Delirium is associated with 5-fold increased mortality in acute ...

Sophia Antipolis, 16 March 2017: Delirium is associated with a five-fold increase in mortality in acute cardiac patients, according to ... Didyouknowthatyourbrowserisoutofdate?Togetthebestexperienceusingourwebsitewerecommendthatyouupgradetoanewerversion.Learnmore. Shownavigation Hidenavigation EuropeanSocietyofCardiology TheESC ESCPressOffice Pressreleases Submenu ESCPressOffice Pressreleases PressServices&MediaAlerts ESCCongresses Factsheets ESCMediaandEmbargoPolicy   Deliriumisassociatedwith5-foldincreasedmortalityinacutecardiacpatients 16Mar2017 Topic(s): AcuteCardiacCare SophiaAntipolis,16March2017:Deliriumisassociatedwithafive-foldincreaseinmortalityinacutecardiacpatients,accordingtoresearchpublishedtodayinEuropeanHeartJournal:AcuteCardiovascularCare.1Deliriumwascommonandaffectedoverhalfofacutecardiacpatientsaged85yearsandolder. Deliriumisaclinicalsyndromecausedbyadisturbanceinthenormalfunctioningofthebrain.Deliriouspatientsarelessawareof,andresponsiveto,theirenvironment.Theycanbedisorientated,incoherent,andinadream-likestate,withhallucinations,disorderedspeechandmemorydisturbances. Deliriumaffectsatleastoneintenhospitalisedpatientsandismorecommonintheelderly.Thesepatientshaveworselong-termprognosisandmorecomplicationsduringtheirhospitalstay. “Amonghospitalisedpatients,thoseadmittedtoanintensivecareunitaremorelikelytodevelopdeliriumandtherearestrategiestolimititsconsequences,”saidleadauthorDrGiovanniFalsini,interventionalcardiologist,SanDonatoHospital,Arezzo,Italy.“Lessisknownaboutdeliriumanditssignificanceinpatientsadmittedtocardiacintensivecareunits.Thisstudyinvestigatedtheincidenceandclinicalimpactofdeliriuminpatientswithacutecardiacdiseases.” Thestudyincludedallpatientsaged65yearsandolderadmittedtotwocardiacintensivecareunitsduringaperiodof15months.Onlynon-intubatedpatientswereenrolled.Validatedscoresystemsandquestionnaireswereusedtodetectanddiagnosethepresenceofdeliriumatadmissionorduringthehospitalstay. Deliriouspatientswerecloselyfollowedbynursingandmedicalstaffwhousedaflowchartfordeliriumtreatment.Thisincludedtreatingpainandanxiety,anddiscontinuingmedicationsknowntocausedelirium.Patientsurvivalatsixmonthswasdeterminedbytelephonecall. Theinvestigatorsfoundthatdeliriumwasafrequentconditionamongelderlypatientswithacutecardiacdiseases.Thestudypopulationconsistedof726patientswithanaverageageof79years,ofwhom15%haddelirium(atadmissionorduringthehospitalstay).Morethanhalf(52%)ofpatientsaged85yearsandolderweredelirious. Patientswithdeliriumhadaworseprognosis,withafive-foldincreaseinbothin-hospitaland30-daymortalityandatwo-foldincreaseinsix-monthmortality.Deliriumwasnotonlyastrongandindependentfactorinpredictingmortality,butwasalsoassociatedwithlongerhospitalstayandmorefrequentrehospitalisationsduringfollow-up. “Deliriumisacommonandseriousconditioninacutecardiacpatients,”saidDrFalsini.“Theystayinhospitallonger,returntohospitalmoreoften,andaremorelikelytodieintheshort-andlong-term.” DrFalsinisaidelderlypatientsmaybeathigherriskbecausetheyusuallyhavepre-existingissuesthatcanpredisposetodeliriumsuchasdementia,visualandhearingimpairments,depression,useofpsychoactivedrugs,infections,orelectrolytedisturbances. Hesaid:“Themorecomplexandfrailthepatientis,thehighertherateofdeliriumandsubsequentworseoutcomes.Itisunknownwhetherdeliriumcanbetreatedtoimproveprognosisincriticallyillpatients,orwhetheritisamarkeroforgandysfunctionorsystemicdiseaseandanearlysignthatcomplicationsarelikely.Monitoringdeliriumhasbeenlinkedwithreducedin-hospitalmortalityinmechanicallyventilatedpatientsanditispossiblethatsimilarbenefitmightoccurinacutenon-intubatedpatients.” DrFalsiniconcluded:“Deliriumiscommon,serious,costlyandunder-recognised.Aprotocolisneededtoidentifyandtreatdeliriuminhigh-risksettings,likecardiacintensivecareunits.” ENDS Notestoeditor ESCPressOfficeTel:+33(0)489873483Email:[email protected] SOURCESOFFUNDING:None. DISCLOSURES:None.References1FalsiniG,etal.Long-termprognosticvalueofdeliriuminelderlypatientswithacutecardiacdiseasesadmittedtotwocardiacintensivecareunits:aprospectivestudy(DELIRIUMCORDIS).EuropeanHeartJournal:AcuteCardiovascularCare.2017.DOI:10.1177/2048872617695235AbouttheEuropeanSocietyofCardiology TheESCbringstogetherhealthcareprofessionalsfrommorethan140countries,workingtoadvancecardiovascularmedicineandhelppeopletolivelonger,healthierlives. Ourmission:Toreducetheburdenofcardiovasculardisease.