Severity of cognitive impairment as a prognostic factor for mortality and functional recovery of geriatric patients with hip fracture.

Autor:	Tarazona‐Santabalbina, Francisco José, Belenguer‐Varea, Ángel, Rovira Daudi, Eduardo, Salcedo Mahiques, Enmanuel, Cuesta Peredó, David, Doménech‐Pascual, Juan Ramón, Gac Espínola, Homero, Avellana Zaragoza, Juan Antonio
Předmět:	TREATMENT of fractures HIP joint injury treatment ACADEMIC medical centers CHI-squared test COGNITION disorders CONFIDENCE intervals CONVALESCENCE STATISTICAL correlation HEALTH status indicators MORTALITY MULTIVARIATE analysis T-test (Statistics) LOGISTIC regression analysis DATA analysis ACTIVITIES of daily living PROPORTIONAL hazards models RETROSPECTIVE studies SEVERITY of illness index DATA analysis software DESCRIPTIVE statistics KAPLAN-Meier estimator LOG-rank test ODDS ratio OLD age
Zdroj:	Geriatrics & Gerontology International; Mar2015, Vol. 15 Issue 3, p289-295, 7p
Abstrakt:	Aim To identify how the severity of dementia influences functional recovery and mortality in elderly patients hospitalized for hip fracture. Methods An observational retrospective study of 1258 patients aged older than 69 years and diagnosed with hip fracture who received care within an orthogeriatrics unit from 2004 to 2008 was carried out. During a 12-month follow-up period, functional recovery and mortality outcomes were measured. Results Dementia was present in 383 (28.1%) patients: it was mild in 183 (48%), moderate in 102 (26.5%) and severe in 98 (25.5%). Compared with patients with preserved cognitive status, patients with dementia had the following statistically significant differences (means [standard deviation] or percentage): older age (preserved, 82.29 years [6.5 years]; mild, 83.63 years [6.1 years]; moderate, 83.47 years [5.9 years]; severe, 84.46 years [6.1 years]; P < 0.001); lower Barthel Index (89.7 [21.6], 72.7 [24.6], 58.9 [28.6], 38.0 [28.1]; P < 0.001); delirium (11.7%, 25.6%, 37.6%, 44.7%; P < 0.001); less ambulation at 6 months postdischarge (83.9%, 72.8%, 56.9%, 41.7%; P < 0.001); and higher mortality at discharge (4%, 5.7%, 8.2%, 10.6%; P < 0.001) and 12 months after discharge (21.2%, 32.3%, 46.3%, 53.5%; P < 0.001). Patients with severe dementia had lower probability of functional recovery at discharge ( OR 0.272, 95% CI 0.140-0.526, P < 0.001) and 6 months after discharge ( OR 0.439, 95% CI 0.197-0.979, P = 0.04), as well as a greater probability of dying ( HR 1.640, 95% CI 1.020-2.635, P = 0.04). Conclusions We observed higher 12-month mortality and less functional recovery with increasing severity of dementia. Geriatr Gerontol Int 2015; 15: 289-295. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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