%0 Journal Article
%T Incomplete functional recovery after delirium in elderly people: a prospective cohort study
%A Melissa K Andrew
%A Susan H Freter
%A Kenneth Rockwood
%J BMC Geriatrics
%D 2005
%I BioMed Central
%R 10.1186/1471-2318-5-5
%X In a prospective cohort study of elderly patients with delirium seen by geriatric medicine services, function was assessed at baseline, at hospital discharge and at six months.Of 77 patients, vital and functional status at 6 months was known for 71, of whom 21 (30%) had died. Incomplete functional recovery, defined as ¡Ý10 point decline in the Barthel Index, compared to pre-morbid status, was present in 27 (54%) of the 50 survivors. Factors associated with death or loss of function at hospital discharge were frailty, absence of agitation (hypoactive delirium), a cardiac cause and poor recognition of delirium by the treating service. Frailty, causes other than medications, and poor recognition of delirium by the treating service were associated with death or poor functional recovery at 6 months.Pre-existing frailty, cardiac cause of delirium, and poor early recognition by treating physicians are associated with worse outcomes. Many physicians view the adverse outcomes of delirium as intractable. While in some measure this might be true, more skilled care is a potential remedy within their grasp.Delirium is a common presentation of illness in frail older adults and is associated with poor outcomes [1-7]. Risk factors for the development of delirium have been investigated [4,8], but factors that predict poor recovery from delirium remain incompletely understood [9]. A recent study of elderly patients admitted to long-term care facilities found that longer duration of delirium was associated with worse functional outcomes [10]. There is also some evidence that hypoactive delirium is associated with poor outcomes [11-13], but results have been conflicting [14,15]. Additionally, delirium is often under-recognized [16,17], and this non-recognition is not without consequence. Compared with patients whose delirium is detected, patients in whom delirium goes unrecognized by treating doctors and nurses have higher 6-month mortality [18]. Risk factors for under-recognition by nu
%U http://www.biomedcentral.com/1471-2318/5/5