Delirium in your house: a survey during General Practitioner-programmed home visits

Tremolizzo, Lucio; Bargossi, Lorena; Storti, Benedetta; Ferrarese, Carlo; Bellelli, Giuseppe; Appollonio, Ildebrando

doi:10.1007/s40520-021-01806-1

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…These rates could be underestimated because many studies exclude patients with cognitive impairment or dementia who are particularly vulnerable to developing delirium [ 20 ]. An observational study assessing the prevalence of delirium among older patients living at home and periodically visited by their general practitioners (GPs) showed a high percentage (44.1%) among vulnerable and frail patients [ 21 ], while it was lower in other community settings (1–2%) [ 22 ].…”

Section: Definition Clinical Presentation and Epidemiologymentioning

confidence: 99%

Proposing a Scientific and Technological Approach to the Summaries of Clinical Issues of Inpatient Elderly with Delirium: A Viewpoint

Frisardi

Nicolini²,

Cautero

et al. 2022

Healthcare

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Background/rationale: Despite mounting evidence about delirium, this complex geriatric syndrome is still not well managed in clinical contexts. The aging population creates a very demanding area for innovation and technology in healthcare. For instance, an outline of an aging-friendly healthcare environment and clear guidance for technology-supported improvements for people at delirium risk are lacking. Objective: We aimed to foster debate about the importance of technical support in optimizing healthcare professional practice and improving the outcomes for inpatients’ at delirium risk. We focused on critical clinical points in the field of delirium worthy of being addressed by a multidisciplinary approach. Methods: Starting from a consensus workshop sponsored by the Management Perfectioning Course based at the Marco Biagi Foundation (Modena, Italy) about clinical issues related to delirium management still not addressed in our healthcare organizations, we developed a requirements’ analysis among the representatives of different disciplines and tried to formulate how technology could support the summaries of the clinical issues. We analyzed the national and international panorama by a PubMed consultation of articles with the following keywords in advanced research: “delirium”, “delirium management”, “technology in healthcare”, and “elderly population”. Results: Despite international recommendations, delirium remains underdiagnosed, underdetected, underreported, and mismanaged in the acute hospital, increasing healthcare costs, healthcare professionals’ job distress, and poor clinical outcomes. Discussion: Although all healthcare professionals recognize delirium as a severe and potentially preventable source of morbidity and mortality for hospitalized older people, it receives insufficient attention in resource allocation and multidisciplinary research. We synthesized how tech-based tools could offer potential solutions to the critical clinical points in delirium management.

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Section: Definition Clinical Presentation and Epidemiologymentioning

confidence: 99%

Proposing a Scientific and Technological Approach to the Summaries of Clinical Issues of Inpatient Elderly with Delirium: A Viewpoint

Frisardi

Nicolini²,

Cautero

et al. 2022

Healthcare

View full text Add to dashboard Cite

show abstract

“…Delirium is an underdiagnosed and undertreated syndrome in all hospitals, long‐term care centres and home settings (Boettger et al, 2021; Sepúlveda et al, 2019; Tremolizzo et al, 2021). It is characterised by disturbed consciousness and changes in cognitive function and/or perception that develop over a short period of time (Oh et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Identification through the Manchester Triage System of the older population at risk of delirium: A case–control study

Soler-Sanchis

Martínez-Arnau

Sánchez-Frutos

et al. 2022

Journal of Clinical Nursing

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Objective To identify the flow charts and discriminators of the Manchester Triage System that are most likely to identify the onset of delirium in older people. Background Delirium is an underdiagnosed geriatric syndrome, and up to 80% of all cases of delirium go undetected in emergency departments. Patient triage seeks to manage clinical risk with a view to safely and appropriately managing patient flows. Design A case–control study was performed according to the STROBE checklist. Setting The emergency department of a secondary hospital. Participants Older adults aged ≥65 years and admitted from 1 January to 31 December 2020. Methods Older patients were identified from the emergency department research database. Cases were defined as patients diagnosed with delirium (n = 128), excluding cases of delirium due to alcohol or substance abuse. Controls were randomised from the remaining patients (n = 128). Results A total of 29.35% of the subjects admitted to the emergency department were older adults with an incidence of delirium of 0.7%. The flow charts with the highest probability of delirium were ‘unwell adult’ [OR = 3.04 (95%CI:1.82–5.1)] and ‘behaving strangely’ [OR = 16.06 (95%CI:3.72–69.29)], and the discriminators were ‘rapid onset’ [OR = 3.3 (95%CI:1.85–5.88)] and ‘new neurological deficit less than 24 h old’ [OR = 4.76 (95%%CI:1.01–22.5). The area under the curve for ‘unwell adult’ in the presence of dementia, previous stroke and fall in the previous 30 days was 0.73 (95%CI: 0.67–0.79), and that for ‘behaving strangely’ in the presence of diabetes was 0.75 (95%CI: 0.69–0.81). Conclusions Knowing which flow charts, discriminators and risk factors are most likely to predict delirium allows the identification of the older population at risk for triage screening in emergency departments. Relevance to clinical practice Risk factors such as diabetes, dementia, previous stroke and recent fall among ‘unwell adult’ or ‘behaving strangely’ triaged older persons should be assessed for the probable presence of delirium.

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The role of hormones in the pathogenesis and treatment mechanisms of delirium in ICU: The past, the present, and the future

Cao

Song

Ding

et al. 2023

The Journal of Steroid Biochemistry and Molecular Biology

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Delirium in your house: a survey during General Practitioner-programmed home visits

Cited by 4 publications

References 27 publications

Proposing a Scientific and Technological Approach to the Summaries of Clinical Issues of Inpatient Elderly with Delirium: A Viewpoint

Proposing a Scientific and Technological Approach to the Summaries of Clinical Issues of Inpatient Elderly with Delirium: A Viewpoint

Identification through the Manchester Triage System of the older population at risk of delirium: A case–control study

The role of hormones in the pathogenesis and treatment mechanisms of delirium in ICU: The past, the present, and the future

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