Frequency of delirium and subsyndromal delirium in an adult acute hospital population

British Journal of Psychiatry

Volumn 205, Issue 6, 2014, Pages 478-485

  Meagher, David ^a,b   O'Regan, N ^c   Ryan, D ^c   Connolly, W ^c   Boland, E ^c   O'Caoimhe, R ^c   Clare, J ^c   Mcfarland, J ^b   Tighe, S ^b   Leonard, M ^b   Adamis, D ^b,d,e   Trzepacz, P T ^f,g,h,i   Timmons, S ^c  

^a UNIVERSITY OF LIMERICK   (Ireland)

^b UNIVERSITY OF LIMERICK   (Ireland)

^c St Finbarr's Hospital   (Ireland)

^d Sligo/Leitrim Mental Health Services   (Ireland)

^e UNIVERSITY OF WEST ATTICA   (Greece)

^f ELI LILLY AND COMPANY   (United States)

^g UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE   (United States)

^h TUFTS UNIVERSITY SCHOOL OF MEDICINE   (United States)

ⁱ INDIANA UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ADULT; AGED; ARTICLE; ATTENTION DISTURBANCE; COGNITIVE DEFECT; CONFUSION ASSESSMENT METHOD; DELIRIUM; DELIRIUM RATING SCALE REVISED 98; DSM-IV; FEMALE; GENERAL HOSPITAL; HUMAN; MAJOR CLINICAL STUDY; MALE; PREVALENCE; RATING SCALE; SCORING SYSTEM; SUBSYNDROMAL DELIRIUM; SYMPTOMATOLOGY; COMPLICATION; CONFUSION; CROSS-SECTIONAL STUDY; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; IRELAND; MASS SCREENING; MIDDLE AGED; NEUROPSYCHOLOGICAL TEST; PATIENT ACUITY; PROCEDURES; PSYCHOLOGICAL RATING SCALE; PSYCHOLOGY; STANDARDS; STATISTICS AND NUMERICAL DATA; SYMPTOM ASSESSMENT; TERTIARY CARE CENTER; VERY ELDERLY;

AGED; AGED, 80 AND OVER; CONFUSION; CROSS-SECTIONAL STUDIES; DELIRIUM; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; FEMALE; HUMANS; IRELAND; MALE; MASS SCREENING; MIDDLE AGED; NEUROPSYCHOLOGICAL TESTS; PATIENT ACUITY; PREVALENCE; PSYCHIATRIC STATUS RATING SCALES; SYMPTOM ASSESSMENT; TERTIARY CARE CENTERS;

EID: 84916618560     PISSN: 00071250     EISSN: 14721465     Source Type: Journal    
DOI: 10.1192/bjp.bp.113.139865     Document Type: Article

References (42)

