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What is acute encephalopathy and what is delirium?

Delirium and Acute Encephalopathy 

Acute encephalopathy

The term acute encephalopathy refers to a rapidly developing (usually within hours to a few days) pathobiological process (disease) in the brain. The diagnosis is made by means of Electroencephalography, EEG. (Slooter et al., 2020, Intensive Care Med ; Hut et al., 2021 Psychiatry and Clinical Neurosciences).

Acute encephalopathy & delirium

Acute encephalopathy often manifests itself as delirium. Delirium is diagnosed based on clinical features. Both diagnoses are characterized by an underlying cause.

Research shows that only 12% to 35% of delirious patients are recognized with current screening tools (Marcantonio, 2017, NEJM).

Better detection is key

Acute encephalopathy and delirium are always associated with an underlying condition. Use of an objective bio signal enables more timely diagnosis and treatment of this underlying condition.

Delirium and Acute Encephalopath
Acute encephalopathy and delirium

The impact of acute encephalopathy and delirium

20 million patients per year

in the US and the EU, need brain state monitoring, because they are at risk of acute encephalopathy /delirium.

 

Conservative estimate based on Inouye et al., 2014, Lancet

Doubling hospital stay

The length of stay in hospital is considerably prolonged by delirium.

Van Den Boogaard, 2012, Crit Care Med

More dementia

People aged 85 or higher have an 8x higher chance to get dementia after delirium.

 

Davis et al, 2012, Brain

 

More nursing home admissions

37% of the patients with post-acute encephalopathy and delirium are admitted to nursing homes.

 

Leslie et al, 2005, JAGS

High mortality risk

Patients with acute encephalopathy and delirium have a 1.5 times higher mortality risk in 1st year after discharge.

 

Inouye et al., 2014, Lancet

 

High healthcare costs

The economic impact of delirium is similar to that of Type 2 diabetes.

 

Leslie and Inouye, 2011, JAGS

A very frequent healthcare problem

The longer delirium lasts, the higher the impact

impact-of-delirium-long-term

Often recognised too little and too late 

Within clinical practice, there is a need for better recognition of acute encephalopathy and delirium. Using questionnaires, the majority of patients are missed and often only patients with hyperactive delirium are recognized.

Current situation

Using checklists that are highly subjective and require symptoms to be present   
Lack of certainty in evaluating clinical signs often leads to delayed diagnosis and treatment
Only 12-35% ¹ of delirious patients are recognized with current screening tools 
Acute encephalopathy is by definition missed because EEG is the only method to detect.
Uncertainty about patient’s brain state using subjective tools does not allow staff to direct care to those in need
Dependent on precious nursing time for qualitative assessment

With our program

Objective screening protocol allows risk stratification for clinicians providing better deployment of precious nursing resources
Early, objective assessment of brain state ²
Provides clear five-point scale to trigger investigation of underlying conditions
Diagnostic performance > 85% for acute encephalopathy  
Easily assesses normalization of the brain state when treatment is applied

Interested? Let's get in touch!

Get in touch to learn how you can reshape acute encephalopathy and delirium care delivery

sources: ¹ Marcantonio, et al. N Engl J Med, 2017; ² Ditzel, F.L., et al. Psychiatry Clin Neurosci, 2022

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