Patient selection: elderly Medicare beneficiaries receiving critical care >= 66 years old
Outcome: diagnosis of dementia in the 3 years following discharge
Exclusions:
(1) pre-existing dementia or cognitive impairment
(2) cardiac surgery during admission or in preceding year
Risk factors for dementia after discharge from the ICU:
(1) infection or severe sepsis
(2) acute dialysis
(3) acute neurologic dysfunction (encephalopathy, anoxic brain damage, transient mental disorder)
where:
• Presumable stroke would qualify for an acute neurologic dysfunction.
• While cardiac surgery was removed from the analysis, it will be added to the implementation.
Mechanical ventilation was not associated with an increased risk.
A patient with multiple risk factors should be monitored for cognitive function following discharge.
