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[Delirium in Chilean elderly inpatients: an overlooked problem].
Rev Med Chil 2005; 133(12):1449-54RM

Abstract

BACKGROUND

Delirium is a common underdiagnosed and undertreated problem in elderly inpatients, associated to higher morbidity, mortality and health cost.

AIM

To evaluate the prevalence of delirium at hospital admission in medically ill elderly patients and the attending physician's diagnosis and treatment of delirium.

PATIENTS AND METHODS

In a prospective and descriptive study, consecutive patients aged 65 years or more, admitted to an internal medicine ward were evaluated by independent physicians, during the first 48 h of admission, to asses the presence of delirium. Diagnosis of delirium was based on the Confusion Assessment Method. Medical and nurse records were reviewed. Family was interviewed when necessary.

RESULTS

One hundred eight patients (52% women, age range 65-94 years) with an APACHE II score of 11.6+/-5, were evaluated. Fifty seven patients (53%) had delirium (32% hyperactive, 72% hypoactive and 5% mixed). Delirium prevalence was significantly higher in older patients (66% among those aged 75 years or older versus 30% in younger, p <0.05) and among patients with more severe conditions (88% among those with an APACHE score over 16 versus 47% below that value, p <0.05). Medical records of patients with delirium showed that this diagnosis was present only in 32% and cognitive deficit was described in 73%. Ten percent of patients with delirium received sedative medication and 38% were physically restricted. There were no environmental interventions to prevent or control delirium.

CONCLUSIONS

Delirium in elderly inpatients at this unit is an extraordinarily prevalent problem, seriously under diagnosed (68%) and under treated. This study should alerts our medical community to improve the diagnosis and management of delirium in elderly inpatients.

Authors+Show Affiliations

Programa de Geriatría, Pontificia Universidad Católica de Chile. mcarras@med.puc.clNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

spa

PubMed ID

16446872

Citation

Carrasco, Marcela, et al. "[Delirium in Chilean Elderly Inpatients: an Overlooked Problem]." Revista Medica De Chile, vol. 133, no. 12, 2005, pp. 1449-54.
Carrasco M, Hoyl T, Marín PP, et al. [Delirium in Chilean elderly inpatients: an overlooked problem]. Rev Med Chil. 2005;133(12):1449-54.
Carrasco, M., Hoyl, T., Marín, P. P., Hidalgo, J., Lagos, C., Longton, C., ... Arriagada, D. (2005). [Delirium in Chilean elderly inpatients: an overlooked problem]. Revista Medica De Chile, 133(12), pp. 1449-54.
Carrasco M, et al. [Delirium in Chilean Elderly Inpatients: an Overlooked Problem]. Rev Med Chil. 2005;133(12):1449-54. PubMed PMID: 16446872.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Delirium in Chilean elderly inpatients: an overlooked problem]. AU - Carrasco,Marcela, AU - Hoyl,Trinidad, AU - Marín,Pedro Paulo, AU - Hidalgo,Jaime, AU - Lagos,Carmen, AU - Longton,Cristóbal, AU - Chávez,Pamela, AU - Valenzuela,Eduardo, AU - Arriagada,Domingo, Y1 - 2006/01/27/ PY - 2006/2/1/pubmed PY - 2006/9/29/medline PY - 2006/2/1/entrez SP - 1449 EP - 54 JF - Revista medica de Chile JO - Rev Med Chil VL - 133 IS - 12 N2 - BACKGROUND: Delirium is a common underdiagnosed and undertreated problem in elderly inpatients, associated to higher morbidity, mortality and health cost. AIM: To evaluate the prevalence of delirium at hospital admission in medically ill elderly patients and the attending physician's diagnosis and treatment of delirium. PATIENTS AND METHODS: In a prospective and descriptive study, consecutive patients aged 65 years or more, admitted to an internal medicine ward were evaluated by independent physicians, during the first 48 h of admission, to asses the presence of delirium. Diagnosis of delirium was based on the Confusion Assessment Method. Medical and nurse records were reviewed. Family was interviewed when necessary. RESULTS: One hundred eight patients (52% women, age range 65-94 years) with an APACHE II score of 11.6+/-5, were evaluated. Fifty seven patients (53%) had delirium (32% hyperactive, 72% hypoactive and 5% mixed). Delirium prevalence was significantly higher in older patients (66% among those aged 75 years or older versus 30% in younger, p <0.05) and among patients with more severe conditions (88% among those with an APACHE score over 16 versus 47% below that value, p <0.05). Medical records of patients with delirium showed that this diagnosis was present only in 32% and cognitive deficit was described in 73%. Ten percent of patients with delirium received sedative medication and 38% were physically restricted. There were no environmental interventions to prevent or control delirium. CONCLUSIONS: Delirium in elderly inpatients at this unit is an extraordinarily prevalent problem, seriously under diagnosed (68%) and under treated. This study should alerts our medical community to improve the diagnosis and management of delirium in elderly inpatients. SN - 0034-9887 UR - https://www.unboundmedicine.com/medline/citation/16446872/[Delirium_in_Chilean_elderly_inpatients:_an_overlooked_problem]_ L2 - http://www.scielo.cl/scielo.php?script=sci_arttext&amp;pid=S0034-98872005001200006&amp;lng=en&amp;nrm=iso&amp;tlng=en DB - PRIME DP - Unbound Medicine ER -