Retrospective delirium ascertainment from case notes: a retrospective cohort study

Geriatric Medicine Research Collaborative; Daisy Wilson

doi:10.1136/bmjopen-2020-042440

Retrospective delirium ascertainment from case notes: a retrospective cohort study

Geriatric Medicine Research Collaborative, Daisy Wilson

Inflammation and Ageing

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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.

Original language	English
Article number	e042440
Number of pages	8
Journal	BMJ open
Volume	11
Issue number	5
DOIs	https://doi.org/10.1136/bmjopen-2020-042440
Publication status	Published - 28 May 2021

Bibliographical note

Keywords

Aged
Delirium/diagnosis
Hospitalization
Humans
Inpatients
Patient Discharge
Retrospective Studies
geriatric medicine
medical education & training
delirium & cognitive disorders
1698
Geriatric medicine
1506

ASJC Scopus subject areas

Medicine(all)

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10.1136/bmjopen-2020-042440Licence: Creative Commons: Attribution-NonCommercial (CC BY-NC)

GMRCollaborative2021Retrospective
Retrospective delirium ascertainment from case notes: a retrospective cohort studyBMJ Open 2021;11:e042440. doi: 10.1136/bmjopen-2020-042440
Final published version, 2.34 MBLicence: Creative Commons: Attribution-NonCommercial (CC BY-NC)

Cite this

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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.",

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author = "{Geriatric Medicine Research Collaborative} and Thomas Jackson and Daisy Wilson",

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T1 - Retrospective delirium ascertainment from case notes

T2 - a retrospective cohort study

AU - Geriatric Medicine Research Collaborative

AU - Jackson, Thomas

AU - Wilson, Daisy

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.

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JF - BMJ open

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ER -

Retrospective delirium ascertainment from case notes: a retrospective cohort study

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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