Evidence map›Paper›PMID 29394886›Full record

ArticleBMC geriatrics2018

Clinical characteristics associated with the onset of delirium among long-term nursing home residents.

Evelyn Ning Man Cheung, Sophiya Benjamin, George Heckman, Joanne Man-Wai Ho, Linda Lee, Samir K Sinha, Andrew P Costa

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 3 pooled it
8.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 77 citations in OpenAlex.

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  16. Organizational Context and Quality Indicators in Nursing Homes: A Microsystem Look.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2024
    Article
  17. Article
  18. Article
  19. Article
  20. Delirium in Nursing Home Residents: A Narrative Review.Healthcare (Basel, Switzerland) · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Evelyn Ning Man CheungDepartment of Medicine, McMaster University, IHB/HSC-McMaster 3016, Victoria 10B St. S., Kitchener, ON, N2G 1C5, Canada. evelyn.cheung@medportal.ca.
Sophiya BenjaminDepartment of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
George HeckmanSchlegel Research Institute for Aging, Waterloo, ON, Canada.
Joanne Man-Wai HoDepartment of Medicine, McMaster University, IHB/HSC-McMaster 3016, Victoria 10B St. S., Kitchener, ON, N2G 1C5, Canada.
Linda LeeBig Data and Geriatric Models of Care, McMaster University, Hamilton, ON, Canada.
Samir K SinhaSinai Health System, Toronto, ON, Canada.
Andrew P CostaDepartment of Medicine, McMaster University, IHB/HSC-McMaster 3016, Victoria 10B St. S., Kitchener, ON, N2G 1C5, Canada.
McMaster University · CASinai Health System · CAUniversity of Waterloo · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNursing home residents are frail, have multiple medical comorbidities, and are at high risk for delirium. Most of the existing evidence base on delirium is derived from studies in the acute in-patient population. We examine the association between clinical characteristics and medication use with the incidence of delirium during the nursing home stay.

methodsThis is a retrospective cohort study of 1571 residents from 12 nursing homes operated by a single care provider in Ontario, Canada. Residents were over the age of 55 and admitted between February 2010 and December 2015 with no baseline delirium and a minimum stay of 180 days. Residents with moderate or worse cognitive impairment at baseline were excluded. The baseline and follow-up characteristics of residents were collected from the Resident Assessment Instrument-Minimal Data Set 2.0 completed at admission and repeated quarterly until death or discharge. Multivariate logistic regression was used to identify characteristics and medication use associated with the onset of delirium.

resultsThe incidence of delirium was 40.4% over the nursing home stay (mean LOS: 32 months). A diagnosis of dementia (OR: 2.54, p < .001), the presence of pain (OR: 1.64, p < .001), and the use of antipsychotics (OR: 1.87, p < .001) were significantly associated with the onset of delirium. Compared to residents who did not develop delirium, residents who developed a delirium had a greater increase in the use of antipsychotics and antidepressants over the nursing home stay.

conclusionsDementia, the presence of pain, and the use of antipsychotics were associated with the onset of delirium. Pain monitoring and treatment may be important to decrease delirium in nursing homes. Future studies are necessary to examine the prescribing patterns in nursing homes and their association with delirium.

Indexed as

AgedAged, 80 and overAntidepressive AgentsAntipsychotic AgentsCognitive DysfunctionCohort StudiesComorbidityDeliriumFemaleHomes for the AgedHumansIncidenceLong-Term CareMaleNursing HomesOntarioAntidepressive AgentsAntipsychotic AgentsDeliriumNursing homesPain

Identifiers

PMID29394886
PMCPMC5797375
OpenAlexW2794961182

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.