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The Effect of Multiple Assessments on Delirium Detection: a Pilot Study
S A de Freitas1,2,3, Ekc Wong4,5, J Y Lee1,5
1Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton.
Canadian Geriatrics Journal : CGJ
|December 7, 2020
Summary
Multiple daily assessments using the Confusion Assessment Method (CAM) can improve delirium detection in older orthopaedic patients. This approach helps identify more cases due to the fluctuating nature of delirium symptoms.
Area of Science:
- Geriatric Medicine
- Internal Medicine
- Psychiatry
Background:
- Delirium, marked by fluctuating attention, is common in orthopaedic settings.
- Orthopaedic patients frequently experience delirium, impacting care and outcomes.
Purpose of the Study:
- To determine the prevalence of delirium in an orthopaedic ward.
- To compare delirium detection rates between a single geriatrician assessment and multiple daily 3-Minute Diagnostic Interview for Confusion Assessment Method (3D-CAM) assessments.
Main Methods:
- A comparative study was conducted at an academic hospital.
- 55 patients aged 65+ admitted to an orthopaedic ward were assessed.
- Delirium was initially assessed by a geriatrician using 3D-CAM, followed by up to four re-assessments by specialized teams.
Main Results:
- The overall prevalence of delirium was 30.9% (17 participants) when using multiple assessments.
- The initial geriatrician assessment detected 76.4% of delirium cases.
- Among patients with hip fractures, 70.6% were identified as delirious through multiple assessments.
Conclusions:
- Multiple daily 3D-CAM assessments can enhance the identification of delirium in orthopaedic inpatients.
- The fluctuating nature of delirium necessitates repeated assessments for accurate diagnosis.
