Healthcare News & Insights

Ask these 2 questions to identify patients with delirium

Delirium is a serious condition that can harm elderly patients’ recovery. And because its effects can be confused with illness fatigue, it can be hard to diagnose. But new research suggests clinicians can ask patients two simple questions to quickly evaluate their risk for delirium. 

Medical Team Meeting With Senior Man In Hospital Room

Many patients develop delirium in the hospital. In fact, between 30% and 40% of older adults who are hospitalized experience hospital-acquired delirium, according to an article in American Nurse Today.

Rates climb even higher if these patients are having surgery or are admitted to the intensive care unit (ICU). Patients who develop sepsis or are ventilator dependent have the highest risk of developing delirium.

It also can have lasting negative effects. At least 25% of patients who have delirium during a hospital stay die within six months.

Most of the time, however, it goes undetected. That’s why it’s critical for hospital staff to get a handle on this condition before elderly patients’ health deteriorates.

Brief bedside evaluation

Evaluating a patient’s mental state can be time-consuming. According to a news release, Edward Marcantonio, a medical professor from Harvard, developed a three-minute assessment method called the 3D-CAM that clinicians and nurses can use to quickly identify patients suffering from delirium.

While the 3D-CAM is relatively short, time is at a premium for nurses and doctors, especially when they’re treating critically ill patients in the emergency department or ICU. With that in mind, Marcantonio and his colleagues wanted to develop an even faster way to determine whether a patient was developing delirium.

As described in the Journal of Hospital Medicine, researchers determined that asking patients these questions only takes an average of 36 seconds for clinical staff – and the success rate for discovering delirium was 93%.

The two questions are:

  1. What day of the week is it today?
  2. Can you recite the months of the year backward?

If a patient doesn’t answer these questions correctly, clinicians can then perform the longer 3D-CAM assessment for a more definitive diagnosis of delirium.

Identifying delirium

Per the Journal of Hospital Medicine, the researchers’ initial pilot study showed promise. Out of 201 patients, 48 were singled out as possibly having delirium, and 42 of these patients actually had it.

More intensive study is planned to make sure these positive effects hold up across a larger group of patients.

In the meantime, though, encouraging providers to tack on these questions to their assessments of older patients couldn’t hurt.

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