Vital signs and impaired cognition in older emergency department patients: The APOP study.

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Názov: Vital signs and impaired cognition in older emergency department patients: The APOP study.
Autori: Jacinta A Lucke, Jelle de Gelder, Laura C Blomaard, Christian Heringhaus, Jelmer Alsma, Stephanie C E Klein Nagelvoort Schuit, Anniek Brink, Sander Anten, Gerard J Blauw, Bas de Groot, Simon P Mooijaart
Zdroj: PLoS ONE, Vol 14, Iss 6, p e0218596 (2019)
Informácie o vydavateľovi: Public Library of Science (PLoS), 2019.
Rok vydania: 2019
Zbierka: LCC:Medicine
LCC:Science
Predmety: Medicine, Science
Popis: Background/objectivesCognitive impairment is a frequent problem among older patients attending the Emergency Department (ED) and can be the result of pre-existing cognitive impairment, delirium, or neurologic disorders. Another cause can also be acute disturbance of brain perfusion and oxygenation, which may be reversed by optimal resuscitation. This study aimed to assess the relationship between vital signs, as a measure of acute hemodynamic changes, and cognitive impairment in older ED patients.DesignProspective cohort study.SettingED's of two tertiary care and two secondary care hospitals in the Netherlands.Participants2629 patients aged 70-years and older.MeasurementsVital signs were measured at the moment of ED arrival as part of routine clinical care. Cognition was measured using the Six-Item Cognitive Impairment Test (6-CIT).ResultsThe median age of patients was 78 years (IQR 74-84). Cognitive impairment was present in 738 patients (28.1%). When comparing lowest with highest quartiles, a systolic blood pressure of 21/min) was associated with increased risk of impaired cognition (OR 2.16, 95% CI 1.58-2.95) as well as oxygen saturation of ConclusionAbnormal vital signs associated with decreased brain perfusion and oxygenation are also associated with cognitive impairment in older ED patients. This may partially be explained by the association between disease severity and delirium, but also by acute disturbance of brain perfusion and oxygenation. Future studies should establish whether normalization of vital signs will also acutely improve cognition.
Druh dokumentu: article
Popis súboru: electronic resource
Jazyk: English
ISSN: 1932-6203
Relation: https://doaj.org/toc/1932-6203
DOI: 10.1371/journal.pone.0218596
Prístupová URL adresa: https://doaj.org/article/2501a1d6788e4c8b83c9a3b4c71733ab
Prístupové číslo: edsdoj.2501a1d6788e4c8b83c9a3b4c71733ab
Databáza: Directory of Open Access Journals
Popis
Abstrakt:Background/objectivesCognitive impairment is a frequent problem among older patients attending the Emergency Department (ED) and can be the result of pre-existing cognitive impairment, delirium, or neurologic disorders. Another cause can also be acute disturbance of brain perfusion and oxygenation, which may be reversed by optimal resuscitation. This study aimed to assess the relationship between vital signs, as a measure of acute hemodynamic changes, and cognitive impairment in older ED patients.DesignProspective cohort study.SettingED's of two tertiary care and two secondary care hospitals in the Netherlands.Participants2629 patients aged 70-years and older.MeasurementsVital signs were measured at the moment of ED arrival as part of routine clinical care. Cognition was measured using the Six-Item Cognitive Impairment Test (6-CIT).ResultsThe median age of patients was 78 years (IQR 74-84). Cognitive impairment was present in 738 patients (28.1%). When comparing lowest with highest quartiles, a systolic blood pressure of 21/min) was associated with increased risk of impaired cognition (OR 2.16, 95% CI 1.58-2.95) as well as oxygen saturation of ConclusionAbnormal vital signs associated with decreased brain perfusion and oxygenation are also associated with cognitive impairment in older ED patients. This may partially be explained by the association between disease severity and delirium, but also by acute disturbance of brain perfusion and oxygenation. Future studies should establish whether normalization of vital signs will also acutely improve cognition.
ISSN:19326203
DOI:10.1371/journal.pone.0218596