Appendix E: Cohort studies - methodological quality: Non pharmacological risk factors

Transcription

1 Appendix E: studies - methodological quality: n pharmacological risk factors Study Andersson 2001; 51/24 (=2) All patients followed up until discharge but in numbers of number of variables studied; 4/4 key RFs: patients with dementia Bohner 200; 60/9 (=7) for 7 days prospective but not enough events per variable; /4 key RFs (age; dementia and polypharmacy constant because cardiac surgery patients) Bucerius 2004; Fairly acceptable: nearly enough key risk factors 154/5 (=9) Unclear data complete for each patient Large prospective ; /4 key RFs: age; dementia and polypharmacy constant because cardiac bypass surgery patients; if Caeiro 2004; 29/4 (=7) Unclear 220 at start; 2 assessment not completed ; acute stroke; not enough events per variable; only 1/4 key RFs (age); general medical. Unstated how cognitive impairment assessed. Edlund 2001; Confounded: no key risk factors 19/8 (=2) 2/101 patients did not full data preoperative analysis (61% patients - ) is essentially a cross sectional ; 2/4 key RFs (polypharmacy, dementia). Postop ( ) had NO KEY RFs Ely 2007; possible 47/6 (=8) Of 59 patients enrolled, 6 were (coma/death) Select group: mechanically ventilated intensive care patients; ratio of events/ is 8; 2/4 key RFs (age; polypharmacy constant because ICU) Page 1 of 6

2 Furlaneto 2006; 0/2 (=15) Significant, more than half of was 7 deaths; 4 in the group and in the control group Selected group: elderly patients admitted to geriatric orthopaedic ward; all patients with appear to been in the analyses (prevalence 17% and incidence 1%); only 1/4 key RFs: dementia Goldenberg 2006; 7/6 (=6) Hip fracture surgery. enough events/; /4 key RFs (age, dementia, polypharmacy) Hofste 1997; possible 44/5 (=9) Unclear Selected group: cardiac surgery patients; 2/4 key RFs: age ; dementia constant because elective cardiac surgery patients; (GDG: blindness/deafness not considered sensory impairment) Inouye 199; 27/1 (=2) /4 key RFs: age and sensory impairment ; dementia from analysis Inouye 2007; possible 48/5 (=10) missing data (all analysed) 2/4 key RF's taken into account: dementia; vision impairment. Kazmierski 2006; 0/16 (=2) Only cardiac surgery patients in ; of 296 consecutively admitted patients, 260 were enrolled; ratio 2 events/; 2/4 key RFs : age and cognitive impairment in analysis Page 2 of 6

3 Korevaar 2005; possible 6/10 (=4) Unclear Of 488 eligible patients,182 were. Of 06, a random sample of 126 patients were 2/4 key RFs (age and cognitive impairment) and ratio of 4 events/; if Leung 2007; 29/10 (=) Unclear 1/20 (6%) lost to follow-up; assessment was not performed on these patients 2/4 key RF (age, dementia) in MV analysis; number of events/ is ; initial Levkoff 1988; Retrospective in retrospe ctive chart review) 117/18 (=6) Groups were matched according to admitting service: medical, cardiology, neurology, medical oncology, orthopaedics, pychiatry, general surgery, etc.. 1/4 key RFs (age); retrospective; in method of assessment Levkoff 1992; MMSE) possible 91/4 (=2) but from analysis with delirum (11%) from analysis Analysis only for ; 2-/4 key RFs: age, dementia; patients with severe sensory impairment were. assessment based on DSM III. Unstated scale for cognitive impairment. Levkoff 1992 ; MMSE) possible 4/4 (=11) but from analysis with (4%) Overall participation rate 79.5% of eligible patients; results may not be generalisable to all elderly people living in the ; 2-/4 key RFs (age, dementia + sensory imp. Excl). Unstated how cognitive impairment assessed. DSM III for Levkoff 1992 institution; MMSE) possible 48/4 (=12) but from analysis with from the analysis (2%) Overall participation rate 79.5% of eligible patients; results may not be generalisable to all elderly people living in institutions; /4 key RFs (age, dementia + severe sensory imp. Excl). Unstated how cognitive impairment assessed. DSM III for Page of 6

