The diagnosis of delirium in an acute-care hospital in Moscow: what does the Pandora&amp;rsquo;s box contain?

Ткачева, О. Н.; Runikhina, N. K.; Верткин, А. Л.; Voronina, Irina V; Sharashkina, Nataliya V; Mkhitaryan, É. A.; Остапенко, В. С.; Прохорович, Е. А.; Freud, Tamar; Press, Yan

doi:10.2147/cia.s123177

Cited by 4 publications

(5 citation statements)

References 21 publications

(53 reference statements)

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“…The association between drugs with an anticholinergic burden and delirium has been reported in previous studies (29)(30)(31). Dementia was found to be a risk factor for ASD, as was reported in many previous studies that showed that impaired cognition (5,8) and dementia (3,32,33) were risk factors for delirium.…”

Section: Risk Factors For Deliriumsupporting

confidence: 68%

“…Delirium is a highly prevalent problem with an occurrence rate of 7-42% among adults hospitalized in internal medicine wards (2)(3)(4)(5) and is associated with poor outcomes, including an increased risk of dementia and functional decline (6), prolonged hospital stay (5,7,8), increased risk of institutionalization (3,6,7), high health care costs (9), and even increased mortality (3,5,6,10,11). Despite its clinical significance delirium often remains undiagnosed by the medical team.…”

Section: Introductionmentioning

confidence: 99%

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Delirium in Internal Medicine Departments in a Tertiary Hospital in Israel: Occurrence, Detection Rates, Risk Factors, and Outcomes

et al. 2020

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Background: The aim of the study was to assess the occurrence rate of delirium among elderly hospitalized patients in the medicine wards of a large tertiary hospital, to identify risk factors, and to evaluate the diagnostic rate for delirium among the medical teams. Methods: A 3-month prospective study of patients 65 years of age and above in three medicine wards: in two wards patients were examined by trained study team members using the Confusion Assessment Method (CAM), while the third was a control ward where CAM was not administered. The third ward served to control for the effect of the presence of investigators in the other wards as a potential confounding factor. Based on the results of this assessment patients were defined as suffering from subsyndromal delirium, full delirium (these two groups were later combined into an "any symptoms of delirium" group), and no delirium. The rate of diagnosis by the medical team was obtained from the electronic medical records. Results: The full delirium rate was 5.1%, the rate of subsyndromal delirium was 14.6%, and the rate of any symptoms of delirium was 19.6%. Absence of a partner, pain, anemia, hyponatremia, hypocalcemia, and the use of drugs with an anticholinergic burden were factors for any symptoms of delirium as well as for subsyndromal delirium. Subsyndromal delirium and any symptoms of delirium were associated with a reduced chance of being discharged to home and a higher 3-month mortality rate. A diagnosis of delirium was found in only 19.4% of the patients with any symptoms of delirium in the medical records. Conclusions: Delirium is a common problem among elderly hospitalized patients, but it is diagnosed sub-optimally by the medical team. There is a need for further training of the medical teams and implementation of delirium assessment as part of the ward's routine.

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Section: Risk Factors For Deliriumsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Delirium in Internal Medicine Departments in a Tertiary Hospital in Israel: Occurrence, Detection Rates, Risk Factors, and Outcomes

et al. 2020

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“…In addition, the unfamiliarity of the hospital environment can harm patients' mental health, which is not conducive to their recovery (22). Prolonged hospitalization can lead to additional risks, such as delirium and infections (23)(24)(25)(26)(27)(28). These problems are mitigated by HaH services, which might be why most of the subjects were willing to accept them.…”

Section: Discussionmentioning

confidence: 99%

Individuals' Awareness of and Willingness to Accept Hospital-at-Home Services and Related Factors: A Cross-Sectional Study

Wang

et al. 2022

Front. Public Health

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IntroductionHospital-at-home (HaH) services have become increasingly popular. However, the experience of HaH implementation in Asia is inadequate. Therefore, the purpose of this study was to investigate individuals' willingness to accept HaH services and the potential related factors.MethodsThe researchers visited households to select appropriate participants. An online questionnaire survey was conducted among the inhabitants of selected communities. An individual's awareness, willingness to accept HaH services, and demands such as ideal service providers and more detailed information to accept HaH care were investigated. The outcome measure was the willingness to accept HaH services. Chi-square tests and logistic regression models were used to analyze the factors.ResultsA total of 622 subjects participated in this study. The findings indicate that 55.9% of the participants were not aware of HaH services, while most of the subjects (88.4%) were willing to accept them. Regression models indicated that having health insurance (OR = 2.170, 95% CI: 1.003–4.697), an awareness of the necessity of HaH services (OR = 4.721, 95% CI: 2.471–9.019), very much hoping staff from central hospitals would be service providers (OR = 20.299, 95% CI: 5.718–72.068), and somewhat hoping that staff from central hospitals would be service providers (OR = 9.139, 95% CI: 2.714–30.775) were the factors associated with a greater willingness to accept HaH services.ConclusionThe study indicates that compared to the awareness of HaH care, residents had a greater willingness to accept such care. The willingness to utilize HaH services among individuals was associated with enabling factors, predisposing factors, and HaH-related demand factors.

