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[Detection of delirium in hospitalized elderly patients using the confusion assessment method]
María Estela Chávez-Delgado1, Maricela Virgen-Enciso, Julio Pérez-Guzmán
1Hospital General de Zona 89, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico. echavez@cencar.udg.mx
Objective:
To determine the prevalence and incidence of delirium using the Confusion Assessment Method (CAM) in hospitalized elderly patients in the geriatric department of IMSS General Hospital No. 89, at Guadalajara, Jalisco.
Methods:
Between May and October 2005, a descriptive and cross-sectional study was conducted with patients older than 60 years that were admitted to the geriatric department. The CAM was used to detect delirium and the Mini-Mental State Examination (MMSE) to identify cognitive impairment; also, comorbidity, length of hospital stay and mortality were analyzed.
Results:
According to CAM, the prevalence of delirium was 38.3 % and the incidence was 11.7%. 48.5% of patients who had developed delirium previously showed cognitive impairment. Patients who experienced delirium were older when compared to non-delirious patients (80 +/- 8.7 versus 74. 4 +/- 8.9 years of age; p < 0. 001). Similarly, length of hospital stay was higher among patients who developed delirium when compared with patients who never developed it (7.5 +/- 2.9 versus 5.8 +/- 2.6 days; p < 0.001). Pneumonia and uremia were most common in delirious patients.
Conclusion:
The CAM and MMSE seems to be an acceptable screening instrument for delirium and cognitive impairment; using theses tests routinely could contribute to improve quality of care for these patients.
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