We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Hospital complications among older adults: Better processes could reduce the risk of delirium.
- Authors
Moura Junior, Valdery; Westover, M Brandon; Li, Feng; Kimchi, Eyal; Kennedy, Maura; Benson, Nicole M; Moura, Lidia Maria; Hsu, John
- Abstract
Using observational data and variation in hospital admissions across days of the week, we examined the association between ED boarding time and development of delirium within 72 hours of admission among patients aged 65+ years admitted to an inpatient neurology ward. We exploited a natural experiment created by potentially exogenous variation in boarding time across days of the week because of competition for the neurology floor beds. Using proportional hazard models adjusting for socio-demographic and clinical characteristics in a propensity score, we examined the time to delirium onset among 858 patients: 2/3 were admitted for stroke, with the remaining admitted for another acute neurologic event. Among all patients, 81.2% had at least one delirium risk factor in addition to age. All eligible patients received delirium prevention protocols upon admission to the floor and received at least one delirium screening event. While the clinical and social-demographic characteristics of admitted patients were comparable across days of the week, patients with ED arrival on Sunday or Tuesday were more likely to have had delayed floor admission (waiting time greater than 13 hours) and delirium (adjusted HR = 1.54, 95%CI:1.37–1.75). Delayed initiation of delirium prevention protocol appeared to be associated with greater risk of delirium within the initial 72 hours of a hospital admission.
- Subjects
RISK of delirium; INTENSIVE care units; HOSPITAL emergency services; NEUROLOGY; STROKE; CONFIDENCE intervals; ACADEMIC medical centers; SCIENTIFIC observation; TIME; AGE distribution; PATIENTS; MEDICAL screening; RETROSPECTIVE studies; ACQUISITION of data; HOSPITAL admission &; discharge; RISK assessment; MEDICAL protocols; COMPARATIVE studies; PREVENTIVE health services; TEST validity; DELIRIUM; HOSPITAL care of older people; HOSPITAL wards; QUALITY assurance; AGE factors in disease; DESCRIPTIVE statistics; AGING; MEDICAL records; SOCIODEMOGRAPHIC factors; DATA analysis software; SENSITIVITY &; specificity (Statistics); ELDER care; PROPORTIONAL hazards models; OLD age
- Publication
Health Services Management Research, 2022, Vol 35, Issue 3, p154
- ISSN
0951-4848
- Publication type
Article
- DOI
10.1177/09514848211028707