Table 3. The Association of CAM-S with Post-Hospital Outcomes*.
| Post-Hospital Outcome | Death within 90 Days (N=919) |
Cost Per Day, First 90 Days (N=831) |
Death or Nursing Home Residence at 90 Days (N=844) |
Functional Decline at 30 Days (N=712)† |
|||
|---|---|---|---|---|---|---|---|
|
| |||||||
| n/N (%) | Adjusted RR (95% CI) |
Adj. Mean (95% CI), $ | n/N (%) | Adjusted RR (95% CI) |
n/N (%) | Adjusted RR (95% CI) |
|
| CAM-S Short Form Severity Rating | |||||||
|
| |||||||
| None (n=598) | 39/598 (7) | Referent | 115.8 (100.2, 131.3) | 81/544 (15) | Referent | 143/497 (29) | Referent |
| Low (n=91) | 14/91 (15) | 2.0 (1.1, 3.5) | 158.4 (108.0, 208.7) | 27/82 (33) | 1.9 (1.3, 2.7) | 29/70 (41) | 1.4 (1.0, 1.9) |
| Moderate (n=128) | 20/128 (16) | 1.8 (1.1, 3.2) | 175.3 (129.8, 220.8) | 48/121 (40) | 2.1 (1.5, 2.9) | 41/91 (45) | 1.5 (1.2, 2.0) |
| High (n=102) | 28/102 (27) | 3.3 (2.1, 5.1) | 168.2 (116.4, 220.0) | 49/97 (51) | 2.5 (1.9, 3.3) | 28/54 (52) | 1.6 (1.2, 2.2) |
|
| |||||||
| P trend | --- | <.001 | <.001 | --- | <.001 | --- | <.001 |
|
| |||||||
| CAM-S Long Form Severity Rating | |||||||
|
| |||||||
| None (n=205) | 14/205 (7) | Referent | 97.6 (76.0, 119.2) | 24/181 (13) | Referent | 35/175 (20) | Referent |
| Low (n=288) | 20/288 (7) | 0.8 (0.4, 1.5) | 126.7 (103.8, 149.7) | 37/263 (14) | 1.0 (0.6, 1.6) | 67/238 (28) | 1.4 (1.0, 2.0) |
| Moderate (n=234) | 25/234 (11) | 1.3 (0.7, 2.4) | 138.0 (110.2, 165.7) | 57/217 (26) | 1.6 (1.0, 2.5) | 77/180 (43) | 2.0 (1.4, 2.8) |
| High (n=192) | 42/192 (22) | 2.3 (1.3, 4.1) | 177.2 (138.2, 216.3) | 87/183 (48) | 2.5 (1.6, 3.7) | 62/119 (52) | 2.3 (1.6, 3.3) |
|
| |||||||
| P trend | --- | <.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 30 days. These analyses included all 728 patients who were available for telephone follow up interviews at one-month, but excluded 16 with missing ADL data.
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. Deaths within 90 days include all in-hospital deaths. 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. Medicare data (nursing home and costs) were missing for 75 patients (including those receiving care in health maintenance organizations). The cost per day analyses additionally excluded 13 patients who died during hospitalization. See text for details.