalizacionenpersonasmayoresdesarrolloyvalidaciondeunmodelodeprediccionclinica
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Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica

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