WHAT IS DELIRIUM?
Delirium is a manifestation of acute brain dysfunction, defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) as:
“a disturbance in attention and awareness that develops in a short period of time, fluctuates, and is accompanied by a change in cognition”.
It is the most common surgical complication amongst older adults, but it can occur in patients of any age.
Delirium and its impact clearly explained, German spoken movie (8 minutes).
– Univ-Prof. Dr. med C. Spies, director of the Clinic of Anesthesiology and Intensive Care Medicine, Charité Berlin, Germany.
“To improve delirium detection, we developed DeltaScan, an objective and practical device”
– Prof. dr. A. Slooter, Intensive Care Neuropsychiatry, University Medical Center Utrecht, the Netherlands.
Delirium, a high incidence, serious and costly complication
Delirium affects over 3 million hospitalised patients in Europe and over 2 million hospitalised Americans every year. It is a potentially fatal medical emergency that increases the risk of long-term cognitive impairment (dementia), results in longer hospital admission, and directly contributes to higher healthcare costs. Every day with delirium is independantly associated with an increased hazard of death of 10% .
Delirium may be a frightening experience, as patients often experience horrific hallucinations.
Patients can present with hyperactive (agitated and combative), hypo-active (apathic) or mixed type delirium, making it more difficult to detect. Dementia and older age greatly increase the chance of patients becoming delirious.
Delirium is by definition caused by physical disorders, mostly acute illnesses or infections, surgery, metabolic disturbances, psychological stress, pain or drug adverse effects or withdrawal. Once detected in an early stage, delirium can be treated well by treatment of disorder(s) that caused delirium and that often do not manifest otherwise.
: Ely EW et al. Delirium as a predictor of mortality in mechanically ventilated patients in the ICU, JAMA 291: 1754-1769.
To date, delirium detection is “too little, too late”
Delirium detection is complicated and confusing. International guidelines say and research shows that in current practice only 30 to 50% of the delirium cases are detected. This means that 50% to 70% of the delirium patients do not get the treatment they need.
In most hospitals, nurses are tasked with delirium detection. The patients who are at risk of delirium are monitored with -at best- a standardized checklist. Current detection systems are subjective and ineffective. The sensitivity is variable and appears to be related to users.
There is a clinical demand to improve delirium detection and to move away from subjective diagnoses, that miss the majority of delirium cases and often only recognize the escalated, hyperactive, type of delirium.
With DeltaScan, healthcare professionals can scan the patient’s brain activity for delirium features. DeltaScan is of great help for delirium detection.
We revolutionize delirium care
To help healthcare professionals detect and monitor delirium, DeltaScan is created. The development is initiated by clinicians, who feel the need to get a grip on delirium, to improve patient recovery.
Prolira’s DeltaScan will improve the quality of care and patient safety. Improved delirium detection improves patient outcome and reduces hospital length of stay, while reducing healthcare costs.
It is beneficial for patients, their families, healthcare professionals and budget holders.
Medical guidelines prescribe patients at risk of delirium to be monitored at least every shift. The use of DeltaScan 3 times a day for every patient at risk, improves compliance. It makes documentation and communication about results effective and practical.
Delirium is progressively portrayed as the next vital sign. Vital signs are clinical measurements that indicate the state of a patient’s essential body functions, specifically pulse rate, temperature, respiratory rate and blood pressure. Delirium provides a vital sign for the brain, and the mental state of the patient. And with DeltaScan it is possible to monitor this next vital sign.
How common is Delirium?
Currently 40% of the patients admitted to hospitals are 65 years or older.
Delirium is extremely common, affecting 1 in 8 hospitalised elderly, 1 in 4 cardiac surgery patients, and 1 in 2 patients in the Intensive Care Unit (ICU).
As high age is one of the major risk factors for delirium, this problem will only grow as the world’s older population continues to grow at an unprecedented rate.
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