1. Witlox J, Eurelings LS, de Jonghe JF, Kalisvaart KJ, Eikelenboom P, van Gool WA. Delirium in elderly patients and the risk of post discharge mortality, institutionalization, and dementia: a meta-analysis. JAMA 2010; 304: 443-51.
2. Marcantonio E, Ta T, Duthie E, Resnick NM. Delirium severity and psychomotor types: their relationship with outcomes after hip fracture repair. J Am Geriatr Soc 2002; 50: 850-7.
3. Dosa D, Intrator O, McNicoll L, Cang Y, TenoJ. Preliminary derivation of a Nursing Home Confusion Assessment Method based on data from the minimum data set. J Am Geriatr Soc 2007; 55: 1099-105.
4. Ouimet S, Riker R, Bergeron N, Cossette M, Kavanagh B, Skrobik Y. Subsyndromal delirium in the ICU: evidence for a disease spectrum. Intensive Care Med 2007; 33: 1007-13.
5. Cole MG, McCusker J, Ciampi A, Belzile E. The 6- and 12-month outcomes of older medical inpatients who recover from subsyndromal delirium. J Am Geriatr Soc 2008; 56: 2093-9.
6. Martinez-Velilla N, Alonso-Bouzon C, Cambra-Contin K, Ibañez-Beroiz B, Alonso-Renedo J. Outcome in complex patients with delirium and subsyndromal delirium one year after hospital discharge. Int Psychogeriatrics 2013; 25: 2087-8.
7. Cole M, McCusker J, Dendukuri N, Han, L. The prognostic significance of subsyndromal delirium in elderly medical inpatients. J Am Geriatr Soc 2003; 51: 754-60.
8. Cole MG, McCusker J, Voyer P, Monette J, Champoux N, Ciampi A, et al. Subsyndromal delirium in older long-term care residents: incidence, risk factors, and outcomes. J Am Geriatr Soc 2011; 59: 1829-36.
9. Bourdel-Marchasson I, Vincent S, Germain C, Salles N, Jenn J, Rasoamanarivo E, et al. Delirium symptoms and low dietary intake in older inpatients are independent predictors of institutionalization: a 1-year prospective population-based study. J Gerontol Biol Med Sci 2004; 59: 350-4.
10. Marcantonio ER, Kiely DK, Simon SE, John Orav E, Jones RN, Murphy KM, et al. Outcomes of older people admitted to postacute facilities with delirium. J Am Geriatr Soc 2005; 53: 963-9.
11. Tan MC, Felde A, Kuskowski M, Ward H, Kelly RF, Adabag AS, et al. Incidence and predictors of post-cardiotomy delirium.Am J Geriatric Psychiatry 2008; 16: 575-83.
12. Leonard M, Spiller J, Keen J, MacLullich A, Kamholtz B, Meagher D. Symptoms of depression and delirium assessed serially in palliative-care inpatients. Psychosomatics 2009; 50: 506-14.
13. Bond SM, Dietrich MS, Shuster JL Jr, Murphy BA. Delirium in patients with head and neck cancer in the outpatient treatment setting. Support Care Cancer 2012; 20: 1023-30.
14. von Gunten A, Mosimann UP. Delirium upon admission to Swiss nursing homes: a cross-sectional study. Swiss Med Wkly 2010; 140: 376-81.
15. Zuliani G, Bonetti F, Magon S, Prandini S, Sioulis F, D'Amato M, et al. Subsyndromal delirium and its determinants in elderly patients hospitalized for acute medical illness. J Gerontol A Biol Sci Med Sci. 2013; 68: 1296-302.
16. Franco JG, Trzepacz PT, MejíaMA, Ochoa SB. Factor analysis of the Colombian translation of the Delirium Rating Scale (DRS), Revised-98. Psychosomatics 2009; 50: 255-62.
17. Grover S, Mattoo S, Chakravarty K, Trzepacz PT, Meagher D, Gupta N. Symptom profile and etiology of delirium in a referral population in Northern India: factor analysis of the DRS-R98. J Neuropsychiatry Clin Neurosci 2012; 24: 95-101.
18. Meagher D, Adamis D, Trzepacz P, Leonard M. Features of subsyndromal and persistent delirium. Br J Psychiatry 2012; 200: 37-44.
19. Ceriana P, Fanfulla F, Mazzacane F, Santoro C, Nava S. Delirium in patients admitted to a step-down unit: analysis of incidence and risk factors. J Crit Care 2010; 25: 136-43.
20. Skrobik Y, Ahern S, Leblanc M, Marquis F, Awissi DK, Kavanagh BP. Protocolized intensive care unit management of analgesia, sedation, and delirium improvesanalgesia and subsyndromal delirium rates. Anesth Analg 2010; 111: 451-63.
