Evidence map›Paper›PMID 34646712›Full record

ArticleCureus2021

Impact of Acute Confusional State in Patients With COVID-19 and a Predictive Score.

Bhanu Gogia, Deep Pujara, Neeharika Thottempudi, Tamer Ghanayem, Yousaf Ajam, Ayush Singh, Alok Dabi, Shekhar Patil, Kyra Curtis, Xiang Fang and 3 more

Open access · diamondAbstract read
In one paragraph

Article in Cureus, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 37% 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

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
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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

13 authors at 5 institutions in 1 country.

Bhanu GogiaNeurology/Vascular Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA.
Deep PujaraNeurology, Case Western Reserve University, Cleveland, USA.
Neeharika ThottempudiNeurology, University of Texas Medical Branch at Galveston, Galveston, USA.
Tamer GhanayemNeurology, Vanderbilt University Medical Center, Nashville, USA.
Yousaf AjamNeurology, University of Texas Medical Branch at Galveston, Galveston, USA.
Ayush SinghNeurology, Emory University School of Medicine, Atlanta, USA.
Alok DabiNeurology, University of Texas Medical Branch at Galveston, Galveston, USA.
Shekhar PatilInternal Medicine, Northeast Internal Medical Associates, Fort Wayne, USA.
Kyra CurtisNeurology, University of Texas Medical Branch at Galveston, Galveston, USA.
Xiang FangNeurology, University of Texas Medical Branch at Galveston, Galveston, USA.
Kamakshi PatelNeurology, University of Texas Medical Branch at Galveston, Galveston, USA.
Anish BhardwajNeurology, University of Texas Medical Branch at Galveston, Galveston, USA.
Prashant RaiNeurology, University of Texas Medical Branch at Galveston, Galveston, USA.
Case Western Reserve University · USMedical Research Associates · USVanderbilt University Medical Center · USBeth Israel Deaconess Medical Center · USThe University of Texas Medical Branch at Galveston · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute confusional state (ACS) in COVID-19 is shown to be associated with poor clinical outcomes.

methodsWe assessed the impact of ACS - defined as a documented deterioration of mental status from baseline on the alertness and orientation to time, place, and person - on inpatient mortality and the need for intensive care unit (ICU) transfer in inpatient admissions with active COVID-19 infection in a single-center retrospective cohort of inpatient admissions from a designated COVID-19 tertiary care center using an electronic health record system. Furthermore, we developed and validated a neurological history and symptom-based predictive score of developing ACS.

resultsThirty seven out of 245 (15%) patients demonstrated ACS. Nineteen (51%) patients had multifactorial ACS, followed by 11 (30%) patients because of hypoxemia. ACS patients were significantly older (80 [70-85] years vs 50.5 [38-69] years, p < 0.001) and demonstrated more frequent history of dementia (43% vs 9%, p < 0.001) and epilepsy (16% vs 2%, p = 0.001). ACS patients observed significantly higher in-hospital mortality (45.9% vs 1.9%, aOR [adjusted odds ratio]: 15.7, 95% CI = 3.6-68.0, p < 0.001) and need for ICU transfer (64.9% vs 35.1%, aOR: 2.7, 95% CI = 1.2-6.1, p = 0.015). In patients who survived hospitalization, ACS was associated with longer hospital stay (6 [3.5-10.5] days vs 3 [2-7] day, p = 0.012) and numerically longer ICU stay (6 [4-10] days vs 3 [2-6] days, p = 0.078). A score to predict ACS demonstrated 75.68% sensitivity and 81.73% specificity at a cutoff of ≥3.

conclusionA high prevalence of ACS was found in patients with COVID-19 in our study cohort. Patients with ACS demonstrated increased mortality and need for ICU care. An internally validated score to predict ACS demonstrated high sensitivity and specificity in our cohort.

Indexed as

acute confusional statecovid-19predictive scorereceiver operating characteristic (roc) analysisretrospective cohort

Identifiers

PMID34646712
PMCPMC8478964
OpenAlexW3204215440

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Registered trials

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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.