4 Lin 2008; possible 1/ (=10) 8/151 (5%) remained comotose throughout the investigation Selected group: mechanically ventillated patients; 1-2/4 key RFs: dementia and polypharmacy held constant because ICU patients McCusker 2001; Fairly acceptable: nearly enough key risk factors 444/24 (=18) at start of stated; Repeated measures analyses (patients >1 in different states). patients with in RCT and 'controls' from patients screened for without. Severity using DI tool based on CAM. key RFs. Ouimet 2007; possible 24/1 (=19) Only 2/4 key RFs : age; polypharmacy constant because ICU Pisani 2007; possible 214/24 (=9) Medical/surgical ICU; Of 18 eligible patients, 09 (97%) were enrolled - 5 of which were (coma); ratio of events/ is 9; 2/4 key RFs (dementia; polypharmacy constant because ICU) Pompei 1994_Chicago; 64/4 (=16) at start of Chicago: Results include % cases; only 1/4 key RFs: dementia. When only: dementia and alcoholism no longer significant. Pompei 1994_Yale; 85/4 (=21) at start of Results include 57% cases overall; only 1/4 key RFs (dementia) Page 4 of 6

5 Ranhoff 2006; 55/8 (=7) Selected group: elderly patients in SICU; ratio of events/ was 7; 4/4 key RFs (age, dementia, polypharmacy, visual impairment). Prevalent + reported; was 47% Redelmeier 2008; Retrospective in retrospe ctive chart review) possible 195/16 (=200) Unclear 2/4 key RF's taken into account: age; possibly polypharmacy constant because surgical patients; retrospective; in measurement of Rolfson 1999; possible 2/ (=8) 4/75 (5%) lost to follow-up ( died and 1 was comotose at follow-up) Yes (and numbe r not met) variables not comparable (evaluated in UV analysis). elderly patients undergoing CABG surgery; assuming alpha=0.05, beta=0.20, and a desired margin of error of 0.10, with 0%, a sample of 81 was estimated; 2/4 key RFs: age constant (GDG: narrow age range) and polypharmacy constant Rudolph 2007; possible 99/6 (=16) 57/1218 (5%) did not postoperative assessments Only 1-2/4 key RFs (age in MV analysis; dementia (held constant), but mild cognitive impairment patients ). Appears to include cases (no details). Santos 2004; 74/6 (=2) Elderly cardiac surgery patients chosen randomly by drawing lots; ratio events/ was 2; -4/4 key RFs (age; dementia + severe sens. imp, polypharmacy constant because cardiac surgery patients) Schor 1992; MMSE) possible 91/9 (=10) 2-/4 key RF's taken into account: age dementia; patients wih severe hearing or vision loss from. assessment using DSI (based on DSM III). Unstated how cognitive impairment assessed. Page 5 of 6

6 Sheng 2006; 9/14 (=) Unclear All patients followed up for risk factor analysis Select group: acute stroke patients; not enough MV analysis; /4 key RFs (age, dementia, sensory impairment) Veliz- Reissmuller 2007; 25/6 (=4) /107 (%) patients died no cognitively assessed at discharge Select group: elective cardiac surgery; ratio of events/ is 4 and /4 key RFs: age and cognitive impairment, polypharmacy constant because cardiac. Inappropriate cut off on MMSE for cognitive impairment Yildizeli 2005; Retrospective in retrospe ctive chart review) Confounded: ratio of events/ less than 1 2/25 (=1) patients died but data analysed Selected group: thoracic surgery patients; not enough MV analysis; retrospective; 1/4 key RFs: age Zakriya 2002; 47/6 (=8) Select group: elderly hip fracture patients; nearly enough patients in MV analysis; only 0-1/4 key RFs: dementia (not stated how measured) Page 6 of 6