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Assessing delirium in acute geriatric wards

Assessing delirium in acute geriatric wards. Leiv Otto Watne Oslo University Hospital, Norway. Delirium. - An acute change in cognition and attention Common condition : - At admission ( medical patients ): 10 - 31%

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Assessing delirium in acute geriatric wards

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  1. Assessing delirium in acute geriatricwards Leiv Otto Watne Oslo University Hospital, Norway

  2. Delirium • - An acutechange in cognition and attention • Commoncondition: • - At admission (medicalpatients): 10 - 31% • - Occurance rate per admission (medicalpatients) 11- 42 %. • - Hip fracturepatients: 4 - 53% • - ICU patients: 50 - 80 % Siddiqi N, House AO, Holmes JD. Age Ageing. 2006 Jul;35(4):350-64. Bruce AJ,IntPsychogeriatr. 2007 Apr;19(2):197-214. Epub 2006 Sep 14. Jones, SF. CurrOpinCritCare. 2012 Apr;18(2):146-51.

  3. Cork University Hospital, Irland: 407 acute adult inpatients beds • 15th of May 2010 were all patientsassessed for delirium • 19,6 % had delirium Only 43,6% had delirium or oneofits synonyms documented in the case notes!! Ryan DJ, BMJ Open. 2013 Jan 7;3

  4. Aim: ”to systematicallyreviewtheevidenceontheaccuracyofbedsideintstruments in diagnosingthepresenceof delirium” • Compared screening instruments to a ”golden standard” • Recommend: CAM, DRS-R98, MDAS Wong CL, JAMA. 2010 Aug 18;304(7)

  5. From the original paper: • - Can be completed in less than 5 minutes • Sensitivity 94-100 % • Specificity 90-95 % Inouye S, Ann Intern Med. 1990 Dec 15;113(12):941-8.

  6. Assessing delirium in acute geriatricwards How to do it?!!

  7. Delirium assessments • For research: CAM, MDAS and/or DRS-R98 • For clinicalwork: ?

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