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首页> 外文期刊>The journals of gerontology.Series A. Biological sciences and medical sciences >Adverse clinical events and mortality during hospitalization and 3 months after discharge in cognitively impaired elderly patients.
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Adverse clinical events and mortality during hospitalization and 3 months after discharge in cognitively impaired elderly patients.

机译：认知障碍老年患者住院期间和出院后3个月的不良临床事件和死亡率。

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Controversial findings are reported on hospital outcome in cognitively impaired patients. The aim of this study was to explore mortality risk according to cognitive status during hospitalization and after 3 months in elderly patients.Sixty-six internal medicine and geriatric wards in Italy participated in the "Registry Politerapie SIMI (REPOSI)" during 2010. Of the 1,380 in-patients, aged 65 and older enrolled, 1,201 were included. Cognition was evaluated with the Short Blessed Test (SBT). Logistic regression was used to evaluate the association of questionable and impaired cognition (according to SBT cutoff points) with mortality during hospitalization and at follow-up. Morbidity, function, and adverse events during hospitalization were covariates.Four hundred and twenty-one participants were classified as normal, 219 questionable, and 561 cognitively impaired. Forty-nine patients died during hospitalization and 70 during follow-up. Sixty-seven point three percent versus 32.7% (p < .001) of patients who died during hospitalization and 54.3% versus 45.7% (p < .001) during follow-up had at least one adverse event. After multiadjustment, impaired cognition was associated with in-hospital mortality (odds ratio [OR] = 3.1; 95% confidence interval [CI] = 1.1-8.6) but not with mortality at follow-up. Increase severity of cognitive impairment was associated with higher odds of mortality (from 2.7 in those with moderate impairment to 4.2 in those with severe impairment). After stratification for adverse clinical events, impaired cognition resulted associated with mortality only in patients having at least one event.Elderly patients with cognitive impairment are more likely to die during hospitalization with a severity-dependent association. Adverse events may represent an important target of prevention due to their high association with mortality and cognitive impairment.
机译：据报道，认知障碍患者的医院治疗结果存在争议。这项研究的目的是根据住院期间和老年患者3个月后的认知状况探讨死亡风险。意大利的66家内科和老年病房于2010年参加了“ Politerapie SIMI（REPOSI）登记处”。纳入了1,380名年龄在65岁及以上的住院患者，其中1,201名。认知通过短祝福测验（SBT）进行评估。 Logistic回归用于评估可疑和受损的认知（根据SBT临界点）与住院期间和随访期间的死亡率之间的关系。住院期间的发病率，功能和不良事件是协变量.41​​2名参与者被分类为正常，219名可疑和561名认知障碍者。四十九名患者在住院期间死亡，七十名在随访期间死亡。在住院期间死亡的患者中，有67％的患者占3％，而在住院期间死亡的患者为32.7％（p <.001），在随访期间死亡的患者中有54.3％与45.7％（p <.001）的患者发生了至少一项不良事件。经过多次调整后，认知能力下降与院内死亡率相关（优势比[OR] = 3.1; 95％置信区间[CI] = 1.1-8.6），但与随访时的死亡率无关。认知障碍严重程度的增加与死亡率更高相关（从中度障碍者的2.7到重度障碍者的4.2）。在对不良临床事件进行分层后，认知障碍仅与至少发生一次事件的患者相关，而死亡。认知障碍的老年患者在住院期间死亡的可能性更高，与严重程度相关。由于不良事件与死亡率和认知障碍高度相关，因此不良事件可能是预防的重要目标。

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