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Estudios originales
Medwave 2015 Nov;15(10):e6311 doi: 10.5867/medwave.2015.10.6311
Prevalencia del delirium en pacientes hospitalizados en un servicio de medicina interna
Prevalence of delirium in hospitalized patients from an internal medicine service
Ana Carolina González Pezoa, Bernardita Claudia Carrillo Venezian, Sandra Castillo Rojas
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Palabras clave: delirium, inpatients, internal medicine

Abstract

INTRODUCTION
Delirium is a common neurocognitive syndrome that takes place during hospitalizations, associated with worse global outcomes in patients who present it. Despite this, it is usually under-recognized as a disease that needs specific treatment.

OBJECTIVES
To determine the rate of prevalence of delirium in Internal Medicine Service patients and evaluate missed diagnosis of the syndrome made by attending physicians, medical residents or interns in charge.

METHODS
This is a descriptive observational study carried out in the Internal Medicine Service of Dr. Eduardo Pereira Hospital (April 12 - May 12, 2014) evaluating 125 patients who were admitted to this service. Through the Confusion Assessment Method Instrument, the prevalence of delirium disease and the number of missed diagnosis was established.

RESULTS
One hundred and two (102) patients met the inclusion criteria. Nineteen (19) (18.6%) of them were diagnosed with delirium. In the diagnosed patient group, 13 (68.4%) were women. Delirium diagnosis was missed in eight patients (42.1%).

CONCLUSIONS
The prevalence of delirium in this specific Hospital is as expected, according to the literature. Considering the diagnostic tools available, it is crucial to train health workers to improve recognition and management of this syndrome.


 

This article does not have an English version.

 

 

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INTRODUCTION
Delirium is a common neurocognitive syndrome that takes place during hospitalizations, associated with worse global outcomes in patients who present it. Despite this, it is usually under-recognized as a disease that needs specific treatment.

OBJECTIVES
To determine the rate of prevalence of delirium in Internal Medicine Service patients and evaluate missed diagnosis of the syndrome made by attending physicians, medical residents or interns in charge.

METHODS
This is a descriptive observational study carried out in the Internal Medicine Service of Dr. Eduardo Pereira Hospital (April 12 - May 12, 2014) evaluating 125 patients who were admitted to this service. Through the Confusion Assessment Method Instrument, the prevalence of delirium disease and the number of missed diagnosis was established.

RESULTS
One hundred and two (102) patients met the inclusion criteria. Nineteen (19) (18.6%) of them were diagnosed with delirium. In the diagnosed patient group, 13 (68.4%) were women. Delirium diagnosis was missed in eight patients (42.1%).

CONCLUSIONS
The prevalence of delirium in this specific Hospital is as expected, according to the literature. Considering the diagnostic tools available, it is crucial to train health workers to improve recognition and management of this syndrome.

Autores: Ana Carolina González Pezoa[1], Bernardita Claudia Carrillo Venezian[1], Sandra Castillo Rojas[1,2]

Filiación:
[1] Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
[2] Servicio de Medicina, Hospital Dr. Eduardo Pereira, Valparaíso, Chile

E-mail: a.cari.gpz@gmail.com

Correspondencia a:
[1] Hontaneda 2653
Valparaíso
Chile

Citación: González Pezoa AC, Carrillo Venezian BC, Castillo Rojas S. Prevalence of delirium in hospitalized patients from an internal medicine service. Medwave 2015 Nov;15(10):e6311 doi: 10.5867/medwave.2015.10.6311

Fecha de envío: 9/7/2015

Fecha de aceptación: 23/10/2015

Fecha de publicación: 11/11/2015

Origen: no solicitado

Tipo de revisión: con revisión por cuatro pares revisores externos, a doble ciego

