Retrospective delirium ascertainment from case notes: a retrospective cohort study

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Retrospective delirium ascertainment from case notes : a retrospective cohort study. / Geriatric Medicine Research Collaborative.

In: BMJ open, Vol. 11, No. 5, e042440, 28.05.2021.

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Geriatric Medicine Research Collaborative. / Retrospective delirium ascertainment from case notes : a retrospective cohort study. In: BMJ open. 2021 ; Vol. 11, No. 5.

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@article{ca9d60e83a93498bba9538a04cc31d19,
title = "Retrospective delirium ascertainment from case notes: a retrospective cohort study",
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.",
keywords = "Aged, Delirium/diagnosis, Hospitalization, Humans, Inpatients, Patient Discharge, Retrospective Studies, geriatric medicine, medical education & training, delirium & cognitive disorders, 1698, Geriatric medicine, 1506",
author = "{Geriatric Medicine Research Collaborative} and Thomas Jackson",
note = "{\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2021",
month = may,
day = "28",
doi = "10.1136/bmjopen-2020-042440",
language = "English",
volume = "11",
journal = "BMJ open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "5",

}

RIS

TY - JOUR

T1 - Retrospective delirium ascertainment from case notes

T2 - a retrospective cohort study

AU - Geriatric Medicine Research Collaborative

AU - Jackson, Thomas

N1 - © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2021/5/28

Y1 - 2021/5/28

N2 - 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.

AB - 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.

KW - Aged

KW - Delirium/diagnosis

KW - Hospitalization

KW - Humans

KW - Inpatients

KW - Patient Discharge

KW - Retrospective Studies

KW - geriatric medicine

KW - medical education & training

KW - delirium & cognitive disorders

KW - 1698

KW - Geriatric medicine

KW - 1506

UR - http://www.scopus.com/inward/record.url?scp=85107174147&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2020-042440

DO - 10.1136/bmjopen-2020-042440

M3 - Article

C2 - 34049901

VL - 11

JO - BMJ open

JF - BMJ open

SN - 2044-6055

IS - 5

M1 - e042440

ER -