Journal of the American Geriatrics Society
-
Randomized Controlled Trial Multicenter Study
Complications in postacute care are associated with persistent delirium.
To investigate whether complications in postacute care (PAC) are associated with delirium persistence 30 days after PAC admission. ⋯ Geriatric syndrome complications are common in individuals admitted to PAC with delirium and are associated with persistence of delirium 1 month later. Proactively addressing risk factors for geriatric syndromes may improve outcomes of vulnerable individuals in PAC.
-
Comparative Study
Screening for cognitive impairment: comparing the performance of four instruments in primary care.
To determine whether brief cognitive screening tests perform as well as a longer screening test in diagnosis of cognitive impairment, no dementia (CIND) or dementia. ⋯ In individuals without a prior diagnosis of cognitive impairment, the prevalence of dementia was low, but the prevalence of CIND was high. The 3MS and Mini-Cog had reasonable performance characteristics for detecting dementia, but a definitive diagnosis requires additional evaluation.
-
To use an expert consensus process to identify indicators of delirium features to help enhance bedside recognition of delirium. ⋯ A systematic, well-described qualitative methodology was used to create a list of indicators for delirium based on the features of the CAM diagnostic algorithm. This indicator list may be useful as a clinical tool for enhancing delirium recognition at the bedside and for aiding in the development of a brief delirium screening instrument.
-
To determine the association between nurse staffing and postsurgical outcomes for older black adults, including 30-day mortality and failure to rescue. ⋯ Older surgical patients experience poorer postsurgical outcomes, including mortality and failure to rescue, when cared for by nurses with higher workloads. The effect of nurse staffing inadequacies is more significant in older black individuals.
-
To ascertain the absolute number of Medicare beneficiaries surviving at least 3 years after severe sepsis and to estimate their burden of cognitive dysfunction and disability. ⋯ Sepsis survivorship, which has substantial long-term morbidity, is a common and rapidly growing public health problem for older Americans. There has been little change in long-term case-fatality, despite changes in practice. Clinicians should anticipate more-frequent sequelae of severe sepsis in their patient populations.