Age and ageing
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there is a growing demand for cardiothoracic surgery in patients' aged ≥65 years. ⋯ the survival rates after cardiothoracic surgery were good, the rates of functional decline were substantial. These results suggest that studies on geriatric rehabilitation before and after surgery might be needed to overcome the decline in functioning.
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Comparative Study
Falls prevention in hospitals and mental health units: an extended evaluation of the FallSafe quality improvement project.
inpatient falls are a major patient safety issue causing distress, injury and death. Systematic review suggests multifactorial assessment and intervention can reduce falls by 20-30%, but large-scale studies of implementation are few. This paper describes an extended evaluation of the FallSafe quality improvement project, which presented key components of multifactorial assessment and intervention as a care bundle. ⋯ : introducing evidence-based care bundles of multifactorial assessment and intervention using a quality improvement approach resulted in improved delivery of multifactorial assessment and intervention and significant reductions in fall rates, but not in injurious fall rates.
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to evaluate the performance of the 4 'A's Test (4AT) in screening for delirium in older patients. The 4AT is a new test for rapid screening of delirium in routine clinical practice. ⋯ the 4AT is a sensitive and specific method of screening for delirium in hospitalised older people. Its brevity and simplicity support its use in routine clinical practice.
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Review Meta Analysis
Risk factors for incident delirium among older people in acute hospital medical units: a systematic review and meta-analysis.
delirium affects up to 40% of older hospitalised patients, but there has been no systematic review focussing on risk factors for incident delirium in older medical inpatients. We aimed to synthesise data on risk factors for incident delirium and where possible conduct meta-analysis of these. ⋯ we identified risk factors consistently associated with incident delirium following admission. These factors help to highlight older acute medical inpatients at risk of developing delirium during their hospital stay.
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Observational Study
Development and validation of a delirium predictive score in older people.
delirium is frequently under diagnosed in older hospitalised patients. Predictive models have not been widely incorporated in clinical practice. ⋯ This simple predictive model highlights functional status and a proxy for dehydration as a useful tool for identifying older patients that may benefit from close monitoring and preventive care for early diagnosis of delirium.