Jin H. Han|Suzanne Bryce|E. Wesley Ely|Sunil Kripalani|Alessandro Morandi|Ayumi Shintani|James C. Jackson|Alan B. Storrow|Robert S. Dittus|John F. Schnelle
The Effect of Cognitive Impairment on the Accuracy of the Presenting Complaint and Discharge Instruction Comprehension in Older Emergency Department Patients
Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|VA Tennessee Valley Healthcare System|Geriatric Research Education and Clinical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|VA Tennessee Valley Healthcare System|Geriatric Research Education and Clinical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|VA Tennessee Valley Healthcare System|Geriatric Research Education and Clinical Center|Vanderbilt University Medical Center|VA Tennessee Valley Healthcare System|Geriatric Research Education and Clinical Center
seek determine delirium dementia affect accuracy presenting illness discharge instruction comprehension older emergency department ed patientsthis crosssectional study conducted academic ed may 2008 july 2008 included nonnursing home patients aged 65 years older two openended interviews performed assess patients ability accurately provide presenting illness comprehension ed discharge instructions surrogates version presenting illness printed discharge instructions reference standards concordance patient reference standards determined 2 reviewers using 5point scale ranging 1 concordance 5 complete concordance proportional odds logistic regression performed determine whether cognitive impairment associated presenting complaint accuracy discharge instruction comprehension models adjusted age health literacy education nonwhite race hearing impairmentfor presenting illness analysis 202 patients participated compared patients without cognitive impairment delirium superimposed dementia dsd lower odds agreeing surrogates regard ed adjusted proportional odds ratio020 95 confidence interval ci 009 043 discharge instruction comprehension analysis 115 patients participated patients dsd significantly lower odds comprehending discharge diagnosis adjusted proportional odds ratio013 95 ci 004 047 return ed instructions adjusted proportional odds ratio018 95 ci 004 082 followup instructions adjusted proportional odds ratio009 95 ci 002 035 compared patients without cognitive impairmentdsd associated decreased accuracy older patients presenting illness decreased comprehension ed discharge instructions