Ficha PubMed

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  1. Young J, Inouye SK. Delirium in older people. BMJ. 2007 Apr 21;334(7598):842-6. | PubMed |
  2. Han JH, Wilson A, Ely EW. Delirium in the older emergency department patient: a quiet epidemic. Emerg Med Clin North Am. 2010 Aug;28(3):611-31. | CrossRef | PubMed |
  3. Marcantonio ER. In the clinic. Delirium. Ann Intern Med. 2011 Jun 7;154(11):ITC6-1. | CrossRef | PubMed |
  4. Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990 Dec 15;113(12):941-8. | PubMed |
  5. O'Keeffe ST, Lavan JN. Clinical significance of delirium subtypes in older people. Age Ageing. 1999 Mar;28(2):115-9. | PubMed |
  6. Kiely DK, Jones RN, Bergmann MA, Marcantonio ER. Association between psychomotor activity delirium subtypes and mortality among newly admitted post-acute facility patients. J Gerontol A Biol Sci Med Sci. 2007 Feb;62(2):174-9. | PubMed |
  7. Alvarez Fernandez B, Formiga F, Gomez R. Delirium in hospitalised older persons: review. J Nutr Health Aging. 2008 Apr;12(4):246-51. | PubMed |
  8. Carrasco M, Hoyl T, Marín PP, Hidalgo J, Lagos C, Longton C, et al. [Delirium in Chilean elderly inpatients: an overlooked problem]. Rev Med Chil. 2005 Dec;133(12):1449-54. | PubMed |
  9. Aris R, Papuzinski C, Martínez F. Multicomponent interventions in preventing incident delirium in elderly inpatients: a critical appraisal of literature. Medwave 2013;13(9):e5822. | CrossRef |
  10. Lonergan E, Britton AM, Luxenberg J, Wyller T. Antipsychotics for delirium. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD005594. | PubMed | Link |
  11. Wei LA, Fearing MA, Sternberg EJ, Inouye SK. The Confusion Assessment Method: a systematic review of current usage. J Am Geriatr Soc. 2008 May;56(5):823-30. | CrossRef | PubMed |
  12. Siddiqi N, House AO, Holmes JD. Occurrence and outcome of delirium in medical in-patients: a systematic literature review. Age Ageing. 2006 Jul;35(4):350-64. | PubMed |
  13. Salluh JI, Wang H, Schneider EB, Nagaraja N, Yenokyan G, Damluji A, Serafim RB, Stevens RD. Outcome of delirium in critically ill patients: systematic review and meta-analysis. BMJ. 2015 Jun 3;350:h2538. | CrossRef | PubMed |
  14. Tobar C, Beddings C, Vallejo G, Martínez F. Prevalencia de Delirium y Diagnóstico por los Médicos Tratantes. Revista ANACEM. 2010;4(29):82-85. | Link |
  15. Inouye SK, Viscoli CM, Horwitz RI, Hurst LD, Tinetti ME. A predictive model for delirium in hospitalized elderly medical patients based on admission characteristics. Ann Intern Med. 1993 Sep 15;119(6):474-81. | PubMed |
Young J, Inouye SK. Delirium in older people. BMJ. 2007 Apr 21;334(7598):842-6. | PubMed |

Han JH, Wilson A, Ely EW. Delirium in the older emergency department patient: a quiet epidemic. Emerg Med Clin North Am. 2010 Aug;28(3):611-31. | CrossRef | PubMed |

Marcantonio ER. In the clinic. Delirium. Ann Intern Med. 2011 Jun 7;154(11):ITC6-1. | CrossRef | PubMed |

Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990 Dec 15;113(12):941-8. | PubMed |

O'Keeffe ST, Lavan JN. Clinical significance of delirium subtypes in older people. Age Ageing. 1999 Mar;28(2):115-9. | PubMed |

Kiely DK, Jones RN, Bergmann MA, Marcantonio ER. Association between psychomotor activity delirium subtypes and mortality among newly admitted post-acute facility patients. J Gerontol A Biol Sci Med Sci. 2007 Feb;62(2):174-9. | PubMed |

Alvarez Fernandez B, Formiga F, Gomez R. Delirium in hospitalised older persons: review. J Nutr Health Aging. 2008 Apr;12(4):246-51. | PubMed |

Carrasco M, Hoyl T, Marín PP, Hidalgo J, Lagos C, Longton C, et al. [Delirium in Chilean elderly inpatients: an overlooked problem]. Rev Med Chil. 2005 Dec;133(12):1449-54. | PubMed |

Aris R, Papuzinski C, Martínez F. Multicomponent interventions in preventing incident delirium in elderly inpatients: a critical appraisal of literature. Medwave 2013;13(9):e5822. | CrossRef |

Lonergan E, Britton AM, Luxenberg J, Wyller T. Antipsychotics for delirium. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD005594. | PubMed | Link |

Wei LA, Fearing MA, Sternberg EJ, Inouye SK. The Confusion Assessment Method: a systematic review of current usage. J Am Geriatr Soc. 2008 May;56(5):823-30. | CrossRef | PubMed |

Siddiqi N, House AO, Holmes JD. Occurrence and outcome of delirium in medical in-patients: a systematic literature review. Age Ageing. 2006 Jul;35(4):350-64. | PubMed |

Salluh JI, Wang H, Schneider EB, Nagaraja N, Yenokyan G, Damluji A, Serafim RB, Stevens RD. Outcome of delirium in critically ill patients: systematic review and meta-analysis. BMJ. 2015 Jun 3;350:h2538. | CrossRef | PubMed |

Tobar C, Beddings C, Vallejo G, Martínez F. Prevalencia de Delirium y Diagnóstico por los Médicos Tratantes. Revista ANACEM. 2010;4(29):82-85. | Link |

Inouye SK, Viscoli CM, Horwitz RI, Hurst LD, Tinetti ME. A predictive model for delirium in hospitalized elderly medical patients based on admission characteristics. Ann Intern Med. 1993 Sep 15;119(6):474-81. | PubMed |