What is delirium?

Delirium, a high incidence, serious and costly complication

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.

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Delirium and its’ significant impact on society

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% [1].

[1]: Ely EW et al. Delirium as a predictor of mortality in mechanically ventilated patients in the ICU, JAMA 291: 1754-1769.

5-8 days longer in hospital

 

 Source: [Lundström et al, 2005, JAGS]

+37% admission to nursing home

 

 Source: [Leslie et al, 2005, JAGS]

Long-term brain dysfunction

 

 Source: [Davis et al, 2012, Brain]

62% increased risk of mortality within 1 year after discharge

 Source: [Leslie and Inouye, 2011, JAGS]

Delirium equals diabetes in societal burden

 

The annual economic burden of delirium is € 173 billion, of which 10% are direct hospital costs

 Source: [Leslie and Inouye, 2011, JAGS]

Delirium has a big impact on patients

As patients often experience horrific hallucinations, delirium can be a frightening experience. Patients can be present with hypo-active (apathic), mixed type or hyperactive (agitated and combative) delirium, making it more difficult to detect.

Hypo-active

Patients with a hypo-active delirium are quiet and can come across as sleepy.

Mixed

At times, patients are restless

Hyperactive

Patients are restless and physically hyperactive

The longer delirium lasts, the higher the impact

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.

To date, delirium detection happens too little, too late

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 measure the patient’s brain activity for delirium features. DeltaScan is of great help for delirium detection.

Complicated and confusing

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.

Subjective and ineffective

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.

DeltaScan

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.

Find more information about delirium care in our e-learning

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