Impact of Delirium on Short-Term Mortality in Elderly Inpatients: A Prospective Cohort Study

González, Matías; Martínez, Gabriel García; Calderón, Jorge; Villarroel, Luis; Yuri, Francisca; Rojas, Carlos; Jeria, Álvaro; Valdívia, Gonzalo; Marín, Pedro Paulo; Carrasco, Marcela

doi:10.1176/appi.psy.50.3.234

Cited by 130 publications

(115 citation statements)

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“…Las evaluaciones fueron realizadas cada 48 h, hasta el alta o por un máximo de 12 días, por un equipo médico de psicogeriatría entrenados en la detección de delirium. Más detalles de las características de esta cohorte fueron publicadas 8 . Se registró información demográfica (género, edad y datos de identificación), laboratorio (electrolitos plasmáticos, nitrógeno ureico, creatinina plasmática, proteína C reactiva, albúmina plasmá-tica); de severidad de la enfermedad mediante el índice APACHE II 21 , carga de comorbilidad mediante el Índice de Charlson 22 y de funcionalidad previa al ingreso mediante índice de Barthel 23 .…”

Section: Cohorte De Desarrollounclassified

“…Uno de los factores que marcan la importancia del delirium es que afecta radicalmente el pro-nóstico del individuo. Ha demostrado asociarse a eventos negativos que incluyen mayor riesgo de complicaciones intrahospitalarias, deterioro funcional, estadía hospitalaria, y mayor mortalidad tanto intra como extrahospitalaria [5][6][7][8] . A pesar de esta evidencia, ha sido difícil incorporar esta condición como un problema relevante en la clínica habitual y aún existen importantes cifras de subdiagnóstico 9 y escasos programas de prevención y manejo en la práctica clínica habitual 10 .…”

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Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica

et al. 2014

Rev. méd. Chile

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Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica

et al. 2014

Rev. méd. Chile

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“…Most research studies report that while around 10-15% of all hospital patients experience acute delirium, it is much more common among older than younger patients (Arnold, 2005). One recent study found 35.4% of elderly persons developed some form of acute delirium when hospitalized (Gonzalez et al, 2009). Other studies indicate as many as 65% of senior citizens, particularly those who have surgery or who require intensive care treatment, will experience it (Kalisvaart & Vreeswijk, 2008).…”

Section: Introductionmentioning

confidence: 99%

“…Regardless, acute delirium is clearly understood as a serious health condition. It is associated with prolonged hospital stays, long-standing (if not permanent) cognitive impairment, high risk of nursing home admission, and death (Gonzalez et al, 2009;MacLullich, Beaglehole, Hall & Meagher, 2009). Many studies have sought to identify the incidence or prevalence of acute delirium, its many causes, and its medical management.…”

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Nursing Practices to Detect Acute Delirium, Safeguard Patients Experiencing Acute Delirium, and Help Reduce or Eliminate Acute Delirium

Wilson¹,

Low²,

Thurston³

et al. 2010

GJHS

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Acute delirium is very common among hospital patients, particularly older patients. Nurses have a major role in the care of these patients, yet there are no evidence-based nursing care guidelines to help nurses detect patients who are experiencing acute delirium, safeguard them, and assist their recovery. This study sought to identify and prioritize nursing practices for detecting these patients, safeguarding them, and assisting their recovery from acute delirium. A two-stage voluntary paper Delphi survey was used for this purpose. This study targeted all nurses who worked on adult medical/surgical units at two full-service acute care hospitals in Western Canada Global Journal of Health Science www.ccsenet.org/gjhs 82 who had cared for a patient diagnosed with acute delirium in the past 12 months. The first survey revealed many nursing practices exist to detect, safeguard, and assist recovery. The second revealed one preferred practice and four others for each of the following: Detecting acute delirium, safeguarding patients, and helping patients recover. Research is now needed to establish if these constitute "best practice" nursing care for enhanced patient outcomes.Keywords: Acute delirium, Confusion, Delphi technique, Hospital care, Nursing practice, Survey Acute delirium is common among hospital patients, although it is often unrecognized or misdiagnosed (Morandi et al., 2009). Acute delirium is therefore typically under reported (Kales, Kamholz, Visnic & Blow, 2003, Minden et al., 2005. Regardless, acute delirium is clearly understood as a serious health condition. It is associated with prolonged hospital stays, long-standing (if not permanent) cognitive impairment, high risk of nursing home admission, and death (Gonzalez et al., 2009;MacLullich, Beaglehole, Hall & Meagher, 2009). Many studies have sought to identify the incidence or prevalence of acute delirium, its many causes, and its medical management. Few studies have focused on the nursing perspective, yet nurses are the most likely healthcare professional to detect patients who are experiencing acute delirium. Nurses are also responsible for planning and managing the day-to-day care of these patients with a need to be kept safe and a need for nursing care that will help them recover.No studies were found through a systematic review of acute delirium research that reveal how nurses identify patients who are experiencing acute delirium, what they do to safeguard these patients, and what they do to help them recover. This research gap lends credence to the assertion of Rapp, Mentes, and Titler (2001) that over half of all nursing care that is considered "appropriate" practice is not evidence based. The need for nurse researchers to focus on acute delirium was pointed out many years ago. In 1996, Meagher, O'Hanlon, O'Mahony, and Casey emphasized the importance of early nursing identification of patients who are confused, as well as the need for best-practice nursing care for patients who are suffering from acute delirium. This lack of nursing r...

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“…It includes factors such as; not giving a high diagnostic and therapeutic priority to delirium, 18 failure to recognize hypoactive variety of delirium and overreliance on orientation when diagnosing delirium. 19,20 Nonrecognition is problematic as mortality seems to increase by about 11% for every additional 48 hours of active delirium, 21 as well as leading to other complications like prolonged hospital stay, 10 increased health care cost, 13 and long term cognitive impairment. 14,15 Routine use of screening instruments like ICDSC could help prevent these complications by aiding in early diagnosis.…”

mentioning

confidence: 99%

Delirium in Critically ill Patients in a Tertiary Care Centre in Western Region of Nepal

Thapa

Chakrabortty

Khattri

et al. 2015

Kathmandu Univ. Med. J.

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Impact of Delirium on Short-Term Mortality in Elderly Inpatients: A Prospective Cohort Study

Cited by 130 publications

References 24 publications

Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica

Riesgo de delirium durante la hospitalización en personas mayores: desarrollo y validación de un modelo de predicción clínica

Nursing Practices to Detect Acute Delirium, Safeguard Patients Experiencing Acute Delirium, and Help Reduce or Eliminate Acute Delirium

Delirium in Critically ill Patients in a Tertiary Care Centre in Western Region of Nepal

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