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British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 9, Issue.: 10

Original-research-article

Improving Cognitive Evaluation and the Diagnosis of Delirium among Elderly Patients Visiting the Emergency Room

 

Boris Punchik1,2,3,  Yan Press1,2,3*, Yakov Grinshpun4,5 and  A. Mark Clarfield4,5,6,7

1Yasski Clinic, Comprehensive Geriatric Assessment Unit, Clalit Health Services, Beer-Sheva, Israel.

2Department of Family Medicine, Sial Family Medicine and Primary Care Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

3Unit for Community Geriatrics, Division of Health in the Community, Ben-Gurion University of the Negev, Beer-Sheva, Israel

4Department of Geriatrics, Soroka University Medical Center, Beer-Sheva, Israel.

5Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

6Medical School for International Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

7McGill University, Montreal, Canada.

Article Information
Editor(s):
(1) Domenico De Berardis, Department of Mental Health, National Health Service, Psychiatric Service of Diagnosis and Treatment, “G. Mazzini” Hospital, Italy.
Reviewers:
(1) Diana Tapia, National Autonomous University of Mexico, Mexico.
(2) Pietro Scicchitano, Cardiology Department, University of Bari, Italy.
(3) Anonymous, Duzce University School of Medicine, Turkey.
Complete Peer review History: http://sciencedomain.org/review-history/10203

Abstracts

Introduction: Delirium is a common problem among elderly patients seen in the emergency department (ED). Under-diagnosis of delirium by the ED team is common and can have serious implications.  In a previous study we found poor quality of cognitive assessment and no mention of delirium in the ED of a large teaching hospital in southern Israel in 2003.

Aim: To evaluate cognitive assessment and delirium diagnosis two years after adding of a consultant geriatrician to the ED team. 

Methods: We examined the rate of mental status assessment and the prevalence of delirium in the ED among patients older than 65 years via a retrospective chart review.

Results: In a random sample utilizing medical records of 317 older people examined in the ED during 2007-2008, cognitive assessment (full or partial) was performed for 192 of 317 (60.6%) of patients (compared with only 12.5% in 2003), and 12 cases of delirium were specifically diagnosed in the ED (3.8%) compared to none in 2003. The rate of cognitive evaluation for subsequently hospitalized patients was 45% (compared with 59% in 2003).

Conclusions: This study indicates a moderate improvement in the rate of cognitive evaluation and the diagnosis of delirium among elderly patients seen in an ED compared with a similar study which was published 5 years ago.

Keywords :

Delirium diagnosis; elderly; emergency department patients; geriatric assessment.

Full Article - PDF    Page 1-7

DOI : 10.9734/BJMMR/2015/19443

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