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Clinical and prognostic implications of delirium in elderly patients with non–ST-segment elevation acute coronary syndromes

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Journal of Geriatric Cardiology 2019年第2期16卷 121-128页

作者： Miquel Vives-Borras Manuel Martinez-Selles Albert Ariza-Sole Maria T.Vidan Francesc Formiga hector bueno Juan Sanchis Oriol Alegre Albert Duran-Cambra Ramon Lopez-Palop Emad Abu-Assi Alessandro Sionis LONGEVO-SCA Investigators Department of Cardiology Hospital de la Santa Creu i Sant PauInstitute of Biomedical Research I1B Sant PauCIBERCVUniversitat Autonoma de BarcelonaBarcelonaSpain department of Cardiology Hospital General Universitario Gregorio MarahonC1BERCVUniversidad ComplutenseUniversidad EuropeaMadridSpain Hospital Universitari de Bellvitge L'Hospitalet de LlobregatBarcelonaSpain Hospital General Universitario Gregorio Maranon IiSGMCIBERFESUniversidad ComplutenseMadrid.Spain Hospital Doce de Octubre Centro Nacional de Investigaciones CardiovascularesMadridSpain Hospital Clinico de Valencia INCLIVAUniversidad de ValenciaCIBERCVSpain Hospital Universitario San Juan AlicanteSpain Hospital Alvaro Cunqueiro VigoSpain 不详

Background Elderly patients with non-ST-segment elevation acute coronary syndromes(NSTE-ACS)may present delirium but its clinical relevance is *** study aimed at detennining the clinical associated factors,and prognostic implications of delirium in old-aged patients admitted for *** LONGEVO-SCA is a prospective multicenter registry including unselected patients with NSTE-ACS aged>80 *** variables and a complete geriatric evaluation were assessed during *** association between delirium and 6-month mortality was assessed by a Cox regression model weighted for a propensity score including the potential confounding *** also analysed its association with 6-month bleeding and cognitive or functional *** Among 527 patients included,thirty-seven(7%)patients presented delirium during the *** 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%V5.2.2%,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 *** 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」6,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.

关键词： Acute coronary syndromes Delirium Prognosis The elderly

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