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

Cognitive 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...

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Bibliographic Details
Published in:PloS one 2019-06, Vol.14 (6), p.e0218596-e0218596
Main Authors: Lucke, Jacinta A, de Gelder, Jelle, Blomaard, Laura C, Heringhaus, Christian, Alsma, Jelmer, Klein Nagelvoort Schuit, Stephanie C E, Brink, Anniek, Anten, Sander, Blauw, Gerard J, de Groot, Bas, Mooijaart, Simon P
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biology and Life Sciences
Blood pressure
Brain
Brain research
Cardiac function
Care and treatment
Cognition
Cognition & reasoning
Cognitive ability
Cognitive disorders
Cognitive Dysfunction - epidemiology
Confidence intervals
Delirium
Dementia
Disturbance
Elderly
Elderly patients
Emergency medical care
Emergency medical services
Emergency Service, Hospital - statistics & numerical data
Female
Future predictions
Geriatrics
Gerontology
Health aspects
Heart failure
Hemodynamics
Hospital emergency services
Hospital patients
Hospitals
Humans
Impairment
Internal medicine
Male
Management
Medical research
Medicine
Medicine and Health Sciences
Mental disorders
Nervous system diseases
Netherlands
Oxygen
Oxygen content
Oxygenation
Patients
Perfusion
Physical Sciences
Quartiles
Research and Analysis Methods
Respiration
Respiratory rate
Resuscitation
Sepsis
Studies
Vital Signs
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Summary:Cognitive 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. Prospective cohort study. ED's of two tertiary care and two secondary care hospitals in the Netherlands. 2629 patients aged 70-years and older. Vital 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). The 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
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0218596