학술논문
Retrospective delirium ascertainment from case notes: a retrospective cohort study
Document Type
article
Author
Qurrat Ul Ain; Lindsay Jones; Swetha Byravan; Joanne Taylor; Carly Welch; Lauren McCluskey; Fiona Herbert; Hussun-Ara Shah; Sarah Richardson; Thomas A Jackson; Gerry McGonigal; Benjamin Jelley; Jane Masoli; Christopher Miller; Daisy Wilson; Elizabeth Lonsdale-Eccles; Abigail Wrathall; Aidan Ryan; Al Wakkass Mahmood; Alexander Harbinson; Alice Wheeler; Amr Bazaraa; Amy Walter; Anekea Ross; Anna Reay; Chenxian Wu; Chioma Iwu; Dhruv Sarma; Elisabeth Hunter; Elizabeth J Ellis; Emily McNicholas; Fiona E Macdonald; Hannah J Robinson; Hannah Watson; Ijeoma T Obi; Imola Bargaoanu; James E Lucocq; Jane Giddings; Jenni Burton; Jodie Crofts; John Headlam; Kelli Torsney; Kumudhini Giridharan; Lahiru Satharasinghe; Laura J Beeley; Liji Ng; Mary Ni Lochlainn; Michael SJ Wilson; Minal D Patel; Mustafa Alsahab; Nader Nashed; Natalie Cox; Oliver Todd; Olivia Handley; Olugbenro Akintade; Philip Nwabufor; Philippa K Traill; Phillipa Adams; Rinata Farah; Robert Grange; Roisin Healy; Ruth Willott; Sarah Jagdeo; Shonit Nagumantry; Simon M Stapley; Sophie J Irwin; Sophie Wright; Srividya Sundara; Tarunya Vedutla; Thomas Arkle; Thyn Thyn; Vee-Han Lim; Victoria Gaunt; Yathu Matheswaran; Zeinab Majid
Source
BMJ Open, Vol 11, Iss 5 (2021)
Subject
Language
English
ISSN
2044-6055
Abstract
Objectives This study sets out to ascertain if recognition of delirium impacts on patient outcomes.Design Retrospective cohort study.Setting Unscheduled admissions to acute care trust/secondary care UK hospitals.Participants Six hundred and fifty-six older adults aged ≥65 years admitted on 14 September 2018.Measurements Delirium was ascertained retrospectively from case notes using medical notes. Documented delirium was classified as recognised delirium and retrospectively ascertained delirium was classified as unrecognised delirium.Primary and secondary outcome measures Primary outcome measure: inpatient mortality. Secondary outcome measures: length of stay, discharge destination.Results Delirium was present in 21.1% (132/626) of patients at any point during admission. The presence of delirium was associated with increased mortality (HR 2.65, CI 1.40 to 5.01). Recognition of delirium did not significantly impact on outcomes.Conclusions Delirium is associated with adverse outcomes in hospitalised older adults. However, there is insufficient evidence that recognition of delirium affects outcomes. However, delirium recognition presents an opportunity to discuss a person’s overall prognosis and discuss this with the patient and their family. Further research is needed to assess the pathophysiology of delirium to enable development of targeted interventions towards improved outcomes in patients with delirium.