Table 2. The Association of CAM-S with Hospital Outcomes*.
| Hospital Outcome |
Length of Stay (N=919) |
Hospital Costs (N=919) |
New Nursing Home Placement (N=851) |
Functional Decline (N=908)† |
Cognitive Decline (N=902)‡ |
|||
|---|---|---|---|---|---|---|---|---|
|
| ||||||||
| Adj. Mean, Days (95% CI) |
Adj. Mean (95% CI), $ × 1000 |
n/N (%) | Adjusted RR (95% CI) |
n/N (%) | Adjusted RR (95% CI) |
n/N (%) | Adjusted RR (95% CI) |
|
| CAM-S Short Form Severity Rating | ||||||||
|
| ||||||||
| None (n=598) | 6.5 (6.2, 6.9) | 5.1 (4.8, 5.5) | 61/571 (11) | Referent | 212/589 (36) | Referent | 93/589 (16) | Referent |
| Low (n=91) | 8.8 (7.6, 9.9) | 7.0 (5.8, 8.2) | 14/85 (16) | 1.4 (0.8, 2.3) | 46/90 (51) | 1.4 (1.1, 1.8) | 23/89 (26) | 1.6 (1.1, 2.4) |
| Moderate (n=128) | 11.1 (9.9, 12.3) | 9.7 (8.3, 11.0) | 29/112 (26) | 2.1 (1.4, 3.1) | 80/128 (63) | 1.7 (1.4, 2.0) | 34/126 (27) | 1.6 (1.1, 2.3) |
| High (n=102) | 12.7 (11.2, 14.3) | 13.2 (11.1, 15.3) | 32/83 (39) | 2.5 (1.6, 3.7) | 69/101 (68) | 1.8 (1.5, 2.2) | 64/98 (65) | 3.9 (3.0, 5.0) |
| P trend | <.001 | <.001 | --- | <.001 | --- | <.001 | --- | <.001 |
|
| ||||||||
| CAM-S Long Form Severity Rating | ||||||||
|
| ||||||||
| None (n=205) | 5.6 (5.1, 6.1) | 4.2 (3.7, 4.7) | 13/198 (7) | Referent | 50/202 (25) | Referent | 20/202 (10) | Referent |
| Low (n=288) | 6.8 (6.4, 7.3) | 5.4 (4.9, 5.9) | 25/278 (9) | 1.4 (0.7, 2.5) | 115/284 (40) | 1.6 (1.2, 2.1) | 53/282 (19) | 1.9 (1.1, 3.0) |
| Moderate (n=234) | 8.8 (8.1, 9.5) | 7.3 (6.5, 8.1) | 40/215 (19) | 2.3 (1.3, 4.2) | 126/231 (55) | 2.1 (1.6, 2.8) | 47/230 (20) | 2.0 (1.2, 3.3) |
| High (n=192) | 11.9 (10.8, 12.9) | 11.4 (10.0, 12.8) | 58/160 (36) | 3.9 (2.1, 7.0) | 116/191 (61) | 2.3 (1.8, 3.0) | 94/188 (50) | 4.8 (3.0, 7.7) |
|
| ||||||||
| P trend | <.001 | <.001 | --- | <.001 | --- | <.001 | --- | <.001 |
Analyses conducted in Project Recovery. The maximal CAM-S score during each patient’s hospitalization was used in all analyses.
Functional decline defined as decline by 2 or more points on the 14-point Activities of Daily Living (ADL) score (equivalent to 1 ADL on the standard 7-point scale) between baseline and discharge.
Cognitive decline defined as decline by 2 or more points on the 30-point Mini-Mental State Examination (MMSE) score between baseline and discharge.
Adj=adjusted; RR=relative risk; CI=confidence interval. Short Form, points: None=0, Mild=1, Moderate=2, Severe=3-7; Long Form, points: None = 0-1, Mild=2, Moderate=3-4, Severe=5-19. All models are adjusted for age, sex, nonwhite race, Apache II score, Charlson comorbidity index, and baseline dementia. All models except the model for functional decline were also adjusted for baseline impairment in activities of daily living. Nursing home analyses excluded 54 patients residing in nursing home at baseline and 14 who died during hospitalization. The functional decline analyses excluded 11 patients with missing ADL information at discharge; the cognitive decline analyses excluded 17 patients with missing MMSE values at discharge.