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Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice

OBJECTIVES: The objectives of the study are to study daily hospital practice regarding detection and management and to study hyperactive and hypoactive delirium of older patients during their hospitalization. METHODS: A retrospective cohort study evaluating care as usual for older hospitalized patie...

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Autores principales: van Velthuijsen, Eveline L., Zwakhalen, Sandra M.G., Mulder, Wubbo J., Verhey, Frans R.J., Kempen, Gertrudis I.J.M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221174/
https://www.ncbi.nlm.nih.gov/pubmed/28194812
http://dx.doi.org/10.1002/gps.4690
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author van Velthuijsen, Eveline L.
Zwakhalen, Sandra M.G.
Mulder, Wubbo J.
Verhey, Frans R.J.
Kempen, Gertrudis I.J.M.
author_facet van Velthuijsen, Eveline L.
Zwakhalen, Sandra M.G.
Mulder, Wubbo J.
Verhey, Frans R.J.
Kempen, Gertrudis I.J.M.
author_sort van Velthuijsen, Eveline L.
collection PubMed
description OBJECTIVES: The objectives of the study are to study daily hospital practice regarding detection and management and to study hyperactive and hypoactive delirium of older patients during their hospitalization. METHODS: A retrospective cohort study evaluating care as usual for older hospitalized patients with delirium at Maastricht University Medical Center+, a university hospital in the Netherlands, was performed. Inclusion criteria were older hospitalized patients (65+ years), diagnosed with delirium between 1 January and 31 December 2014. Data were retrieved from the patients' medical files. Delirium was categorized as hyperactive or hypoactive. Primary outcome measures were prevalence and management (pharmacological, reorientation, screening for delirium and delirium consultations, and physical restraints). Secondary outcomes were short‐term adverse outcomes. RESULTS: Prevalence of delirium was 5% (N = 401), of which 77% (n = 307) was hyperactive and 23% (n = 94) was hypoactive. Significantly, more patients with a hyperactive delirium received medication to manage the delirium than patients with a hypoactive delirium (89% vs. 77%, respectively, p = 0.004). No other significant differences between the subtypes were found. CONCLUSION: There was probably a strong under‐recognition of delirium. Drugs were the main intervention of choice, especially for patients with hyperactive delirium. The two subtypes did not differ on non‐pharmacological management. The retrospective nature of this study sheds light on the status quo of recognition, management, and care as usual for the different delirium subtypes in daily hospital practice, which may help in forming new guidelines and protocols for the detection and treatment of delirium for older patients in hospitals.
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spelling pubmed-62211742018-11-15 Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice van Velthuijsen, Eveline L. Zwakhalen, Sandra M.G. Mulder, Wubbo J. Verhey, Frans R.J. Kempen, Gertrudis I.J.M. Int J Geriatr Psychiatry Special Issue Papers OBJECTIVES: The objectives of the study are to study daily hospital practice regarding detection and management and to study hyperactive and hypoactive delirium of older patients during their hospitalization. METHODS: A retrospective cohort study evaluating care as usual for older hospitalized patients with delirium at Maastricht University Medical Center+, a university hospital in the Netherlands, was performed. Inclusion criteria were older hospitalized patients (65+ years), diagnosed with delirium between 1 January and 31 December 2014. Data were retrieved from the patients' medical files. Delirium was categorized as hyperactive or hypoactive. Primary outcome measures were prevalence and management (pharmacological, reorientation, screening for delirium and delirium consultations, and physical restraints). Secondary outcomes were short‐term adverse outcomes. RESULTS: Prevalence of delirium was 5% (N = 401), of which 77% (n = 307) was hyperactive and 23% (n = 94) was hypoactive. Significantly, more patients with a hyperactive delirium received medication to manage the delirium than patients with a hypoactive delirium (89% vs. 77%, respectively, p = 0.004). No other significant differences between the subtypes were found. CONCLUSION: There was probably a strong under‐recognition of delirium. Drugs were the main intervention of choice, especially for patients with hyperactive delirium. The two subtypes did not differ on non‐pharmacological management. The retrospective nature of this study sheds light on the status quo of recognition, management, and care as usual for the different delirium subtypes in daily hospital practice, which may help in forming new guidelines and protocols for the detection and treatment of delirium for older patients in hospitals. John Wiley and Sons Inc. 2017-02-14 2018-11 /pmc/articles/PMC6221174/ /pubmed/28194812 http://dx.doi.org/10.1002/gps.4690 Text en © 2017 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Special Issue Papers
van Velthuijsen, Eveline L.
Zwakhalen, Sandra M.G.
Mulder, Wubbo J.
Verhey, Frans R.J.
Kempen, Gertrudis I.J.M.
Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice
title Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice
title_full Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice
title_fullStr Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice
title_full_unstemmed Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice
title_short Detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice
title_sort detection and management of hyperactive and hypoactive delirium in older patients during hospitalization: a retrospective cohort study evaluating daily practice
topic Special Issue Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221174/
https://www.ncbi.nlm.nih.gov/pubmed/28194812
http://dx.doi.org/10.1002/gps.4690
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