title: Persistent delirium predicts greater mortality.
abstract: OBJECTIVE
  To examine the association between persistent delirium and 1-year mortality in newly admitted postacute care (PAC) facility patients with delirium who were followed regardless of residence.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  Eight greater-Boston skilled nursing facilities specializing in PAC.
  
  
  METHODS
  Four hundred twelve PAC patients with delirium at admission after an acute hospitalization.
  
  
  METHODS
  Assessments were done at baseline and four follow-up times: 2, 4, 12, and 26 weeks. Delirium, defined using the Confusion Assessment Method, was assessed, as were factors used as covariates in analyses: age, sex, comorbidity, functional status, and dementia. The outcome was 1-year mortality determined according to the National Death Index and corroborated using medical record and proxy telephone interview.
  
  
  RESULTS
  Nearly one-third of subjects remained delirious at 6 months. Cumulative 1-year mortality was 39%. Independent of age, sex, comorbidity, functional status, and dementia, subjects with persistent delirium were 2.9 (95% confidence interval 51.9-4.4) times as likely to die during the 1-year follow-up as subjects whose delirium resolved. This association remained strong and significant in groups with and without dementia. Additionally, when delirium resolved, the risk of death diminished thereafter.
  
  
  CONCLUSIONS
  In patients who were delirious at the time of PAC admission, persistent delirium was a significant independent predictor of 1-year mortality.
authors.affiliation: Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts 02131-1097, USA. kiely@hrca.harvard.edu
authors.forename: Dan K
authors.initials: DK
authors.lastname: Kiely
authors.forename: Edward R
authors.initials: ER
authors.lastname: Marcantonio
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Inouye
authors.forename: Michele L
authors.initials: ML
authors.lastname: Shaffer
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Bergmann
authors.forename: Frances M
authors.initials: FM
authors.lastname: Yang
authors.forename: Michael A
authors.initials: MA
authors.lastname: Fearing
authors.forename: Richard N
authors.initials: RN
authors.lastname: Jones
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003693:Delirium / Q000209:etiology / Q000401:mortality*; D005260:Female; D006707:Homes for the Aged; D006760:Hospitalization; D006801:Humans; D008297:Male; D009735:Nursing Homes