21. Hakim SM, Othman AI, Naoum DO. Early treatment with risperidone for subsyndromal delirium after on-pump cardiac surgery in the elderly: a randomized trial. Anesthesiology 2012; 116: 987-97.
22. Voyer P, Richard S, Doucet L, Carmichael PH. Detecting delirium and subsyndromal delirium using different diagnostic criteria among demented long-term care residents. J Am Med Dir Assoc 2009; 10 : 181-8.
23. Ryan DJ, O'Regan NA,Ó Caoimh R, Clare J, O'Connor M, Leonard M, et al. Delirium in an adult acute hospital population: predictors, prevalence and detection. BMJ Open 2013; 3: e001772.
24. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder (4th edn) (DSM-IV). APA, 1994.
25. Hart RP, Levenson JL, Sessler CN, Best AM, Schwartz SM, Rutherford LE. Validation of a cognitive test for delirium in medical ICU patients. Psychosomatics 1996; 37: 533-46.
26. Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry 1968; 114: 797-811.
27. Meagher DJ, Leonard M, Donnelly S, Conroy M, Saunders J, Trzepacz PT. A comparison of neuropsychiatric and cognitive profiles in delirium, dementia, comorbid delirium-dementia and cognitively intact controls. J Neurol Neurosurg Psychiatry 2010; 81: 876-81.
28. Inouye SK, C. H. van Dyck, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med 1990; 113: 941-8.
29. Trzepacz PT, Mittal D, Torres R, Kanary K, Norton J, Jimerson N. Validation of the Delirium Rating Scale-Revised-98: comparison with the delirium rating scale and the cognitive test for delirium. J Neuropsychiatry Clin Neurosci 2001; 13: 229-42.
30. Trzepacz PT, Maldonado JR, Kean J, Abell M, Meagher DJ. The Delirium Rating Scale- Revised-98 (DRS-R98) Administration Manual. A Guide to Increase Understanding of How to Solicit Delirium Symptoms to Administer the DRS-R98. Paula Trzepacz, 2010.
31. Franco JG, Mejía MA, Ochoa SB, Ramírez LF, Bulbena A, Trzepacz PT. Delirium rating scale-revised-98 (DRS-R-98): Colombian adaptation of the Spanish version. Actas Esp Psiquiatr 2007; 35: 170-5.
32. Kato M, Kishi Y, Okuyama T, Trzepacz PT, Hosaka T. Japanese version of the Delirium Rating Scale, Revised-98 (DRS-R98-J): reliability and validity. Psychosomatics 2010; 51: 425-31.
33. Jorm AF. The Informant Questionnaire on cognitive decline in the elderly (IQCODE): a review. IntPsychogeriatrics 2004; 16: 275-93.
34. Charlson ME, Pompei P, Ales KL, Mackenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 1987; 40: 373-83.
35. World Medical Association. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. World Medical Association, 2004 (http://www.wma.net/en/30publications/10policies/b3/).
36. Siddiqi N, House AO, Holmes JD. Occurrence and outcome of delirium in medical in-patients: a systematic literature review. Age Ageing 2006; 35: 350-64.
37. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder (5th edn) (DSM-5). APA, 2013.
38. Inouye SK, Foreman MD, Mion LC, Katz KH, Cooney LM Jr. Nurses' recognition of delirium and its symptoms: comparison of nurse and researcher ratings. Arch Intern Med 2001; 161: 2467-73.
39. Ryan K, Leonard M, Guerin S, Donnelly S, Conroy M, Meagher D. Validation of the confusion assessment method in the palliative care setting. Palliat Med 2009; 23: 40-5.
40. Sands MB, Dantoc BP, Hartshorn A, Ryan CJ, Lujic S. Single Question in Delirium (SQiD): testing its efficacy against psychiatrist interview, the Confusion Assessment Method and the Memorial Delirium Assessment Scale. Palliat Med 2010; 24: 561-5.
41. Meagher DJ, Leonard M, Donnelly S, Conroy M, Adamis D, Trzepacz PT. A longitudinal study of motor subtypes in delirium: relationship with other phenomenology, etiology, medication exposure and prognosis. J Psychosom Res 2011; 71: 395-403.
42. Trzepacz PT, Franco JG, Meagher DJ, Lee Y, Kim JL, Kishi Y, et al. Phenotype of subsyndromal delirium using pooled multicultural Delirium Rating Scale-Revised-98 data. J Psychosom Res 2012; 73: 10-7. D.M., M.L., S.T. and N.O'R. are all in receipt of funding from the Health Research Board.