restricted access 18. Cardiovascular Iatrogenicity in Older Adults
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AGING AND IATROGENICITY An iatrogenic adverse event is defined as any unintended injury or complication that results from medical management rather than the under­ lying disease pro­ cess and results in prolonged hospitalization or disability at discharge (1,2). Older patients are more likely to experience iatrogenic complications than younger patients (45% versus 29%; p 65 years of age with acute decompensated heart failure. Am J Cardiol. 2011;​108(3):​402–408. 17. Mangusan RF, Vooper V, Denslow AS, et al. Outcomes associated with postoperative delirium­ after cardiac surgery. Am J Crit Care. 2015;​24(2):​ 156–163. 18. Stransky M, Schmidt C, Ganslmeier P, et al. Hypoactive delirium ­ after cardiac surgery as an in­ de­ pen­ dent risk ­ factor for prolonged mechanical ventilation. J Cardiothorac Vasc Anesth. 2011;​ 25(6):​968–974. 19. Rudolph JL, Inouye SK, Jones RN, et al. Delirium: an in­ de­ pen­ dent predictor of functional decline­ after cardiac surgery. J Am Geriatric Soc. 2010;​ 58(4):​643–649. 20. McCusker J, Cole M, Dendukuri N, et al. Delirium in older medical inpatients and subsequent cognitive and functional status. Can Med Assoc J. 2001;​165(5):​575–583. 21. Leslie DL, Marcantonio ER, Zhang Y, et al. One-­ year health care costs associated with delirium in the el­ derly population. Arch Intern Med. 2008;​ 168(1):​27–32. 22. G. Bellelli, A. Morandi, E. Zanetti, M. et al. Recognition and management of delirium among doctors , nurses, physiotherapists, and psychologists: an Italian survey. Int Psychogeriatr. 2014;​26(12):​ 2093–2102. doi:10.1017/S1041610214001653. 23. Inouye S, Forman M, Mion L, et al. Nurses’ recognition of delirium and its symptoms: comparison of nurse and researcher ratings. Arch Intern Med. 2001;​161:​2467–2473. 24. LaMantia MA, Messina FC, Hobgood CD, et al. Screening for delirium in the emergency department : a systematic review. Ann of Emerg Med. 2014;​63:​551–560. 25. Bellilli G, Morandi A, Davis DH, et al. Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalized older­people. Age Aging. 2014;​43:​496–502. 26. Inouye SK, van Dyck CH, Alessi CA, et al. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;​113:​941–948. 27. Guenther U, Theuerkauf N, Frommann I, et al. Predisposing and precipitating ­ factors of delirium 216 / Cardiovascular Iatrogenicity in Older Adults 57. Kumbhani DJ, Steg G, Cannon CP, et al. Adherence to secondary prevention medi­ cations and four-­ year outcomes in outpatients with atherosclerosis . Am J Med. 2013;​126(8)693–700. 58. Campanelli C. American Geriatrics Society updated Beers Criteria for potentially inappropriate medi­ cation use in older adults. The American Geriatrics Society 2012 Beers Criteria Update Expert Panel J Am Geriatr Soc. 2012;​60(4):​ 616–631. 59. Flood KL, Rohlfing A, Le CV, et al. Geriatric syndromes in el­ derly patients admitted to an inpatient cardiology ward. J Hosp Med. 2007;​ 2(6):​394–400. 60. Kidd AC, Musonda P, Soiza RL, et al. The relationship between total anticholinergic burden (ACB) and early in-­ patient hospital mortality and length of stay in the oldest old aged 90 years and over admitted with an acute illness. Arch Gerontol Geriatr. 2014;​59(1):​155–161. 61. Purser JL, Kuchibhatla MN, Fillenbaum GG, et al. Identifying frailty in hospitalized older adults with significant coronary artery disease. J Am Geriatr Soc. 2006;​ 54: 1674–1681. 62. Afilalo J, Alexander KP, Mack MJ, et al. Frailty assessment in the cardiovascular care of older adults. J Am Coll Cardiol. 2014; 63(8):​ 747–762. 63. Chaudhry SI, McAvay G, Chen S, et al. Risk­ factors for hospital admission among older persons with newly diagnosed heart failure: findings from the Cardiovascular Health Study. J Am Coll Cardiol. 2013;​61:​635–642. 64. Singh M, Rihal CS, Lennon RJ, et al. Influence of frailty and health status on outcomes in patients with coronary disease undergoing percutaneous revascularization. Circ Cardiovasc Qual Outcomes . 2011;​4:​496–495. 65. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;​56(3):M146–156. 66. Counsell SR, Holder CM, Liebenauer LL, et al. Effects of a multicomponent intervention on functional outcomes and pro­ cess of care in hospitalized older patients: a randomized controlled trial of Acute Care for Elders (ACE) in a community hospital. Journal of the American Geriatrics Society . 2000;​48(12):​1572–1581. 67. Fox MT...