3 results
Search Results
2. Geriatric syndromes and functions in older adults with COVID-19 hospitalized in sub-acute care: a multicenter study.
- Author
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Morandi, Alessandro, Gual, Neus, Cesari, Matteo, Mota, Miriam, Buttò, Valeria, Gentile, Simona, Balestreri, Genny, Camussi, Alessandro, Platto, Caterina, Roig, Thais, de Andrés, Ana M., Bellelli, Giuseppe, and Inzitari, Marco
- Subjects
RESEARCH ,COVID-19 ,SYNDROMES ,SCIENTIFIC observation ,FRAIL elderly ,CONFIDENCE intervals ,MULTIVARIATE analysis ,CONVALESCENCE ,GERIATRIC assessment ,SUBACUTE care ,SEVERITY of illness index ,SEX distribution ,HOSPITAL care of older people ,DELIRIUM ,LOGISTIC regression analysis ,ODDS ratio ,BARTHEL Index ,LONGITUDINAL method ,COMORBIDITY - Abstract
Objective: Alternatives to conventional acute hospitalizations have been particularly useful during the COVID-19 pandemic. However, little is known on the management and outcomes of COVID-19 in older patient admitted to non-acute settings. The main aim of this study was to determine the effect of geriatrics syndromes on functional outcomes in older COVID-19 patients cared in sub-acute units. Methods: Prospective multicenter observational cohort study of patients aged 65 years and older with COVID-19, admitted to sub-acute units in Italy and Spain. Multivariable logistic regression models were used to test the association between geriatric syndromes and other clinical variables, and the functional status at discharge, defined by a Barthel Index > = 80. Results: A total of 158 patients were included in the study with a median age of 82 [Interquartile Range 81, 83]; of these 102 (65%) patients had a Barthel Index ≥ 80 at discharge. In the main multivariable logistic regression model a higher severity of frailty-measured with the Clinical Frailty Scale—(OR 0.30; CI 0.18–0.47), and the presence of delirium (OR 0.04; CI 0.00–0.35) at admission were associated with lower odds of a higher functional status at discharge. Other variables associated with lower functional status were female gender (OR 0.36; CI 0.13–0.96), and a higher number of comorbidities (OR 0.48; CI 0.26–0.82). Conclusion: The study reports a relatively high prevalence of functional recovery for older COVID-19 patients admitted to sub-acute units. Additionally, it underlines the importance of targeting geriatrics syndromes, in particular frailty and delirium, for their possible effects on functional recovery. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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3. Factors Associated with Delirium in COVID-19 Patients and Their Outcome: A Single-Center Cohort Study.
- Author
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Di Giorgio, Annabella, Mirijello, Antonio, De Gennaro, Clara, Fontana, Andrea, Alboini, Paolo Emilio, Florio, Lucia, Inchingolo, Vincenzo, Zarrelli, Michele, Miscio, Giuseppe, Raggi, Pamela, Marciano, Carmen, Antonioni, Annibale, De Cosmo, Salvatore, Aucella, Filippo, Greco, Antonio, Carella, Massimo, Copetti, Massimiliano, and Leone, Maurizio A.
- Subjects
CORONAVIRUS diseases ,COVID-19 ,DELIRIUM ,PROPORTIONAL hazards models ,GLASGOW Coma Scale ,COHORT analysis - Abstract
Background: A significant proportion of patients with coronavirus disease 2019 (COVID-19) suffer from delirium during hospitalization. This single-center observational study investigates the occurrence of delirium, the associated risk factors and its impact on in-hospital mortality in an Italian cohort of COVID 19 inpatients. Methods: Data were collected in the COVID units of a general medical hospital in the South of Italy. Socio-demographic, clinical and pharmacological features were collected. Diagnosis of delirium was based on a two-step approach according to 4AT criteria and DSM5 criteria. Outcomes were: dates of hospital discharge, Intensive Care Unit (ICU) admission, or death, whichever came first. Univariable and multivariable proportional hazards Cox regression models were estimated, and risks were reported as hazard ratios (HR) along with their 95% confidence intervals (95% CI). Results: A total of 47/214 patients (22%) were diagnosed with delirium (21 hypoactive, 15 hyperactive, and 11 mixed). In the multivariable model, four independent variables were independently associated with the presence of delirium: dementia, followed by age at admission, C-reactive protein (CRP), and Glasgow Coma Scale. In turn, delirium was the strongest independent predictor of death/admission to ICU (composite outcome), followed by Charlson Index (not including dementia), CRP, and neutrophil-to-lymphocyte ratio. The probability of reaching the composite outcome was higher for patients with the hypoactive subtype than for those with the hyperactive subtype. Conclusions: Delirium was the strongest predictor of poor outcome in COVID-19 patients, especially in the hypoactive subtype. Several clinical features and inflammatory markers were associated with the increased risk of its occurrence. The early recognition of these factors may help clinicians to select patients who would benefit from both non-pharmacological and pharmacological interventions in order to prevent delirium, and in turn, reduce the risk of admission to ICU or death. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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