7 research outputs found
Reforming Sentence Deferrals in Victoria. Consultation Paper - A Response
No full textReforming Sentence Deferrals in Victoria. Consultation Paper - A Respons
Why prosecution guidance on women suspected of endangering or harming their infants needs to be updated and published
No full textWhy prosecution guidance on women suspected of endangering or harming their infants needs to be updated and publishe
Memorandum on potential international law issues arising from the sale of Telenor Myanmar
No full textMemorandum on potential international law issues arising from the sale of Telenor Myanma
Editorial: The over-representation of neurodivergent children in Youth Justice Systems and The Youth Court
No full textFoetal Alcohol Spectrum Disorder (FASD) and the Courts: How England and Wales Could Benefit From Following an Australian Model
No full textFoetal alcohol spectrum disorder (FASD) is a set of symptoms and signs that may follow from exposure of the unborn child to alcohol during pregnancy. Characterised by cognitive and behavioural impairments, one secondary outcome from FASD, is encounters with the criminal justice system (CJS). In some countries, for example, England and Wales, it seems likely that many cases are missed at this point and, thus, courts are at risk of making unsafe judgements. We could learn a lot from countries where services are generally more used to dealing with FASD. Australia is one such country
Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study
No full textPurpose:
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
