Retrospective delirium ascertainment from case notes: a retrospective cohort study

ObjectivesThis study sets out to ascertain if recognition of delirium impacts on patient outcomes.DesignRetrospective cohort study.SettingUnscheduled admissions to acute care trust/secondary care UK hospitals.ParticipantsSix hundred and fifty-six older adults aged >= 65 years admitted on 14 September 2018.MeasurementsDelirium was ascertained retrospectively from case notes using medical notes. Documented delirium was classified as recognised delirium and retrospectively ascertained delirium was classified as unrecognised delirium.Primary and secondary outcome measuresPrimary outcome measure: inpatient mortality. Secondary outcome measures: length of stay, discharge destination.ResultsDelirium was present in 21.1% (132/626) of patients at any point during admission. The presence of delirium was associated with increased mortality (HR 2.65, CI 1.40 to 5.01). Recognition of delirium did not significantly impact on outcomes.ConclusionsDelirium is associated with adverse outcomes in hospitalised older adults. However, there is insufficient evidence that recognition of delirium affects outcomes. However, delirium recognition presents an opportunity to discuss a person's overall prognosis and discuss this with the patient and their family. Further research is needed to assess the pathophysiology of delirium to enable development of targeted interventions towards improved outcomes in patients with delirium.

Automated summary

Delirium is associated with adverse outcomes in hospitalized older adults, but recognition of delirium did not significantly impact outcomes. Further research is needed to understand the pathophysiology of delirium and develop targeted interventions for improved patient outcomes.