Characteristics, treatment and delirium incidence of older adults hospitalized with COVID-19: a multicentre retrospective cohort study. Wong EK, et al, CMAJ Open 2022.
Adopter cette revue :
Si vous souhaitez prendre en charge cette revue d'article, merci de remplacer le tag Non_attribué par Attribué et ajoutez aussi votre nom d'utilisateur à l'emplacement prévu.
Réaliser des modifications :
Pour modifier ce document, il est nécessaire d'être connecté au site. Pour cela, assurez-vous d'avoir des identifiants valides. Si vous n'en avez pas, contactez-nous. Pour vous connecter, cliquez sur l'icône dans la barre de navigation.
Demander la finalisation de la revue de l'article :
Une fois revue et complétée, merci de remplacer l'étiquette Non_finalisé par A_finaliser. Un administrateur se chargera de valider la revue et de la publier avec le tag Finalisé.
Résumé et points clés
Background: The COVID-19 pandemic has affected older adults disproportionately, and delirium is a concerning consequence; however, the relationship between delirium and corticosteroid use is uncertain. The objective of the present study was to describe patient characteristics, treatments and outcomes among older adults hospitalized with COVID-19, with a focus on dexamethasone use and delirium incidence.
Methods: We completed this retrospective cohort study at 7 sites (including acute care, rehabilitation and long-term care settings) in Toronto, Ontario, Canada. We included adults aged 65 years or older, consecutively hospitalized with confirmed SARS-CoV-2 infection, between Mar. 11, 2020, and Apr. 30, 2021. We abstracted patient characteristics and outcomes from charts and analyzed them descriptively. We used a logistic regression model to determine the association between dexamethasone use and delirium incidence.
Results: During the study period, 927 patients were admitted to the acute care hospitals with COVID-19. Patients' median age was 79.0 years (interquartile range [IQR] 72.0-87.0), and 417 (45.0%) were female. Most patients were frail (61.9%), based on a Clinical Frailty Scale score of 5 or greater. The prevalence of delirium was 53.6%, and the incidence was 33.1%. Use of restraints was documented in 20.4% of patients. In rehabilitation and long-term care settings (n = 115), patients' median age was 86.0 years (IQR 78.5-91.0), 72 (62.6%) were female and delirium occurred in 17 patients (14.8%). In patients admitted to acute care during wave 2 of the pandemic (Aug. 1, 2020, to Feb. 20, 2021), dexamethasone use had a nonsignificant association with delirium incidence (adjusted odds ratio 1.38, 95% confidence interval 0.77-2.50). Overall, in-hospital death occurred in 262 (28.4%) patients in acute care settings and 28 (24.3%) patients in rehabilitation or long-term care settings.
Interpretation: In-hospital death, delirium and use of restraints were common in older adults admitted to hospital with COVID-19. Further research should be directed to improving the quality of care for this population with known vulnerabilities during continued waves of the COVID-19 pandemic.
Références de l'article
Characteristics, treatment and delirium incidence of older adults hospitalized with COVID-19: a multicentre retrospective cohort study.
Characteristics, treatment and delirium incidence of older adults hospitalized with COVID-19: a multicentre retrospective cohort study.
Wong EK, Watt J, Zou H, Chandraraj A, Zhang AW, Brookes J, Verduyn A, Berall A, Norman R, Piggott KL, Izukawa T, Straus SE, Liu B
Cette section peut être éditée par les relecteurs, les rédacteurs, les modérateurs et les administrateurs. Elle regroupe l'ensemble des échanges autours de la référence ci-dessus présentée.
Référez-vous à cette page pour connaître le rôle des utilisateurs et pour participer à la discussion.
Il n'y a, pour l'instant, aucune discussion en cours.