Heidi Lindroth, Keibun Liu, Laura Szalacha, Shelly Ashkenazy, Giuseppe Bellelli, Mark van den Boogaard, Gideon Caplan, Chi Ryang Chung, Muhammed Elhadi, Mohan Gurjar, Gabriel Heras-La-Calle, Magdalena Hoffman, Marie-Madlen Jeitziner, Karla Krewulak, Tanja Mailhot, Alessandro Morandi, Ricardo Kenji Nawa, Esther S Oh, Marie Oxenboell Collet, Maria Carolina Paulino, Rebecca von Haken, Peter Nydahl
{"title":"2023 年世界谵妄意识和质量调查--一项全球点流行率研究。","authors":"Heidi Lindroth, Keibun Liu, Laura Szalacha, Shelly Ashkenazy, Giuseppe Bellelli, Mark van den Boogaard, Gideon Caplan, Chi Ryang Chung, Muhammed Elhadi, Mohan Gurjar, Gabriel Heras-La-Calle, Magdalena Hoffman, Marie-Madlen Jeitziner, Karla Krewulak, Tanja Mailhot, Alessandro Morandi, Ricardo Kenji Nawa, Esther S Oh, Marie Oxenboell Collet, Maria Carolina Paulino, Rebecca von Haken, Peter Nydahl","doi":"10.1093/ageing/afae248","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Delirium, an acute brain dysfunction, is proposed to be highly prevalent in clinical care and shown to significantly increase the risk of mortality and dementia.</p><p><strong>Objectives: </strong>To report on the global prevalence of clinically documented delirium and delirium-related clinical practices in wards caring for paediatric and adult patients in healthcare facilities.</p><p><strong>Design: </strong>A prospective, cross-sectional, 39-question survey completed on World Delirium Awareness Day, 15 March 2023.</p><p><strong>Participants: </strong>Clinicians or researchers with access to clinical data.</p><p><strong>Main outcome and measure: </strong>The primary outcome was the prevalence of clinically documented delirium at 8:00 a.m. (4 h) and 8:00 p.m. (±4 h). Secondary outcomes included delirium-related care practices and barriers to use. Descriptive statistics were calculated and multilevel modelling was completed.</p><p><strong>Results: </strong>1664 wards submitted surveys from 44 countries, reporting on delirium assessments at 8:00 a.m. (n = 36 048) and 8:00 p.m. (n = 32 867); 61% reported use of validated delirium assessment tools. At 8:00 a.m., 18% (n = 2788/15 458) and at 8:00 p.m., 17.7% (n = 2454/13 860) were delirium positive. Top prevention measures were pain management (86.7%), mobilisation (81.4%) and adequate fluids (80.4%). Frequently reported pharmacologic interventions were benzodiazepines (52.7%) and haloperidol (46.2%). Top barriers included the shortage of staff (54.3%), lack of time to educate staff (48.6%) and missing knowledge about delirium (38%).</p><p><strong>Conclusion and relevance: </strong>In this study, approximately one out of five patients were reported as delirious. The reported high use of benzodiazepines needs further evaluation as it is not aligned with best-practice recommendations. Findings provide a benchmark for future quality improvement projects and research.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"53 11","pages":""},"PeriodicalIF":6.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579530/pdf/","citationCount":"0","resultStr":"{\"title\":\"World delirium awareness and quality survey in 2023-a worldwide point prevalence study.\",\"authors\":\"Heidi Lindroth, Keibun Liu, Laura Szalacha, Shelly Ashkenazy, Giuseppe Bellelli, Mark van den Boogaard, Gideon Caplan, Chi Ryang Chung, Muhammed Elhadi, Mohan Gurjar, Gabriel Heras-La-Calle, Magdalena Hoffman, Marie-Madlen Jeitziner, Karla Krewulak, Tanja Mailhot, Alessandro Morandi, Ricardo Kenji Nawa, Esther S Oh, Marie Oxenboell Collet, Maria Carolina Paulino, Rebecca von Haken, Peter Nydahl\",\"doi\":\"10.1093/ageing/afae248\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Delirium, an acute brain dysfunction, is proposed to be highly prevalent in clinical care and shown to significantly increase the risk of mortality and dementia.</p><p><strong>Objectives: </strong>To report on the global prevalence of clinically documented delirium and delirium-related clinical practices in wards caring for paediatric and adult patients in healthcare facilities.</p><p><strong>Design: </strong>A prospective, cross-sectional, 39-question survey completed on World Delirium Awareness Day, 15 March 2023.</p><p><strong>Participants: </strong>Clinicians or researchers with access to clinical data.</p><p><strong>Main outcome and measure: </strong>The primary outcome was the prevalence of clinically documented delirium at 8:00 a.m. (4 h) and 8:00 p.m. (±4 h). Secondary outcomes included delirium-related care practices and barriers to use. Descriptive statistics were calculated and multilevel modelling was completed.</p><p><strong>Results: </strong>1664 wards submitted surveys from 44 countries, reporting on delirium assessments at 8:00 a.m. (n = 36 048) and 8:00 p.m. (n = 32 867); 61% reported use of validated delirium assessment tools. At 8:00 a.m., 18% (n = 2788/15 458) and at 8:00 p.m., 17.7% (n = 2454/13 860) were delirium positive. Top prevention measures were pain management (86.7%), mobilisation (81.4%) and adequate fluids (80.4%). Frequently reported pharmacologic interventions were benzodiazepines (52.7%) and haloperidol (46.2%). Top barriers included the shortage of staff (54.3%), lack of time to educate staff (48.6%) and missing knowledge about delirium (38%).</p><p><strong>Conclusion and relevance: </strong>In this study, approximately one out of five patients were reported as delirious. The reported high use of benzodiazepines needs further evaluation as it is not aligned with best-practice recommendations. 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World delirium awareness and quality survey in 2023-a worldwide point prevalence study.
Background: Delirium, an acute brain dysfunction, is proposed to be highly prevalent in clinical care and shown to significantly increase the risk of mortality and dementia.
Objectives: To report on the global prevalence of clinically documented delirium and delirium-related clinical practices in wards caring for paediatric and adult patients in healthcare facilities.
Design: A prospective, cross-sectional, 39-question survey completed on World Delirium Awareness Day, 15 March 2023.
Participants: Clinicians or researchers with access to clinical data.
Main outcome and measure: The primary outcome was the prevalence of clinically documented delirium at 8:00 a.m. (4 h) and 8:00 p.m. (±4 h). Secondary outcomes included delirium-related care practices and barriers to use. Descriptive statistics were calculated and multilevel modelling was completed.
Results: 1664 wards submitted surveys from 44 countries, reporting on delirium assessments at 8:00 a.m. (n = 36 048) and 8:00 p.m. (n = 32 867); 61% reported use of validated delirium assessment tools. At 8:00 a.m., 18% (n = 2788/15 458) and at 8:00 p.m., 17.7% (n = 2454/13 860) were delirium positive. Top prevention measures were pain management (86.7%), mobilisation (81.4%) and adequate fluids (80.4%). Frequently reported pharmacologic interventions were benzodiazepines (52.7%) and haloperidol (46.2%). Top barriers included the shortage of staff (54.3%), lack of time to educate staff (48.6%) and missing knowledge about delirium (38%).
Conclusion and relevance: In this study, approximately one out of five patients were reported as delirious. The reported high use of benzodiazepines needs further evaluation as it is not aligned with best-practice recommendations. Findings provide a benchmark for future quality improvement projects and research.
期刊介绍:
Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.