Persistent delirium predicts greater mortality

Dan K. Kiely, Edward R. Marcantonio, Sharon K. Inouye, Michele L. Shaffer, Margaret A. Bergmann, Frances M. Yang, Michael A. Fearing, Richard N. Jones

Research output: Contribution to journalArticle

116 Citations (Scopus)

Abstract

OBJECTIVES: To examine the association between persistent delirium and 1-year mortality in newly admitted post-acute care (PAC) facility patients with delirium who were followed regardless of residence. DESIGN: Observational cohort study. SETTING: Eight greater-Boston skilled nursing facilities specializing in PAC. PARTICIPANTS: Four hundred twelve PAC patients with delirium at admission after an acute hospitalization. MEASUREMENTS: Assessments were done at baseline and four follow-up times: 2, 4, 12, and 26 weeks. Delirium, defined using the Confusion Assessment Method, was assessed, as were factors used as covariates in analyses: age, sex, comorbidity, functional status, and dementia. The outcome was 1-year mortality determined according to the National Death Index and corroborated using medical record and proxy telephone interview. RESULTS: Nearly one-third of subjects remained delirious at 6 months. Cumulative 1-year mortality was 39%. Independent of age, sex, comorbidity, functional status, and dementia, subjects with persistent delirium were 2.9 (95% confidence interval=1.9-4.4) times as likely to die during the 1-year follow-up as subjects whose delirium resolved. This association remained strong and significant in groups with and without dementia. Additionally, when delirium resolved, the risk of death diminished thereafter. CONCLUSION: In patients who were delirious at the time of PAC admission, persistent delirium was a significant independent predictor of 1-year mortality.

Original languageEnglish (US)
Pages (from-to)55-61
Number of pages7
JournalJournal of the American Geriatrics Society
Volume57
Issue number1
DOIs
StatePublished - Jan 1 2009

Fingerprint

Delirium
Subacute Care
Mortality
Dementia
Comorbidity
Skilled Nursing Facilities
Confusion
Proxy
Medical Records
Observational Studies
Hospitalization
Cohort Studies
Confidence Intervals
Interviews

Keywords

  • Delirium
  • Mortality
  • Post-acute care
  • Survival

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Kiely, D. K., Marcantonio, E. R., Inouye, S. K., Shaffer, M. L., Bergmann, M. A., Yang, F. M., ... Jones, R. N. (2009). Persistent delirium predicts greater mortality. Journal of the American Geriatrics Society, 57(1), 55-61. https://doi.org/10.1111/j.1532-5415.2008.02092.x

Persistent delirium predicts greater mortality. / Kiely, Dan K.; Marcantonio, Edward R.; Inouye, Sharon K.; Shaffer, Michele L.; Bergmann, Margaret A.; Yang, Frances M.; Fearing, Michael A.; Jones, Richard N.

In: Journal of the American Geriatrics Society, Vol. 57, No. 1, 01.01.2009, p. 55-61.

Research output: Contribution to journalArticle

Kiely, DK, Marcantonio, ER, Inouye, SK, Shaffer, ML, Bergmann, MA, Yang, FM, Fearing, MA & Jones, RN 2009, 'Persistent delirium predicts greater mortality', Journal of the American Geriatrics Society, vol. 57, no. 1, pp. 55-61. https://doi.org/10.1111/j.1532-5415.2008.02092.x
Kiely DK, Marcantonio ER, Inouye SK, Shaffer ML, Bergmann MA, Yang FM et al. Persistent delirium predicts greater mortality. Journal of the American Geriatrics Society. 2009 Jan 1;57(1):55-61. https://doi.org/10.1111/j.1532-5415.2008.02092.x
Kiely, Dan K. ; Marcantonio, Edward R. ; Inouye, Sharon K. ; Shaffer, Michele L. ; Bergmann, Margaret A. ; Yang, Frances M. ; Fearing, Michael A. ; Jones, Richard N. / Persistent delirium predicts greater mortality. In: Journal of the American Geriatrics Society. 2009 ; Vol. 57, No. 1. pp. 55-61.
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