Delirium and Survival in Post-Acute Care

谵妄与急性期后护理中的生存

• 批准号: 6967220
• 负责人: Richard N Jones
• 金额: $ 6.39万
• 依托单位: HEBREW REHABILITATION CENTER FOR AGED
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6967220
• 关键词: behavioral /social science research tag; clinical research; clinical trials; comorbidity; data collection methodology /evaluation; death certificates; delirium; human data; human mortality; human very old age (85+); long term survivor; longitudinal human study; outcomes research; posthospitalization care; vital statistics

DESCRIPTION (provided by applicant): The main goal of this application is to add to the body of knowledge regarding the symptoms and sequelae of delirium in the post-acute care (PAC) setting by adding to and expanding upon an existing database of clinical characteristics and outcomes of patients admitted to PAC with delirium. Over the past 4 years we have been conducting a randomized clinical trial (RCT) of a Delirium Abatement Program (DAP) for patients admitted to eight Boston area post-acute skilled nursing facilities with the support of the National Institute on Aging. We have screened 8198 admissions, and enrolled 457 subjects (mean age 84 years, 65% women) into our trial, making it by far the largest cohort of delirious patients ever enrolled in a research study. Our goal with this application is to obtain support for additional secondary analyses (not among the primary or secondary outcomes of the original RCT) that inform the clinical epidemiology of delirium in post-acute care. The specific aims of this application are to: (1) Obtain longitudinal survival information on patients enrolled in our RCT by linking with the National Death Index, (2) Examine the association of persistent delirium, delirium symptoms, and delirium severity on long-term (4 year) survival following post-acute admission with delirium. Additionally, we will pursue exploratory analyses probing the nature of the relationship of persistent delirium and mortality, examining closely differences in specific causes of death, and the possible moderating or mediating role of comorbidity. Addressing these aims will contribute substantially to the understanding of delirium in the PAC setting, and may be generalizable to other settings. Our study team includes the senior members participating in the ongoing RCT. Therefore, we are familiar with the context and structure of the data, and have already produced some secondary analyses based on this dataset.

描述(由申请人提供)：本申请的主要目的是通过增加和扩展现有的PAC患者临床特征和结果数据库，增加有关急性后护理(PAC)环境中精神错乱症状和后遗症的知识。在过去的4年里，我们在国家老龄研究所的支持下，对波士顿地区8个急性后熟练护理机构的患者进行了妄想症缓解计划(DAP)的随机临床试验(RCT)。我们筛选了8198名入院患者，并招募了457名受试者(平均年龄84岁，女性占65%)参加试验，使其成为迄今为止参加研究研究的最大规模的精神错乱患者队列。我们使用这一应用程序的目标是获得对其他二次分析的支持(不在原始随机对照试验的主要或次要结果中)，以提供急性后护理中精神错乱的临床流行病学信息。这项应用的具体目的是：(1)通过与国家死亡指数的联系，获得我们随机对照试验中登记的患者的纵向生存信息，(2)检查持续性精神错乱、精神错乱症状和精神错乱的严重程度与急性入院后精神错乱后长期(4年)存活率的关系。此外，我们还将进行探索性分析，探讨持续性精神错乱与死亡率的关系的本质，密切研究特定死亡原因的差异，以及合并症可能起到的调节或调节作用。解决这些目标将大大有助于理解PAC背景下的精神错乱，并可能推广到其他背景下。我们的研究团队包括参与正在进行的随机对照试验的高级成员。因此，我们熟悉数据的背景和结构，并已在此数据集的基础上进行了一些二次分析。