Delirium in an adult acute hospital population: predictors, prevalence and detection

摘要: Background To date, delirium prevalence and incidence in acute hospitals has been estimated from pooled findings of studies performed distinct patient populations. Objective determine across an care facility. Design A point study. Setting large tertiary care, teaching hospital. Patients 311 general hospital adult inpatients were assessed over a single day. Of those, 280 had full data collected within the study9s time frame (90%). Measurements Initial screening for inattention was using spatial span forwards months backwards tests by junior medical staff, followed two independent formal assessments: first Confusion Assessment Method (CAM) trained geriatric medicine consultants registrars, and, subsequently, Delirium Rating Scale-Revised-98 (DRS-R98) experienced psychiatrists. The diagnosis ultimately made DSM-IV (Diagnostic Statistical Manual Mental Disorders, Fourth Edition) criteria. Results Using criteria, 55 patients (19.6%) versus 17.6% CAM. DRS-R98 total score diagnosis, 20.7% delirium, 8.6% subsyndromal delirium. Prevalence higher older (4.7% if 80 years) particularly those with prior dementia (OR=15.33, p Conclusions Our study confirms that occurs about 1/5 cognitive impairment. Recognition strategies may need to be tailored symptoms most noticed detector (patient, nurse or primary physician) assessments are not available.