Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Study of design discharge and river capacity in Celeng Sub-watershed, Special Region of Yogyakarta

Abstract Celeng sub-watershed is a catchment area located in the Oyo watershed. This catchment has circular shape which is situated in the alluvial plain. In the 2018, there was a huge flood occurred in the area that was triggered by Savana Cyclone. The cyclone itself contributed in extreme precipitation, resulted in high discharge in a very short time, and spilled over the riverbank. The research aims (1) to analyze the discharge capacity in the Celeng sub-watershed, (2) to determine the design discharge of Celeng sub-watershed for 2, 5, 10, and 25 years return period, and (3) to evaluate whether the design discharge excess the Celeng river capacity or not. The research uses quantitative analysis through rational method and slope area method. The design discharge measured by rational method and applied to evaluate the river capacity along with rational method. The result shows that the area does not experience flood in all return period.</jats:p

Laser-based formation of copper nanoparticles in aqueous solution: Optical properties, particle size distributions, and formation kinetics

We explore the formation kinetics, optical absorption spectra, and particle size distributions of copper nanoparticles (CuNPs) formed by direct laser ablation from the bulk metal via a process we refer to as Laser Ablation Synthesis in Solution (LASiS). Comparisons are made between CuNPs formed in pure water versus those formed in the presence of 1×10 -4 M solutions of the N-donor ligands 4,4'-bipyridine (4,4'Bipy) and 1H-5-(4-pyridyl)tetrazole (T-4Py). CuNPs formed in pure water and in the presence of 4,4'Bipy display similar UV-visible absorption spectra and very similar particle size distributions. In comparison, CuNPs formed in the presence of T-4Py display significantly different absorption properties, with the surface plasmon resonance transition blue-shifted by ~55nm, and a much smaller and narrower particle size distribution compared with the former samples. Based on previous literature reports, it is possible to ascribe these differences to differences in the CuNP surface oxidation states for samples prepared in the presence of T-4Py. However, an analysis of the formation kinetics of all three samples indicates near-identical behaviour