Diagnosing delirium in very elderly intensive care patients

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• 作者：Natalie R. Heriot^a ; Michele R. Levinson^a ; ^b ; Amber C. Mills^a ; ^{AMills@Cabrini.com.au} ; Thinn Thinn Khine^c ; Anthea L. Gellie^a ; Gaya Sritharan^a
• 关键词：Delirium ; Critical care ; Intensive care units ; Aged ; 80 and over ; International classification of diseases ; Diagnostic and statistical manual of mental disorders
• 刊名：Intensive and Critical Care Nursing
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：38
• 期：Complete
• 页码：10-17
• 全文大小：421 K
• 卷排序：38

文摘

To determine the incidence of delirium in elderly intensive care patients and to compare incidence using two retrospective chart-based diagnostic methods and a hospital reporting measure (ICD-10).DesignRetrospective study.SettingAn ICU in a large metropolitan private hospital in Melbourne, Australia.PatientsEnglish-speaking participants (n = 348) 80+ years, admitted to ICU for >24 hours.Measurements and main resultsMedical files of ICU patients admitted October 2009–October 2012 were retrospectively assessed for delirium using the Inouye chart review method, DSM-IV diagnostic criteria and ICD-10 coding data. General patient characteristics, first onset of delirium symptoms, source of delirium information, administration of delirium medication, hospital and ICU length of stay, 90 day mortality were documented. Delirium was found in 11–29% of patients, the highest incidence identified by chart review. Patients diagnosed with delirium had higher 90 day mortality, and those meeting criteria for all three methods had longer hospital and ICU length of stay.ConclusionsICU delirium in the elderly is often under-reported and strategies are needed to improve staff education and diagnosis.