Development and validation of a delirium risk assessment tool in older patients admitted to the Emergency Department Observation Unit
| Autor: | Alessandro Padovani, Giuseppe Bellelli, Alberto Zucchelli, S. De Bianchi, V. Prestipino, R. Apuzzo, Alessandra Marengoni, C. Paolillo, Giuseppe Romanelli |
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| Přispěvatelé: | Zucchelli, A, Apuzzo, R, Paolillo, C, Prestipino, V, De Bianchi, S, Romanelli, G, Padovani, A, Marengoni, A, Bellelli, G |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Aging
medicine.medical_specialty Risk management tools Older person Risk Assessment Prediction score Hospital 03 medical and health sciences 0302 clinical medicine Older patients Clinical Observation Units mental disorders 80 and over medicine Humans Dementia diagnosis 030212 general & internal medicine Prospective Studies Geriatric Assessment Aged Aged 80 and over Emergency Service Geriatrics gerontology business.industry Emergency department Delirium Older persons Emergency Service Hospital Emergency medicine Original Article Geriatrics and Gerontology medicine.symptom business 030217 neurology & neurosurgery Observation unit |
| Zdroj: | Aging Clinical and Experimental Research |
| Popis: | Background Delirium is frequent though undetected in older patients admitted to the Emergency Department (ED). Aims To develop and validate a delirium risk assessment tool for older persons admitted to the ED Observation Unit (OU). Methods We used data from two samples of 65 + year-old patients, one admitted to the ED of Brescia Hospital (n = 257) and one to the ED of Desio Hospital (n = 107), Italy. Data from Brescia were used as training sample, those collected in Desio as testing one. Delirium was assessed using the 4AT and patients’ characteristic were retrieved from medical charts. Variables found to be associated with delirium in the training sample were tested for the creation of a delirium risk assessment tool. The resulting tool’s performances were assessed in the testing subsample. Results Of all possible scores tested, the combination with the highest discriminative ability in the training sample included: age ≥ 75 years, dementia diagnosis, chronic use of neuroleptics, and hearing impairment. The delirium score exhibited an AUC of 0.874 and 0.893 in the training and testing samples, respectively. For a 1-point increase in the score, the odds of delirium increased more than twice in both samples. Discussion We propose a delirium risk assessing tool that includes variables that can be easily collected at ED admission and that can be calculated rapidly. Conclusion A risk assessment tool could help improving delirium detection in older persons referring to ED. |
| Databáze: | OpenAIRE |
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