{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:53:09Z","timestamp":1753869189167,"version":"3.41.2"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>During the coronavirus disease (COVID\u201019) pandemic, patients with altered mental status (AMS: dementia, delirium and delirium superimposed on dementia) were profoundly affected by an abrupt transformation in healthcare systems. Here, we evaluated quality\u2010care outcomes, including length of stay (LOS), in\u2010hospital mortality, early readmission and mortality after hospital discharge, in older adults admitted for AMS during the pandemic and compared them to patients admitted prior to the pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Chi\u2010squared and Fisher's exact tests were used to examine changes to admissions for AMS before and during the pandemic, and their outcomes. Logistic regression analyses, with reference to pre\u2010pandemic data, were conducted to examine the impact of the pandemic on outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective data of 21,192 non\u2010COVID admissions to an acute general medical department in a Surrey (UK) hospital were collected from patients admitted before (1st April 2019 to 29th February 2020) and during the pandemic (1st March 2020 to 31st March 2021).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 10,173 (47.7% men) from the pre\u2010pandemic and 11,019 (47.5% men) from the pandemic periods; overall mean age \u00a0=\u00a0 68.3yr. During the pandemic AMS patients had significantly higher admission rates (1.1% vs 0.6%, <jats:italic>P<\/jats:italic> &lt; 0.001). However, median LOS in hospital was shorter (9.0 days [IQR\u00a0=\u00a05.3\u201316.2] vs 15.5 days [IQR \u00a0=\u00a0 6.2\u201325.7], <jats:italic>P<\/jats:italic> &lt; 0.001) and thus were less likely to stay in hospital &gt;3 weeks: adjusted OR \u00a0=\u00a0 0.26 (95%CI \u00a0=\u00a0 0.12\u20130.57). In\u2010hospital mortality and readmission within 28 days of discharge did not change during the pandemic, but were less likely to die within 30 days of discharge: adjusted OR\u00a0=\u00a00.32 (95%CI\u00a0=\u00a00.11\u20130.96).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This combination of higher admission rate, shorter LOS, and an unchanging early readmission suggests a higher admission\u2010discharge turnover of different patients with AMS and provides important insights into the potential impact of the COVID\u201019 pandemic on healthcare delivery to individuals with AMS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/gps.6125","type":"journal-article","created":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T01:18:22Z","timestamp":1721351902000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of the COVID\u201019 pandemic on care\u2010quality outcomes in older adults admitted to hospital with altered mental status"],"prefix":"10.1002","volume":"39","author":[{"given":"Adam","family":"Fluck","sequence":"first","affiliation":[{"name":"Faculty of Medical Sciences The Medical School Newcastle University  Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher H.","family":"Fry","sequence":"additional","affiliation":[{"name":"School of Physiology Pharmacology and Neuroscience University of Bristol  Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Robin","sequence":"additional","affiliation":[{"name":"Department of Medicine Ashford and St Peter's Hospitals NHS Foundation Trust  Surrey UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Fluck","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ashford and St Peter's Hospitals NHS Foundation Trust  Surrey UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2570-0938","authenticated-orcid":false,"given":"Thang S.","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Ashford and St Peter's Hospitals NHS Foundation Trust  Surrey UK"},{"name":"Institute of Cardiovascular Research Royal Holloway University of London  Surrey UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582\u2010022\u201000698\u20107"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(13)60688\u20101"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532\u20105415.2002.50468.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2016.07.014"},{"volume-title":"Elective Care in England Assessing the Impact 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