Delirium is seen in one-third of patients in an acute hospital setting. Identification, pharmacologic and non-pharmacologic treatment is inadequate.
BACKGROUND
Delirium is an organically caused acute dysfunction of the brain associated with increased morbidity, mortality, cost of care and poor cognitive recovery.


METHODS
This point prevalence study of delirium was conducted at Hvidovre Hospital, Copenhagen, Denmark at two separate occasions. Patients were examined with the Brief Confusion Assessment Method (bCAM) in both, but in the second survey bCAM was supplemented with a psychiatric assessment using the Diagnostic and Statistical Manual of Mental Disorders, fourth ed. In all, 126 patients were assessed and eight patients were excluded. The delirious patients' charts were examined.


RESULTS
Out of the 118 patients included in the study, 38 (32%) were delirious and in 18 (47%) patients, the diagnosis was documented. Furthermore, in 18 (47%) patients, a pharmacological treatment plan for agitation was prepared (in 89% of those diagnosed with delirium and in 10% of those without the diagnosis). In 26 (68%), a plan to increase care existed (in 78% of those with a diagnosis of delirium and in 60% without the diagnosis). In 11 patients (29%), there was a plan for reducing stress (in 44% of those with a diagnosis of delirium and in 15% without the diagnosis).


CONCLUSIONS
Delirium is a common phenomenon in a Danish acute hospital setting. Identification and treatment are inadequate. The diagnosis of delirium is a possible determinant for treatment is care; hence, this study found that pharmacological treatment for agitation, optimised care and stress reduction were more frequently considered in patients with the delirium diagnosis than in patients who did not have the diagnosis.


BACKGROUND
This study has no external funding.


BACKGROUND
The local Danish Research Ethics Committee was notified, but as it was a non-intervention study no permission was required.
jens.noerbaek@regionh.dk.
Jens
J
Nørbæk
Elsebeth
E
Glipstrup
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy*; D003718:Denmark / Q000453:epidemiology; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D010347:Patient Care Planning; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000188:drug therapy; D013315:Stress, Psychological / Q000517:prevention & control; D055815:Young Adult