Hospitalisation costs and health related quality of life in delirious patients: a scoping review

Lieshout, Chris van; Schuit, Ewoud; Hermes, Carsten; Kerrigan, Matthew; Frederix, Geert

doi:10.1016/j.zefq.2022.02.001

Cited by 10 publications

(4 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, increased LOS varied between 2.5 and 10.4 additional days. 37 Significantly worse outcomes were observed for patients with delirium in our study, with nearly twice the 30-days mortality rate and a 1.2-fold higher 30-days readmission rate as compared to those without delirium. Delirium has been described as an independent marker for increased mortality among older inpatients up to 12 months post-discharge and shown to be a significant predictor of 30-days hospital readmission.…”

Section: Discussioncontrasting

confidence: 45%

See 1 more Smart Citation

Delirium is significantly associated with hospital frailty risk score derived from administrative data

Lim

Ling

et al. 2023

Int J Geriat Psychiatry

View full text Add to dashboard Cite

Objectives Delirium is highly prevalent in hospitalised older adults, under‐diagnosed and associated with poor outcomes. We aim to determine (i) association of frailty measured using Hospital Frailty Risk Score (HFRS) with delirium, (ii) impact of delirium on mortality, 30‐days readmission, extended length of stay (eLOS) and cost (eCOST). Methods Retrospective cohort study was conducted on 902 older adults ≥75 years discharged from an academic tertiary hospital between March and September 2021. Data was obtained from hospital administrative database. Results Delirium was prevalent in 39.1%, 58.1% were female with mean age 85.3 ± 6.2 years. Patients with delirium were significantly older, had higher HFRS, pneumonia, urinary tract infection (UTI), E.coli and Klebsiella infection, constipation, dehydration, stroke and intracranial bleed, with comorbidities including dementia, diabetes, hypertension, hyperlipidaemia and chronic kidney disease. In‐hospital mortality, 30‐days mortality, 30‐days readmission, median LOS and cost was significantly higher. Delirium was significantly associated with at least intermediate frailty (OR = 3.52; CI = 2.48–4.98), dementia (OR = 2.39; CI = 1.61–3.54), UTI (OR = 1.95; CI = 1.29–2.95), constipation (OR = 2.49; CI = 1.43–4.33), Klebsiella infection (OR = 3.06; CI = 1.28–7.30), dehydration (OR = 2.01; CI = 1.40 ‐ 2.88), 30‐day mortality (OR = 2.52; CI = 1.42–4.47), 30‐day readmission (OR = 2.18; CI = 1.36–3.48), eLOS (OR = 1.80; CI = 1.30–2.49) and eCOST (OR = 1.67; CI = 1.20–2.35). Conclusions Delirium was highly prevalent in older inpatients, and associated with dementia, frailty, increased cost, LOS, 30‐day readmissions and mortality. Hospital Frailty Risk Score had robust association with delirium and can be auto‐populated from electronic medical records. Prospective studies are needed on multicomponent delirium preventive measures in high‐risk groups identified by HFRS in acute care settings.

show abstract

Section: Discussioncontrasting

confidence: 45%

“…In a recent scoping review, there was a wide variation in increased cost associated with delirium ranging from $1532 to $22,269 depending on the country, patient population and healthcare systems. Similarly, increased LOS varied between 2.5 and 10.4 additional days 37 …”

Section: Discussionmentioning

confidence: 93%

Delirium is significantly associated with hospital frailty risk score derived from administrative data

Lim

Ling

et al. 2023

Int J Geriat Psychiatry

View full text Add to dashboard Cite

show abstract

“…Several factors might contribute to delirium underestimation: first, the lack of knowledge among health professionals of delirium (clinical and economic costs) and, secondly, the remuneration system based on the DRG/ROD (diagnosis-related group system, homogeneous clusters of diagnosis) is a classification system for discharged patients based on clusters homogeneous of diagnosis. Delirium is not an appropriate and profitable diagnosis in terms of reimbursement compared to other specific diagnoses [ 32 ], and inaccuracies in a discharge summary are deleterious for patients (hospital readmission and adverse events). However, Chuen and colleagues demonstrated higher rates of delirium documentation than in previous studies [ 17 ].…”

Section: Delirium Assessment and Reporting: From Research To Clinical...mentioning

confidence: 99%

Proposing a Scientific and Technological Approach to the Summaries of Clinical Issues of Inpatient Elderly with Delirium: A Viewpoint

Frisardi

Nicolini²,

Cautero

et al. 2022

Healthcare

View full text Add to dashboard Cite

Background/rationale: Despite mounting evidence about delirium, this complex geriatric syndrome is still not well managed in clinical contexts. The aging population creates a very demanding area for innovation and technology in healthcare. For instance, an outline of an aging-friendly healthcare environment and clear guidance for technology-supported improvements for people at delirium risk are lacking. Objective: We aimed to foster debate about the importance of technical support in optimizing healthcare professional practice and improving the outcomes for inpatients’ at delirium risk. We focused on critical clinical points in the field of delirium worthy of being addressed by a multidisciplinary approach. Methods: Starting from a consensus workshop sponsored by the Management Perfectioning Course based at the Marco Biagi Foundation (Modena, Italy) about clinical issues related to delirium management still not addressed in our healthcare organizations, we developed a requirements’ analysis among the representatives of different disciplines and tried to formulate how technology could support the summaries of the clinical issues. We analyzed the national and international panorama by a PubMed consultation of articles with the following keywords in advanced research: “delirium”, “delirium management”, “technology in healthcare”, and “elderly population”. Results: Despite international recommendations, delirium remains underdiagnosed, underdetected, underreported, and mismanaged in the acute hospital, increasing healthcare costs, healthcare professionals’ job distress, and poor clinical outcomes. Discussion: Although all healthcare professionals recognize delirium as a severe and potentially preventable source of morbidity and mortality for hospitalized older people, it receives insufficient attention in resource allocation and multidisciplinary research. We synthesized how tech-based tools could offer potential solutions to the critical clinical points in delirium management.

show abstract

“… 1 , 7 – 10 Multiple studies have also shown that patients with delirium have longer lengths of hospital stay. 11 – 13 …”

Section: Introductionmentioning

confidence: 99%

Development and evaluation of a concise nurse-driven non-pharmacological delirium reduction workflow for hospitalized patients: An interrupted time series study.

Harrison,

Rathfon,

Binford

et al. 2024

Geriatric Nursing

View full text Add to dashboard Cite

Hospitalisation costs and health related quality of life in delirious patients: a scoping review

Cited by 10 publications

References 41 publications

Delirium is significantly associated with hospital frailty risk score derived from administrative data

Delirium is significantly associated with hospital frailty risk score derived from administrative data

Proposing a Scientific and Technological Approach to the Summaries of Clinical Issues of Inpatient Elderly with Delirium: A Viewpoint

Development and evaluation of a concise nurse-driven non-pharmacological delirium reduction workflow for hospitalized patients: An interrupted time series study.

Contact Info

Product

Resources

About