BACKGROUND: Delirium is a common and poorly diagnosed cause of behavioral change in elderly. This study aimed to estimate the prevalence, diagnostic accuracy and factors associated with the onset of delirium in the elderly admitted to an urgency unit. METHODS: Cross-sectional study including clinically stable subjects aged ≥60 years between April and June of 2014. Diagnosis of delirium based on the Confusion Assessment Method (CAM, gold standard) was compared to the subjective assessment made by physicians on duty as recorded in the medical chart. Association of sociodemographic, psychological/behavioural, and clinical variables with delirium was assessed using multivariate analysis. RESULTS: A sample of 110 participants with a mean age of 72.7 ± 8.3 years was studied. Of these, 56.4% were men and 28.2% had a diagnosis of delirium on CAM. Significant associations were observed between delirium and male gender (P-value = 0.019), poor or very poor self-perception of health (P-value = 0.033), previous diagnosis of dementia (P-value = 0.001), previous history of stroke (P-value = 0.014), and acute bacterial infection (P-value = 0.008). Physician diagnosis had a sensitivity of 35.5%, specificity of 100%, and accuracy of 81.8% to detect delirium. Rate of misdiagnosis was 64.5%. CONCLUSION: Delirium was underdiagnosed in this urgent care hospital setting.
BACKGROUND:Delirium is a common and poorly diagnosed cause of behavioral change in elderly. This study aimed to estimate the prevalence, diagnostic accuracy and factors associated with the onset of delirium in the elderly admitted to an urgency unit. METHODS: Cross-sectional study including clinically stable subjects aged ≥60 years between April and June of 2014. Diagnosis of delirium based on the Confusion Assessment Method (CAM, gold standard) was compared to the subjective assessment made by physicians on duty as recorded in the medical chart. Association of sociodemographic, psychological/behavioural, and clinical variables with delirium was assessed using multivariate analysis. RESULTS: A sample of 110 participants with a mean age of 72.7 ± 8.3 years was studied. Of these, 56.4% were men and 28.2% had a diagnosis of delirium on CAM. Significant associations were observed between delirium and male gender (P-value = 0.019), poor or very poor self-perception of health (P-value = 0.033), previous diagnosis of dementia (P-value = 0.001), previous history of stroke (P-value = 0.014), and acute bacterial infection (P-value = 0.008). Physician diagnosis had a sensitivity of 35.5%, specificity of 100%, and accuracy of 81.8% to detect delirium. Rate of misdiagnosis was 64.5%. CONCLUSION:Delirium was underdiagnosed in this urgent care hospital setting.
Authors: Sunyang Fu; Guilherme S Lopes; Sandeep R Pagali; Bjoerg Thorsteinsdottir; Nathan K LeBrasseur; Andrew Wen; Hongfang Liu; Walter A Rocca; Janet E Olson; Jennifer St Sauver; Sunghwan Sohn Journal: J Gerontol A Biol Sci Med Sci Date: 2022-03-03 Impact factor: 6.053
Authors: Carl M Zipser; Tobias R Spiller; Florian F Hildenbrand; Annina Seiler; Jutta Ernst; Roland von Känel; Sharon K Inouye; Soenke Boettger Journal: J Am Med Dir Assoc Date: 2022-02-13 Impact factor: 7.802
Authors: Robert Fleischmann; Steffi Traenkner; Antje Kraft; Sein Schmidt; Stephan J Schreiber; Stephan A Brandt Journal: Pilot Feasibility Stud Date: 2019-01-07
Authors: Sunyang Fu; Guilherme S Lopes; Sandeep R Pagali; Bjoerg Thorsteinsdottir; Nathan K LeBrasseur; Andrew Wen; Hongfang Liu; Walter A Rocca; Janet E Olson; Jennifer St Sauver; Sunghwan Sohn Journal: J Gerontol A Biol Sci Med Sci Date: 2022-03-03 Impact factor: 6.053
Authors: Luke C Pilling; Lindsay C Jones; Jane A H Masoli; João Delgado; Janice L Atkins; Jack Bowden; Richard H Fortinsky; George A Kuchel; David Melzer Journal: J Am Geriatr Soc Date: 2020-10-05 Impact factor: 5.562