The Effect of Multiple Assessments on Delirium Detection: a Pilot Study*
| Autor: | Sa. De Freitas, A. Curkovic, Christopher Gabor, Christina Reppas-Rindlisbacher, Ekc. Wong, Jy. Lee, Cj. Patterson |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Prevalence Diagnostic interview behavioral disciplines and activities 03 medical and health sciences delirium 0302 clinical medicine multiple observations mental disorders medicine In patient 030212 general & internal medicine orthopedic Original Research Geriatrics High prevalence business.industry 3D-CAM nervous system diseases point-prevalence Orthopedic surgery Emergency medicine Assessment methods Delirium Geriatrics and Gerontology medicine.symptom business Gerontology 030217 neurology & neurosurgery |
| Zdroj: | Canadian Geriatrics Journal |
| ISSN: | 1925-8348 |
| DOI: | 10.5770/cgj.23.433 |
| Popis: | Background Delirium is characterized by fluctuating attention or arousal, with high prevalence in the orthopaedic ward. Our aim was to: 1) establish the prevalence of delirium on an orthopaedic ward, and 2) compare delirium prevalence using a single geriatrician assessment vs. multiple 3D-CAM (3-Minute Diagnostic Interview for Confusion Assessment Method) assessments during the day. We hypothesized that multiple assessments would increase the detection rate due to the fluctuating nature of delirium. Methods Comparative study conducted at an academic hospital in Hamilton, Ontario. Participants included patients 65 years and older admitted to the orthopaedic ward (n=55). After a geriatrician made the first assessment of delirium by 3D-CAM on each patient, teams with specialized geriatrics training re-assessed participants up to four times. Delirium rates based on first assessment were compared to cumulative end-of-day rates to determine if detection increased with multiple assessments. Results The prevalence of delirium was 30.9% (17 participants) using multiple assessments. Of these cases, 13 (76.4%) were detected in the initial geriatrician assessment. In patients with hip fractures, 70.6% (12 of 17) were identified as delirious by multiple assessments. Conclusion As symptoms fluctuate, multiple daily CAM assessments may increase the identification of delirium in orthopaedic inpatients. |
| Databáze: | OpenAIRE |
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