Post-discharge Mortality in Patients With Delirium and Dementia: A 3-Year Follow Up Study

Abstract

BackgroundDelirium and dementia are prominent psychiatric diseases in old age and connected with poor outcomes for people affected. Nevertheless, there is a lack of knowledge concerning the long-term prognosis of patients with dementia and delirium. This study analyzes mortality, readmission rates and discharge destinations of patients with dementia or delirium superimposed on dementia (DSD) within 3 years after discharge from hospital.MethodsA cross-sectional, monocentric cohort study was conducted at the department of geriatric psychiatry of the LVR hospital cologne, using structured telephone interviews and analyses from the clinical information system. All patients with dementia and DSD, admitted between December 2014 and November 2015, were screened for eligibility.ResultsIn total, 113 patients were included, 49 patients with dementia (M 80 years, female 49%) and 64 with DSD (M 82 years, female 47%). Three years after discharge, 66 patients (58%) had died (95% CI 91.9–112.5; p = 0.53). Within the first 3 months, 9 patients (14%) with DSD deceased, but no patient from the dementia group (95% CI 11.3–12.7; p = 0.01). Out of all patients, 17 patients were readmitted and nursing homes were the predominant discharge destination (55%).ConclusionsThis analysis revealed a high post-discharge mortality rate of patients with dementia and DSD. For patients with DSD, a close clinical monitoring, mainly within the first 3 months after discharge, should challenge the significantly increased acute-mortality. These findings should set the pattern for a comprehensive analysis of long-term effects of dementia and DSD. More studies are required for better understanding and comparability in this field of research and healthcare.

Proof-of-concept for an automatable mortality prediction scoring in hospitalised older adults

“…Mortality rates for AMI are known to be higher in older age groups, even after adjusting for patient characteristics ( 29 ). Delirium is one of the most common complications in older general medicine patients ( 30 , 31 ), but is often missed in clinical practice. Delirium is associated with more than three-fold mortality compared to non-delirious patients ( 32 ).…”

The effects of anesthesia methods and anesthetics on postoperative delirium in the elderly patients: A systematic review and network meta-analysis

“…Delirium was previously considered to be a transient and self-limiting syndrome ( AGS/NIA Delirium Conference Writing Group, Planning Committee and Faculty, 2015 ), and a growing body of studies ( Koster et al, 2009 ; Saczynski et al, 2012 ; Goldberg et al, 2020 ) is now leading to an awareness of the long-term adverse effects of POD. It is significantly associated with higher perioperative and long-term mortality rates, prolonged hospital stays, long-term cognitive dysfunction, and other poor prognostic outcomes ( Koster et al, 2012 ; Schnorr et al, 2022 ). Numerous physical and psychological complications will bring serious consequences to patients and a greater burden on the social healthcare system.…”