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Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia

The detection of delirium in acutely ill older patients is challenging with the lack of informants and the necessity to identify subtle and fluctuating signs. We conducted a cross-sectional study among older patients admitted to a university hospital in Malaysia to determine the presence, characteri...

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Autores principales: Khor, Hui Min, Ong, Hwee Chin, Tan, Bee Kuan, Low, Chung Min, Saedon, Nor’Izzati, Tan, Kit Mun, Chin, Ai Vyrn, Kamaruzzaman, Shahrul B., Tan, Maw Pin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6787739/
https://www.ncbi.nlm.nih.gov/pubmed/31514465
http://dx.doi.org/10.3390/geriatrics4030052
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author Khor, Hui Min
Ong, Hwee Chin
Tan, Bee Kuan
Low, Chung Min
Saedon, Nor’Izzati
Tan, Kit Mun
Chin, Ai Vyrn
Kamaruzzaman, Shahrul B.
Tan, Maw Pin
author_facet Khor, Hui Min
Ong, Hwee Chin
Tan, Bee Kuan
Low, Chung Min
Saedon, Nor’Izzati
Tan, Kit Mun
Chin, Ai Vyrn
Kamaruzzaman, Shahrul B.
Tan, Maw Pin
author_sort Khor, Hui Min
collection PubMed
description The detection of delirium in acutely ill older patients is challenging with the lack of informants and the necessity to identify subtle and fluctuating signs. We conducted a cross-sectional study among older patients admitted to a university hospital in Malaysia to determine the presence, characteristics, and mortality outcomes of delirium. Consecutive patients aged ≥65years admitted to acute medical wards were recruited from August to September 2016. Cognitive screening was performed using the mini-mental test examination (MMSE) and the Confusion Assessment Method (CAM). The CAM-Severity (CAM-S) score was also performed in all patients. Of 161 patients recruited, 43 (26.7%) had delirium. At least one feature of delirium from the CAM-S short and long severity scores were present in 48.4% and 67.1%, respectively. Older age (OR: 1.07, 95% CI: 1.01–1.14), immobility (OR: 3.16, 95% CI: 1.18–8.50), cognitive impairment (OR: 5.04, 95% CI: 2.07–12.24), and malnutrition (OR: 3.37; 95% CI: 1.15–9.85) were significantly associated with delirium. Older patients with delirium had a higher risk of mortality (OR: 7.87, 95% CI: 2.42–25.57). Delirium is common among older patients in our setting. A large proportion of patients had altered mental status on admission to hospital although they did not fulfill the CAM criteria of delirium. This should prompt further studies on strategies to identify delirium and the use of newer, more appropriate assessment tools in this group of vulnerable individuals.
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spelling pubmed-67877392019-10-16 Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia Khor, Hui Min Ong, Hwee Chin Tan, Bee Kuan Low, Chung Min Saedon, Nor’Izzati Tan, Kit Mun Chin, Ai Vyrn Kamaruzzaman, Shahrul B. Tan, Maw Pin Geriatrics (Basel) Article The detection of delirium in acutely ill older patients is challenging with the lack of informants and the necessity to identify subtle and fluctuating signs. We conducted a cross-sectional study among older patients admitted to a university hospital in Malaysia to determine the presence, characteristics, and mortality outcomes of delirium. Consecutive patients aged ≥65years admitted to acute medical wards were recruited from August to September 2016. Cognitive screening was performed using the mini-mental test examination (MMSE) and the Confusion Assessment Method (CAM). The CAM-Severity (CAM-S) score was also performed in all patients. Of 161 patients recruited, 43 (26.7%) had delirium. At least one feature of delirium from the CAM-S short and long severity scores were present in 48.4% and 67.1%, respectively. Older age (OR: 1.07, 95% CI: 1.01–1.14), immobility (OR: 3.16, 95% CI: 1.18–8.50), cognitive impairment (OR: 5.04, 95% CI: 2.07–12.24), and malnutrition (OR: 3.37; 95% CI: 1.15–9.85) were significantly associated with delirium. Older patients with delirium had a higher risk of mortality (OR: 7.87, 95% CI: 2.42–25.57). Delirium is common among older patients in our setting. A large proportion of patients had altered mental status on admission to hospital although they did not fulfill the CAM criteria of delirium. This should prompt further studies on strategies to identify delirium and the use of newer, more appropriate assessment tools in this group of vulnerable individuals. MDPI 2019-09-11 /pmc/articles/PMC6787739/ /pubmed/31514465 http://dx.doi.org/10.3390/geriatrics4030052 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Khor, Hui Min
Ong, Hwee Chin
Tan, Bee Kuan
Low, Chung Min
Saedon, Nor’Izzati
Tan, Kit Mun
Chin, Ai Vyrn
Kamaruzzaman, Shahrul B.
Tan, Maw Pin
Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia
title Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia
title_full Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia
title_fullStr Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia
title_full_unstemmed Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia
title_short Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia
title_sort assessment of delirium using the confusion assessment method in older adult inpatients in malaysia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6787739/
https://www.ncbi.nlm.nih.gov/pubmed/31514465
http://dx.doi.org/10.3390/geriatrics4030052
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