Subdiagnóstico de delirium en adultos mayores hospitalizados

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...

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Autores principales:	Carrasco G,Marcela, Hoyl M,Trinidad, Marín L,Pedro Paulo, Hidalgo A,Jaime, Lagos D,Carmen, Longton B,Cristóbal, Chávez B,Pamela, Valenzuela A,Eduardo, Arriagada M,Domingo
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2005
Materias:	Aged Delirium Frailelderly Hospitalized
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001200006
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spelling	oai:scielo:S0034-988720050012000062006-01-27Subdiagnóstico de delirium en adultos mayores hospitalizadosCarrasco G,MarcelaHoyl M,TrinidadMarín L,Pedro PauloHidalgo A,JaimeLagos D,CarmenLongton B,CristóbalChávez B,PamelaValenzuela A,EduardoArriagada M,Domingo Aged Delirium Frailelderly Hospitalized 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 (Rev Méd Chile 2005; 133: 1449-54)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.133 n.12 20052005-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001200006es10.4067/S0034-98872005001200006
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Aged Delirium Frailelderly Hospitalized
spellingShingle	Aged Delirium Frailelderly Hospitalized Carrasco G,Marcela Hoyl M,Trinidad Marín L,Pedro Paulo Hidalgo A,Jaime Lagos D,Carmen Longton B,Cristóbal Chávez B,Pamela Valenzuela A,Eduardo Arriagada M,Domingo Subdiagnóstico de delirium en adultos mayores hospitalizados
description	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 (Rev Méd Chile 2005; 133: 1449-54)
author	Carrasco G,Marcela Hoyl M,Trinidad Marín L,Pedro Paulo Hidalgo A,Jaime Lagos D,Carmen Longton B,Cristóbal Chávez B,Pamela Valenzuela A,Eduardo Arriagada M,Domingo
author_facet	Carrasco G,Marcela Hoyl M,Trinidad Marín L,Pedro Paulo Hidalgo A,Jaime Lagos D,Carmen Longton B,Cristóbal Chávez B,Pamela Valenzuela A,Eduardo Arriagada M,Domingo
author_sort	Carrasco G,Marcela
title	Subdiagnóstico de delirium en adultos mayores hospitalizados
title_short	Subdiagnóstico de delirium en adultos mayores hospitalizados
title_full	Subdiagnóstico de delirium en adultos mayores hospitalizados
title_fullStr	Subdiagnóstico de delirium en adultos mayores hospitalizados
title_full_unstemmed	Subdiagnóstico de delirium en adultos mayores hospitalizados
title_sort	subdiagnóstico de delirium en adultos mayores hospitalizados
publisher	Sociedad Médica de Santiago
publishDate	2005
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001200006
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Subdiagnóstico de delirium en adultos mayores hospitalizados

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