Evidence mapPaperPMID 38878221Full record

ArticleEuropean geriatric medicine2024

The Multidimensional Prognostic Index predicts incident delirium among hospitalized older patients with COVID-19: a multicenter prospective European study.

Wanda Morganti, Carlo Custodero, Nicola Veronese, Eva Topinkova, Helena Michalkova, M Cristina Polidori, Alfonso J Cruz-Jentoft, Christine A F von Arnim, Margherita Azzini, Heidi Gruner and 9 more

Abstract readMulticenter Study
In one paragraph

Article in European geriatric medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
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

4 citing papers in PubMed.

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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

19 authors.

Wanda MorgantiDepartment of Geriatric Care, Neurology and Rehabilitation, Galliera Hospital, Genoa, Italy. wanda.morganti@galliera.it.ORCID http://orcid.org/0000-0001-6214-7276
Carlo CustoderoDepartment of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy.ORCID http://orcid.org/0000-0003-1549-6451
Nicola VeroneseDepartment of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.ORCID http://orcid.org/0000-0002-9328-289X
Eva TopinkovaDepartment of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic.
Helena MichalkovaDepartment of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic.
M Cristina PolidoriDepartment II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine, Ageing Clinical Research, University Hospital Cologne, Cologne, Germany.
Alfonso J Cruz-JentoftServicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain.
Christine A F von ArnimDepartment of Geriatrics, University Medical Center Göttingen, Göttingen, Germany.
Margherita AzziniGeriatrics Unit, "Mater Salutis" Hospital, Legnago ULSS 9 Scaligera, Verona, Italy.
Heidi GrunerServiço de Medicina Interna, Hospital Curry Cabral, Centro Hospitalar Universitário Lisboa Central/Universidade Nova de Lisboa, Lisbon, Portugal.
Alberto CastagnaGeriatrics Unit, "Pugliese Ciaccio" Hospital, Catanzaro, Italy.
Giovanni CenderelloInfectious Disease Unit, Sanremo Hospital, ASL 1 Imperiese, Sanremo, Italy.
Romina CustureriDepartment of Geriatric Care, Neurology and Rehabilitation, Galliera Hospital, Genoa, Italy.
Emanuele SeminerioDepartment of Geriatric Care, Neurology and Rehabilitation, Galliera Hospital, Genoa, Italy.ORCID http://orcid.org/0009-0000-5342-7102
Tania ZieschangUniversity-Clinic for Geriatric Medicine, Klinikum Oldenburg AöR, Oldenburg University, Oldenburg, Germany.
Alessandro PadovaniNeurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Elisabet Sanchez-GarciaServicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain.
Alberto PilottoDepartment of Geriatric Care, Neurology and Rehabilitation, Galliera Hospital, Genoa, Italy.ORCID http://orcid.org/0000-0002-8615-1955
MPI-COVID-19 Study Group Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIncident delirium is a frequent complication among hospitalized older people with COVID-19, associated with increased length of hospital stay, higher morbidity and mortality rates. Although delirium is preventable with early detection, systematic assessment methods and predictive models are not universally defined, thus delirium is often underrated. In this study, we tested the role of the Multidimensional Prognostic Index (MPI), a prognostic tool based on Comprehensive Geriatric Assessment, to predict the risk of incident delirium.

methodsHospitalized older patients (≥ 65 years) with COVID-19 infection were enrolled (n = 502) from ten centers across Europe. At hospital admission, the MPI was administered to all the patients and two already validated delirium prediction models were computed (AWOL delirium risk-stratification score and Martinez model). Delirium occurrence during hospitalization was ascertained using the 4A's Test (4AT). Accuracy of the MPI and the other delirium predictive models was assessed through logistic regression models and the area under the curve (AUC).

resultsWe analyzed 293 patients without delirium at hospital admission. Of them 33 (11.3%) developed delirium during hospitalization. Higher MPI score at admission (higher multidimensional frailty) was associated with higher risk of incident delirium also adjusting for the other delirium predictive models and COVID-19 severity (OR = 12.72, 95% CI = 2.11-76.86 for MPI-2 vs MPI-1, and OR = 33.44, 95% CI = 4.55-146.61 for MPI-3 vs MPI-1). The MPI showed good accuracy in predicting incident delirium (AUC = 0.71) also superior to AWOL tool, (AUC = 0.63) and Martinez model (AUC = 0.61) (p < 0.0001 for both comparisons).

conclusionsThe MPI is a sensitive tool for early identification of older patients with incident delirium.

Indexed as

COVID-19DeliriumGeriatric AssessmentHospitalizationAgedAged, 80 and overEuropeFemaleHumansIncidenceMalePrognosisProspective StudiesRisk AssessmentRisk FactorsSARS-CoV-2Comprehensive geriatric assessmentCOVID-19Delirium predictionMultidimensional Prognostic IndexOlder people

Identifiers

PMID38878221
PMCPMC11377617

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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 Socratic graph.