Clinical and prognostic implications of delirium in elderly patients with non-ST-segment elevation acute coronary syndromes
Miquel Vives-Borrás
Manuel Martínez-Sellés
Albert Ariza-Solé
María T.Vidán
Francesc Formiga
Héctor Bueno
Juan Sanchís
Oriol Alegre
Albert Durán-Cambra
Ramón López-Palop
Emad Abu-Assi
Alessandro Sionis
LONGEVO-SCA Investigators
摘要：Background Elderly patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) may present delirium but its clinical relevance is unknown.This study aimed at determining the clinical associated factors,and prognostic implications of delirium in old-aged patients admitted for NSTE-ACS.Methods LONGEVO-SCA is a prospective multicenter registry including unselected patients with NSTE-ACS aged ≥ 80 years.Clinical variables and a complete geriatric evaluation were assessed during hospitalization.The association between delirium and 6-month mortality was assessed by a Cox regression model weighted for a propensity score including the potential confounding variables.We also analysed its association with 6-month bleeding and cognitive or functional decline.Results Among 527 patients included,thirty-seven (7％) patients presented delirium during the hospitalization.Delirium was more frequent in patients with dementia or depression and in those from nursing homes (27.0％ vs.3.1％,24.3％ vs.11.6％,and 11.1％ vs.2.2％,respectively;all P ＜ 0.05).Delirium was significantly associated with in-hospital infections (27.0％ vs.5.3％,P ＜ 0.001) and usage of diuretics (70.3％ vs.49.8％,P =0.02).Patients with delirium had longer hospitalizations [median 8.5 (5.5-14) vs.6.0 (4.0-10) days,P =0.02] and higher incidence of 6-month bleeding and mortality (32.3％ vs.10.0％ and 24.3％ vs.10.8％,respectively;both P ＜ 0.05) but similar cognitive or functional decline.Delirium was independently associated with 6-month mortality (HR =1.47,95％ CI:1.02-2.13,P =0.04) and 6-month bleeding events (OR =2.87;95％ CI:1.98-4.16,P ＜ 0.01).Conclusions In-hospital delirium in elderly patients with NSTE-ACS is associated with some preventable risk factors and it is an independent predictor of 6-month mortality.
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论文发表日期：2019-01-01
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：8( 121-128 )
英文信息