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Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method

Background: Delirium is a brain condition associated with poor outcomes in rehabilitation. It is therefore important to assess delirium incidence in rehabilitation. Purpose: To develop and validate a chart-based method to identify incident delirium episodes within the electronic database of a Swiss...

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Autores principales: Ceppi, Marco G., Rauch, Marlene S., Sándor, Peter S., Gantenbein, Andreas R., Krishnakumar, Shyam, Albert, Monika, Meier, Christoph R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705493/
https://www.ncbi.nlm.nih.gov/pubmed/34940753
http://dx.doi.org/10.3390/neurolint13040067
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author Ceppi, Marco G.
Rauch, Marlene S.
Sándor, Peter S.
Gantenbein, Andreas R.
Krishnakumar, Shyam
Albert, Monika
Meier, Christoph R.
author_facet Ceppi, Marco G.
Rauch, Marlene S.
Sándor, Peter S.
Gantenbein, Andreas R.
Krishnakumar, Shyam
Albert, Monika
Meier, Christoph R.
author_sort Ceppi, Marco G.
collection PubMed
description Background: Delirium is a brain condition associated with poor outcomes in rehabilitation. It is therefore important to assess delirium incidence in rehabilitation. Purpose: To develop and validate a chart-based method to identify incident delirium episodes within the electronic database of a Swiss rehabilitation clinic, and to identify a study population of validated incident delirium episodes for further research purposes. Design: Retrospective validation study. Settings: Routinely collected inpatient clinical data from ZURZACH Care. Participants: All patients undergoing rehabilitation at ZURZACH Care, Rehaklinik Bad Zurzach between 2015 and 2018 were included. Methods: Within the study population, we identified all rehabilitation stays for which ≥2 delirium-predictive key words (common terms used to describe delirious patients) were recorded in the medical charts. We excluded all prevalent delirium episodes and defined the remaining episodes to be potentially incident. At least two physicians independently confirmed or refuted each potential incident delirium episode by reviewing the patient charts. We calculated the positive predictive value (PPV) with 95% confidence interval (95% CI) for all potential incident delirium episodes and for specific subgroups. Results: Within 10,515 rehabilitation stays we identified 554 potential incident delirium episodes. Overall, 125 potential incident delirium episodes were confirmed by expert review. The PPV of the chart-based method varied from 0.23 (95% CI 0.19–0.26) overall to 0.69 (95% CI 0.56–0.79) in specific subgroups. Conclusions: Our chart-based method was able to capture incident delirium episodes with low to moderate accuracy. By conducting an additional expert review of the medical charts, we identified a study population of validated incident delirium episodes. Our chart-based method contributes towards an automated detection of potential incident delirium episodes that, supplemented with expert review, efficiently yields a validated population of incident delirium episodes for research purposes.
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spelling pubmed-87054932021-12-25 Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method Ceppi, Marco G. Rauch, Marlene S. Sándor, Peter S. Gantenbein, Andreas R. Krishnakumar, Shyam Albert, Monika Meier, Christoph R. Neurol Int Article Background: Delirium is a brain condition associated with poor outcomes in rehabilitation. It is therefore important to assess delirium incidence in rehabilitation. Purpose: To develop and validate a chart-based method to identify incident delirium episodes within the electronic database of a Swiss rehabilitation clinic, and to identify a study population of validated incident delirium episodes for further research purposes. Design: Retrospective validation study. Settings: Routinely collected inpatient clinical data from ZURZACH Care. Participants: All patients undergoing rehabilitation at ZURZACH Care, Rehaklinik Bad Zurzach between 2015 and 2018 were included. Methods: Within the study population, we identified all rehabilitation stays for which ≥2 delirium-predictive key words (common terms used to describe delirious patients) were recorded in the medical charts. We excluded all prevalent delirium episodes and defined the remaining episodes to be potentially incident. At least two physicians independently confirmed or refuted each potential incident delirium episode by reviewing the patient charts. We calculated the positive predictive value (PPV) with 95% confidence interval (95% CI) for all potential incident delirium episodes and for specific subgroups. Results: Within 10,515 rehabilitation stays we identified 554 potential incident delirium episodes. Overall, 125 potential incident delirium episodes were confirmed by expert review. The PPV of the chart-based method varied from 0.23 (95% CI 0.19–0.26) overall to 0.69 (95% CI 0.56–0.79) in specific subgroups. Conclusions: Our chart-based method was able to capture incident delirium episodes with low to moderate accuracy. By conducting an additional expert review of the medical charts, we identified a study population of validated incident delirium episodes. Our chart-based method contributes towards an automated detection of potential incident delirium episodes that, supplemented with expert review, efficiently yields a validated population of incident delirium episodes for research purposes. MDPI 2021-12-09 /pmc/articles/PMC8705493/ /pubmed/34940753 http://dx.doi.org/10.3390/neurolint13040067 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ceppi, Marco G.
Rauch, Marlene S.
Sándor, Peter S.
Gantenbein, Andreas R.
Krishnakumar, Shyam
Albert, Monika
Meier, Christoph R.
Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method
title Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method
title_full Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method
title_fullStr Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method
title_full_unstemmed Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method
title_short Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method
title_sort detecting incident delirium within routinely collected inpatient rehabilitation data: validation of a chart-based method
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705493/
https://www.ncbi.nlm.nih.gov/pubmed/34940753
http://dx.doi.org/10.3390/neurolint13040067
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