Delirium is frequently underdiagnosed among older hospitalised patients despite available information in hospital medical records

• DOI: 10.1093/ageing/afae006
• Publication Date: 2024-02-12T02:19:51Z
• Authors: Irit Titlestad; Kristoffer Haugar...; Stein-Erik H Solvang; Tone Merete Norekvål; Ragnhild E Skogseth; Ole A Andreassen; Dag Årsland; Bjørn Erik Neerland; Jan Erik Nordrehaug; Grethe S Tell; Lasse M Giil
• Keywords: Medical record

Abstract Background In-hospital delirium is associated with adverse outcomes and underdiagnosed, limiting research clinical follow-up. Objective To compare the incidence of in-hospital determined by chart-based review electronic medical records (D-CBR) discharge diagnoses (D-DD). Furthermore, to identify differences in symptoms, treatments triggers between D-CBR D-DD. Method The community-based cohort included 2,115 participants Hordaland Health Study born 1925 1927. Between 2018 2022, we retrospectively reviewed hospital from baseline (1997–99) until death prior 2023. D-DD were validated using Diagnostic Statistical Manual Mental Disorders, Fifth Edition, criteria for delirium. Results Of participants, 638 had rate (IR) was 29.8 [95% confidence interval 28, 32] per 1,000 person-years, whereas IR 3.4 [2.8, 4.2]. ratio 9.14 (P < 0.001). Patients who received pharmacological treatment (n = 121, odds (OR) 3.4, [2.1, 5.4], P 0.001), affected acute memory impairment 149, OR 2.8, [1.8, 4.5], or change perception 137, 2.9, 4.6] 0.001) higher In contrast, post-operative cases (OR 0.2, [0.1, 0.4], lower Conclusion Underdiagnosis a major issue our study, especially less severe cases. Our findings emphasise need integrating systematic diagnostics documentation into admission routines.