‘Confusion’ is commonly considered normal in older patients, who are most at risk. 9, 10 The reasons for poor recognition are multifactorial. 6, 7 Collins et al found recognition rates to be as low as 28% in older medical inpatients 8 and studies in the emergency department (ED) show similar rates of underdetection. 3 Detection rates are lower in older patients, 4 those with premorbid dementia 5 and in hypoactive cases. 1 In a study of general hospital referrals to liaison psychiatry, Kishi et al showed that 46% of delirium diagnoses were missed by the referring team. In a point-prevalence study of delirium in 311 patients across a general hospital, doctors missed over half the delirium cases. It is independently associated with adverse outcomes, 2 including increased length of stay, increased mortality and accelerated cognitive and functional decline.Ī major challenge in delirium care is that, despite its significance, delirium is commonly missed or mistaken for other conditions across treatment settings. ![]() It is ubiquitous in the acute hospital setting, having a point prevalence of almost 20%, 1 with higher rates in older patients. 7 Cognitive Impairment Research Group, Centre for Interventions in Infection, Inflammation & Immunity (4i), Graduate Entry Medical School, University of Limerick, Limerick, Irelandĭr Niamh O'Regan, Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, St Finbarr's Hospital, Douglas Road, Cork, Ireland .ukĭelirium is a serious neuropsychiatric condition which occurs in the setting of acute illness.6 Department of Psychiatry, University of Limerick, Limerick, Ireland. ![]()
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