New Cutoff Scores for Delirium Screening Tools to Predict Patient Mortality

Yamanashi, Takehiko; Iwata, Masaaki; Crutchley, Kaitlyn J.; Sullivan, Eleanor J.; Malicoat, Johnny R.; Anderson, Zoe-Ella M.; Marra, Pedro S.; Chang, Gloria; Kaneko, Koichi; Shinozaki, Eri; Lee, Sangil; Shinozaki, Gen

doi:10.1111/jgs.16815

Cited by 15 publications

(25 citation statements)

References 39 publications

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“…We conducted a retrospective cohort study with additional chart review using an existing data collected through previous clinical observational studies of delirium at the University of Iowa Hospitals and Clinics (UIHC) 13 , 14 , 24 . This study was approved by the UIHC Institutional Review Board, and was performed in accordance with relevant guidelines and regulations.…”

Section: Methodsmentioning

confidence: 99%

“…Details of study subjects and enrollment process have been described previously 13 , 14 , 24 . Inclusion criteria was (1) subjects who were admitted to the emergency department, the orthopedics floor, the general medicine floor, or the intensive care unit in UIHC; (2) subjects whose age were from 18 years or older.…”

Section: Methodsmentioning

confidence: 99%

“…We collected clinical data as we described previously 13 , 14 , 24 . Briefly, we obtained demographics information and baseline medical and surgical history from patient interviews and EMRs.…”

Section: Methodsmentioning

confidence: 99%

“…We assessed all-cause mortality from the study participants based on review of their EMRs and obituary records as previously described 14 , 24 . We compared mortality among groups based on status of sepsis and BSEEG score.…”

Section: Methodsmentioning

confidence: 99%

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Mortality among patients with sepsis associated with a bispectral electroencephalography (BSEEG) score

Yamanashi

Marra

Crutchley

et al. 2021

Sci Rep

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We have previously developed a bispectral electroencephalography (BSEEG) device, which was shown to be effective in detecting delirium and predicting patient outcomes. In this study we aimed to apply the BSEEG approach for a sepsis. This was a retrospective cohort study conducted at a single center. Sepsis-positive cases were identified based on retrospective chart review. EEG raw data and calculated BSEEG scores were obtained in the previous studies. The relationship between BSEEG scores and sepsis was analyzed, as well as the relationship among sepsis, BSEEG score, and mortality. Data were analyzed from 628 patients. The BSEEG score from the first encounter (1st BSEEG) showed a significant difference between patients with and without sepsis (p = 0.0062), although AUC was very small indicating that it is not suitable for detection purpose. Sepsis patients with high BSEEG scores showed the highest mortality, and non-sepsis patients with low BSEEG scores showed the lowest mortality. Mortality of non-sepsis patients with high BSEEG scores was as bad as that of sepsis patients with low BSEEG scores. Even adjusting for age, gender, comorbidity, and sepsis status, BSEEG remained a significant predictor of mortality (p = 0.008). These data are demonstrating its usefulness as a potential tool for identification of patients at high risk and management of sepsis.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Mortality among patients with sepsis associated with a bispectral electroencephalography (BSEEG) score

Yamanashi

Marra

Crutchley

et al. 2021

Sci Rep

Self Cite

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“…The DOS was administered three times per day during the first 3 days of admission for all patients in this cohort. The cutoff of ≥3 is commonly used ( 22 ), as it has good screening performance, with a sensitivity of 0.89, a specificity of 0.88, and a high negative predictive value for delirium of almost 100% ( 23 ). The patient data presented here include patients from the cardiology ward.…”

Section: Methodsmentioning

confidence: 99%

Predisposing and Precipitating Risk Factors for Delirium in Elderly Patients Admitted to a Cardiology Ward: An Observational Cohort Study in 1,042 Patients

Zipser

Hildenbrand

Haubner

et al. 2021

Front. Cardiovasc. Med.

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Aim: Although the risk factors for delirium in general medicine are well-established, their significance in cardiac diseases remains to be determined. Therefore, we evaluated the predisposing and precipitating risk factors in patients hospitalized with acute and chronic heart disease.Methods and Results: In this observational cohort study, 1,042 elderly patients (≥65 years) admitted to cardiology wards, 167 with and 875 without delirium, were included. The relevant sociodemographic and cardiac- and medical-related clusters were assessed by simple and multiple regression analyses and prediction models evaluating their association with delirium. The prevalence of delirium was 16.0%. The delirious patients were older (mean 80 vs. 76 years; p < 0.001) and more often institutionalized prior to admission (3.6 vs. 1.4%, p = 0.05), hospitalized twice as long (12 ± 10 days vs. 7 ± 7 days; p < 0.001), and discharged more often to nursing homes (4.8 vs. 0.6%, p < 0.001) or deceased (OR, 2.99; 95% CI, 1.53–5.85; p = 0.003). The most relevant risk factor was dementia (OR, 18.11; 95% CI, 5.77–56.83; p < 0.001), followed by history of stroke (OR, 6.61; 95% CI 1.35–32.44; p = 0.020), and pressure ulcers (OR, 3.62; 95% CI, 1.06–12.35; p = 0.040). The predicted probability for developing delirium was highest in patients with reduced mobility and institutionalization prior to admission (PP = 31.2%, p = 0.001). Of the cardiac diseases, only valvular heart disease (OR, 1.57; 95% CI, 1.01–2.44; p = 0.044) significantly predicted delirium. The patients undergoing cardiac interventions did not have higher rates of delirium (OR, 1.39; 95% CI 0.91–2.12; p = 0.124).Conclusion: In patients admitted to a cardiology ward, age-related functional and cognitive impairment, history of stroke, and pressure ulcers were the most relevant risk factors for delirium. With regards to specific cardiological factors, only valvular heart disease was associated with risk for delirium. Knowing these factors can help cardiologists to facilitate the early detection and management of delirium.

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The Association Between Frailty and Delirium Among Hospitalized Patients: An Updated Meta-Analysis

Zhang

Jiao

Xie

et al. 2021

Journal of the American Medical Directors Association

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New Cutoff Scores for Delirium Screening Tools to Predict Patient Mortality

Cited by 15 publications

References 39 publications

Mortality among patients with sepsis associated with a bispectral electroencephalography (BSEEG) score

Mortality among patients with sepsis associated with a bispectral electroencephalography (BSEEG) score

Predisposing and Precipitating Risk Factors for Delirium in Elderly Patients Admitted to a Cardiology Ward: An Observational Cohort Study in 1,042 Patients

The Association Between Frailty and Delirium Among Hospitalized Patients: An Updated Meta-Analysis

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