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“…En relación con las variables estudiadas que no han resultado predictivas del desarrollo del SCA, se incluyen la deambulación previa a la fractura, presencia de cardiopatías, HTA, depresión, fibrilación auricular, artrosis, diabetes, tipo de cirugía empleada, tipo de fractura, anestesia utilizada, así como las complicaciones de trasfusión, estreñimiento, respiratorias, alteraciones renales, desnutrición, ICC y cardiopatía isquémica (Tabla 23). Estos resultados difieren de otros estudios donde algunas comorbilidades como son las diabetes, HTA y alteraciones respiratorias, si están relacionadas de manera significativa con el desarrollo de SCA en la estancia hospitalaria (Tkacheva et al, 2017).…”

Section: Factores Predictores Del Sca O Delirium En Pacientes Con Fraunclassified

“…No obstante, los datos que relacionan ambas variables son poco precisos. Téngase en cuenta que la procedencia más común de este tipo de pacientes es un centro residencial por lo que es complicado evaluar el tipo de convivencia (Tkacheva et al, 2017). Por consiguiente, los resultados dispares podrían estar relacionados con la falta de precisión en la definición de esta variable.…”

Section: Factores Predictores Del Sca O Delirium En Pacientes Con Fraunclassified

Síndrome confusional agudo en pacientes con fractura de cadera en el área sanitaria de León: buenas prácticas de enfermería = Acute confusional syndrome in patients with hip fracture in the León health care area: good nursing practice

Carmona¹,

Inmaculada²

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Introduction: Delirium is considered one of the great geriatric syndromes because of the economic and social impact it has on the health system.The presence of this syndrome in the elderly has been shown to be more prevalent in those cases that have been operated on by orthopaedic surgeries.Objective: Firstly, the aim is to analyse the clinical and socioenvironmental predictive factors in the development of ACS or delirium during hospitalisation for hip fracture. On the other hand, it is proposed to address a nursing care plan or good practice action in nursing to prevent, palliate or reduce ACS in patients hospitalized for hip fracture. Methodology: Two types of methodology have been used to develop this work. On the one hand, a prospective cohort study carried out with a sample of 287 orthogeriatric patients (87.2 ± 3.2 years) recruited in the Trauma Unit of the Hospital Complex of León. Predisposing, precipitating and risk factors in the development of acute confusional syndrome were analysed according to sociodemographic, baseline, surgical, pharmacological variables, comorbidities and complications. The statistical data were analyzed by means of a Chi -test of association between categorical variables, Mann-Whitney U test for the contrast of means between groups, multivariate logistic regression test and segmentationanalysis by means of the CHAID method. On the other hand, a bibliometric review of the scientific literature on the approach to nursing performance in the phases of diagnosis and treatment of ACS in elderly patients hospitalized for CF diagnosis was carried out. Results:The results of the predictive factors show that the presence of anaemia (30.5 % vs 47.4 %; OR=0.48) is a significant (P<.05) and effective (although with a slight effect: 2 %) predictor of delirium. Furthermore, ASA in categories 3 or 4 (36.3 %; OR=1.95), cognitive impairment, UTI (63.4 % vs 27.6 %; OR=4.54), visual disturbances (44.8 % vs 29.7 %; OR=1.92) and RAO (58.1 % vs 29.7 %; OR=3.28), in this order, are predictive variables of delirium in hospitalized older patients with hip fracture. Based on the multidimensional nature of the variables that precipitate ACS, we propose to combine the pharmacological therapeutic approach with non-pharmacological action. In this sense, the results of the bibliometric study highlight the relevance of nonpharmacological factors to be implemented in nursing care plans or good practice for the treatment of ACS. Conclusion:The environmental predictive factors that impact on the development of delirium can be controlled from the very moment of the patient's hospitalisation. Therefore, on the basis of a good nursing practice action plan, it is possible to minimise the disruption caused by this syndrome to the patients, their families and health care providers themselves.

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The diagnosis of delirium in an acute-care hospital in Moscow: what does the Pandora’s box contain?

Cited by 4 publications

References 21 publications

Delirium in Internal Medicine Departments in a Tertiary Hospital in Israel: Occurrence, Detection Rates, Risk Factors, and Outcomes

Delirium in Internal Medicine Departments in a Tertiary Hospital in Israel: Occurrence, Detection Rates, Risk Factors, and Outcomes

Individuals' Awareness of and Willingness to Accept Hospital-at-Home Services and Related Factors: A Cross-Sectional Study

Síndrome confusional agudo en pacientes con fractura de cadera en el área sanitaria de León: buenas prácticas de enfermería = Acute confusional syndrome in patients with hip fracture in the León health care area: good nursing practice

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