title: Management and outcomes of delirious patients with hyperactive symptoms in a secured behavioral unit jointly used by geriatricians and pyschogeriatricians.
abstract: To compare the clinical outcomes and length of stay (LOS) between delirious patients with hyperactive symptoms admitted directly and those admitted indirectly from Emergency Department into a secured, behavioral unit jointly used by geriatricians and pyschogeriatricians (the Unit). A retrospective study analyzing data from the medical records of 122 patients with an admission diagnosis of delirium with hyperactive symptoms and subsequently discharged from the Unit, including restraint, one-to-one nursing care, falls, absconding, duration of delirium, recovery from delirium, destination and LOS. Significantly fewer patients with direct admission (n=68) required physical restraint or chemical restraint compared with those transferred (n=54). Patients admitted directly showed a higher discharge rate back home, shorter LOS, shorter duration of delirium and a higher rate of recovery from delirium than transferred patients. Of the transferred patients, more received one-to-one nursing care before transfer than after transfer. Three (5.6%) absconded before transfer, but none absconded from the Unit. The falls rate reduced from 14.2 to 6.7 falls/1000 patient delirium days after transfer. Delirious patients with hyperactive symptoms admitted directly to the Unit fared better in clinical outcomes and LOS. They also required less restraint, less intensive nursing and were unlikely to abscond compared to those transferred.
authors.affiliation: Department of Aged Care and Rehabilitation, Bankstown-Lidcombe Hospital, Locked Bag 1600, Bankstown, NSW 2200, Australia.
authors.forename: Ji Hui
authors.initials: JH
authors.lastname: Lu
authors.forename: Daniel K Y
authors.initials: DK
authors.lastname: Chan
authors.forename: Fintan
authors.initials: F
authors.lastname: O'Rourke
authors.forename: Bin
authors.initials: B
authors.lastname: Ong
authors.forename: Qing
authors.initials: Q
authors.lastname: Shen
authors.forename: Sharon
authors.initials: S
authors.lastname: Reutens
authors.forename: Anita
authors.initials: A
authors.lastname: Ko
mesh_terms: D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003693:Delirium / Q000628:therapy*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005853:Geriatrics / Q000706:statistics & numerical data; D006801:Humans; D006948:Hyperkinesis / Q000523:psychology / Q000628:therapy; D007902:Length of Stay; D008297:Male; D016017:Odds Ratio; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D012149:Restraint, Physical / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome