Journal of Alzheimer's Disease
Published on Journal of Alzheimer's Disease (https://www.j-alz.com)

Home > The In-Hospital Length of Stay after Hip Fracture in Octogenarians: Do Delirium and Dementia Shape a New Care Process?

TitleThe In-Hospital Length of Stay after Hip Fracture in Octogenarians: Do Delirium and Dementia Shape a New Care Process?
Publication TypeJournal Article
Year of Publication2018
AuthorsMonacelli, F, Pizzonia, M, Signori, A, Nencioni, A, Giannotti, C, Minaglia, C, di Casaleto, TGranello, Podestà, S, Santolini, F, Odetti, P
JournalJ Alzheimers Dis
Volume66
Issue1
Pagination281-288
Date Published2018
ISSN1875-8908
Abstract

BACKGROUND: Hip fracture is a major health problem and a patient's biological age, comorbidity, and cognitive vulnerability have an impact on its related outcomes. Length of stay (LOS) for these highly vulnerable patients is rather long and the possible causes have not been clearly identified yet.

OBJECTIVE: We aimed to assess the main clinical factors associated with protracted LOS, focusing on delirium with or without dementia in older age hip fractured patients.

METHODS: 218 subjects (mean age 86.70±6.18 years), admitted to the Orthogeriatric Unit of the Ospedale Policlinico San Martino (Italy), were recruited. All patients received physical and comprehensive geriatric assessment. Days to surgery, days from surgery to rehabilitation, and LOS were recorded. In-hospital and three months' mortality were reported.

RESULTS: Prevalent delirium at hospital admission was of 3.1%. 35% of patients developed incident delirium. 56.4% were affected by dementia of Alzheimer-type. In addition, 52% of patients developed delirium superimposed to dementia. Mean LOS was 13.5±4.99 days. Namely, delirium, time to surgery, and complication rate disproportionally affected LOS. The analysis with 3 months mortality, based on cognitive vulnerability profiles, showed how delirium mainly affect short-term mortality in patients with dementia.

CONCLUSION: Our exploratory study originally pointed out the high incidence of delirium superimposed to dementia in orthogeriatric wards and how delirium turns to be a moderator of LOS. The results meet the need for additional research by virtue of a deeper understanding of the impact of delirium and dementia on orthogeriatric clinical management and outcomes.

DOI10.3233/JAD-180153
Alternate JournalJ. Alzheimers Dis.
PubMed ID30248051
E-mail Icon
Comment Icon
  • Comment
Bookmark Icon Bookmark Recommend Icon Recommend Follow Icon Follow
  • Comment
| Bookmark | Recommend | Follow

Source URL: https://www.j-alz.com/content/hospital-length-stay-after-hip-fracture-octogenarians-do-delirium-and-dementia-shape-new