TY - JOUR
T1 - Delirium in emergency patients with decompensated heart failure: Clinical characteristics and course
AU - Rizzi, Miguel Alberto
AU - Torres Bonafonte, Olga H.
AU - López Sánchez, Gabriel
AU - Puig Campmany, Mireia
AU - Benito, Salvador
AU - Ruiz Hidalgo, Domingo
PY - 2012/9/3
Y1 - 2012/9/3
N2 - Objective: To analyze the clinical characteristics of patients with decompensated heart failure who are brought to a hospital emergency department and to describe the long-term clinical course in these patients. Methods: Prospective observational study of 60 emergency patients with decompensated heart failure. We used the Confusional Assessment Method to assess the presence of delirium and subsyndromal delirium. The patients were followed by means of telephone interviews for 1 year. Results: The mean (SD) age was 80.5 (11); 61.7% were women. Delirium was detected in 11.7% and subsyndromal delirium in 3.3%. Patients with delirium were older (P=.004), showed greater dependency with respect to both instrumental activities of daily living (ADLs) (P=.001) and basic ADLs (Barthel index) (P=.001), and had higher rates of dementia (P=.007) and peripheral vascular disease (P=.029). No significant differences were detected in the causes or characteristics of heart failure between the patients with and without delirium. Two patients with delirium died in hospital (P=.23). Only 2 patients with delirium survived the year of follow-up (P=.4); both showed cognitive dysfunction and high levels of functional dependency. Conclusions: Delirium in patients with decompensated heart failure seems to be more associated with older age, a baseline situation of functional dependency, and cognitive decline than with the seriousness or stage of heart failure.
AB - Objective: To analyze the clinical characteristics of patients with decompensated heart failure who are brought to a hospital emergency department and to describe the long-term clinical course in these patients. Methods: Prospective observational study of 60 emergency patients with decompensated heart failure. We used the Confusional Assessment Method to assess the presence of delirium and subsyndromal delirium. The patients were followed by means of telephone interviews for 1 year. Results: The mean (SD) age was 80.5 (11); 61.7% were women. Delirium was detected in 11.7% and subsyndromal delirium in 3.3%. Patients with delirium were older (P=.004), showed greater dependency with respect to both instrumental activities of daily living (ADLs) (P=.001) and basic ADLs (Barthel index) (P=.001), and had higher rates of dementia (P=.007) and peripheral vascular disease (P=.029). No significant differences were detected in the causes or characteristics of heart failure between the patients with and without delirium. Two patients with delirium died in hospital (P=.23). Only 2 patients with delirium survived the year of follow-up (P=.4); both showed cognitive dysfunction and high levels of functional dependency. Conclusions: Delirium in patients with decompensated heart failure seems to be more associated with older age, a baseline situation of functional dependency, and cognitive decline than with the seriousness or stage of heart failure.
KW - Decompensated heart failure
KW - Delirium
KW - Emergency health services
KW - Mortality
M3 - Article
SN - 1137-6821
VL - 24
SP - 283
EP - 288
JO - Emergencias
JF - Emergencias
IS - 4
ER -