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Cognitive Impairment Often Goes Undocumented In Hospital Charts

A recent JHM study found that hospital staff often don’t recognize cognitive impairment in patients age 65 and older. This was especially true for patients on the younger end of the spectrum, and those with more comorbidity.

Of the 424 patients (43%) in the study who were cognitively impaired, 61% weren’t recognized as such by ICD-9 coding. Interestingly, there was no significant difference between patients with documented and undocumented cognitive impairment as far as mortality, length of stay, home discharge, readmission rates, incidence of delirium, or receipt of anticholinergics. One troubling finding: a significant number of patients with cognitive impairment received anticholinergic medication, even though it’s not recommended for patients with any type of CI.

The researchers also found that 38% of elderly patients with cognitive impairment had at least one day of delirium during their hospitalization. The patients with delirium had higher death rates (9% vs. 4%), were less likely to be discharged to home (75% vs. 31%) and stayed in the hospital longer (9.2 days vs. 5.9 days).

For more information on spotting and treating delirium, see this ACP Hospitalist article from last June.

*This blog post was originally published at ACP Hospitalist*

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