The 6- and 12-Month Outcomes of Older Medical Inpatients Who Recover from Subsyndromal Delirium

Authors

  • Martin G. Cole MD, FRCP(C),

    1. From the *Department of PsychiatryClinical Epidemiology and Community Studies, St. Mary's Hospital CenterDepartment of Psychiatry, Montreal, Quebec, Canada§Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
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  • Jane McCusker MD, DrPH,

    1. From the *Department of PsychiatryClinical Epidemiology and Community Studies, St. Mary's Hospital CenterDepartment of Psychiatry, Montreal, Quebec, Canada§Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
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  • Antonio Ciampi PhD,

    1. From the *Department of PsychiatryClinical Epidemiology and Community Studies, St. Mary's Hospital CenterDepartment of Psychiatry, Montreal, Quebec, Canada§Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
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  • Eric Belzile MSc

    1. From the *Department of PsychiatryClinical Epidemiology and Community Studies, St. Mary's Hospital CenterDepartment of Psychiatry, Montreal, Quebec, Canada§Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
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Address correspondence to Martin G. Cole, MD, FRCP(C), Department of Psychiatry, St. Mary's Hospital Center, 3830 avenue Lacombe, Montreal, Quebec, H3T 1M5, Canada. E-mail: martin.cole@ssss.gouv.qc.ca

Abstract

OBJECTIVES: To compare the 6- and 12-month outcomes of patients who recovered from subsyndromal delirium (SSD) by 8 weeks with the outcomes of patients who did not recover or did not have an index episode.

DESIGN: Secondary analysis of data collected for a cohort study of the prognosis of delirium.

SETTING: University-affiliated primary acute care hospital.

PARTICIPANTS: Older medical inpatients with prevalent, incident, or no SSD were classified into three mutually exclusive groups at 8 weeks (SSD-recovered, SSD-not recovered, no SSD) and followed up at 6 and 12 months.

MEASUREMENTS: The primary hierarchical composite outcome was death, institutionalization, or cognitive or functional decline at 6 and 12 months. In secondary analyses, components of the primary outcome were examined separately.

RESULTS: Of the 129 patients assessed at 8 weeks, 51, 47, and 31 met criteria for SSD-recovered, SSD-not recovered and no SSD, respectively. At 6 and 12 months, the primary and secondary outcomes of the SSD-recovered group were better than the outcomes of the SSD-not recovered group and, for the most part, intermediate between the outcomes of the SSD-not recovered and no SSD groups.

CONCLUSION: Recovery from SSD appears to predict better longer-term outcomes than no recovery. Efforts to identify and treat SSD in older medical inpatients may improve outcomes.

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