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Risk factors for delirium at discharge: development and validation of a predictive model
Inouye SK, Zhang Y, Jones RN, Kiely DK, Yang F, Marcantonio ER.. Archives of internal medicine, 2007-07-01
Topic: Risk, prevention and care in population studies
Background Persistent delirium at the time of hospital discharge is associated with poor outcomes. The objectives of this study were to develop and validate a predictive model for persistent delirium at hospital discharge. Methods This study followed a prospective validation design. For the development cohort, 491 consecutive patients 70 years or older admitted to the hospital without delirium and surviving to discharge were enrolled from the general medical units of an academic teaching hospital. For the validation cohort, 461 comparable subjects were enrolled. Twenty-two candidate risk factors were examined, including 12 baseline factors (present on admission) and 10 precipitating factors (hospital related). The primary outcome was delirium at hospital discharge, measured by the Confusion Assessment Method. Results Delirium at discharge was present in 58 patients (11.8%) in the development cohort. Five independent risk factors for delirium at discharge were identified: dementia (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.4-3.7); vision impairment (OR, 2.1; 95% CI, 1.3-3.2); functional impairment (OR, 1.7; 95% CI, 1.2-3.0); high comorbidity (OR, 1.7; 95% CI, 1.1-2.6); and use of physical restraints during delirium (OR, 3.2; 95% CI, 1.9-5.2). A risk stratification system was created by adding 1 point for each factor present. Rates of delirium for the low-risk (0-1 factors), intermediate-risk (2-3 factors), and high-risk (4-5 factors) groups were 4%, 18%, and 63%, respectively (P < .001). The corresponding rates in the validation cohort, where 28 patients (6.1%) had delirium at discharge, were 3%, 14%, and 27% (P < .001). Conclusions A predictive model based on 5 risk factors has been successfully validated for prediction of delirium at discharge in hospitalized older patients. At least 4 of these risk factors are amenable to intervention strategies.
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APA 7th
Inouye, S. K., Zhang, Y., Jones, R. N., Kiely, D. K., Yang, F., & Marcantonio, E. R. (2007). Risk factors for delirium at discharge: development and validation of a predictive model. Archives of internal medicine. https://doi.org/10.1001/archinte.167.13.1406
Vancouver
Inouye SK, Zhang Y, Jones RN, Kiely DK, Yang F, Marcantonio ER. Risk factors for delirium at discharge: development and validation of a predictive model. Archives of internal medicine. 2007. doi:10.1001/archinte.167.13.1406. PMID: 17620535.
BibTeX
@article{inouye2007-17620535,
author = {Inouye, S. K. and Zhang, Y. and Jones, R. N. and Kiely, D. K. and Yang, F. and Marcantonio, E. R.},
title = {{Risk factors for delirium at discharge: development and validation of a predictive model}},
journal = {Archives of internal medicine},
year = {2007},
doi = {10.1001/archinte.167.13.1406},
pmid = {17620535},
url = {https://doi.org/10.1001/archinte.167.13.1406}
}
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Key findings
- Background Persistent delirium at the time of hospital discharge is associated with poor outcomes.
- Results Delirium at discharge was present in 58 patients (11.8%) in the development cohort.
Study details
- Participants58
- Effect size11.8%; 6.1%
- Evidence strengthModerate
How this study scored 50/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 29 of the 58 points we could judge it on, which is 50 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of internal medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2007 — within 20 year(s) of the newest study here |
| Sample size | 1 / 4 | 58 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 17620535) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 29 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 29 of the 58 points we could judge it on is 50 out of 100. |
| Total | 50 / 100 | — |
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