Survey on Current Practice of Canadian Physicians Regarding the Investigation in Older Patients with Delirium

Authors

  • Antoine Laguë Centre de recherche du CHU de Québec—Université Laval; VITAM—Centre de recherche en santé durable; Université Laval
  • Valérie Boucher Centre de recherche du CHU de Québec—Université Laval; VITAM—Centre de recherche en santé durable; Université Laval; Centre d’Excellence sur le Vieillissement de Québec https://orcid.org/0000-0002-3117-2177
  • Pil Joo University of Ottawa; Ottawa Hospital Research Institute
  • Krishan Yadav University of Ottawa; Ottawa Hospital Research Institute
  • Charles Morasse Université Laval
  • Marcel Émond Centre de recherche du CHU de Québec—Université Laval; VITAM—Centre de recherche en santé durable; Université Laval; Centre d’Excellence sur le Vieillissement de Québec

DOI:

https://doi.org/10.5770/cgj.25.580

Keywords:

delirium, older patients, investigation

Abstract

Background

The current literature provides heterogeneous recommendation regarding the investigation of older delirious patients, which may lead to over-testing. Our study aims to describe Canadian physicians’ current practice for the investigation of older patients with delirium. Our secondary objective is to define specific indications for performing a CT head scan in this population.

Methods

Design: cross-sectional online survey. Participants: physicians who conduct their clinical practice in Canada and who care for older patients with delirium. Potential study participants were reached through Canadian associations: Canadian Geriatrics Society, the Canadian Association of Emergency Physicians, the Association des Médecins d’Urgence du Québec, and members of Choosing Wisely Canada.

Results

We received 296 survey responses. More than 80% of respondents always order complete blood count, urea, and creatinine and electrolytes. Extended electrolytes, TSH, chest X-ray, electrocardiogram, urinalysis and urinary culture tests tend to be ordered somewhat frequently. Physicians mostly agreed to order a head CT scan for loss of consciousness, altered mental status, fall, and anticoagulation.

Conclusions

Physicians’ investigations for older patients with delirium are highly variable, even with the lack of evidence supporting a broad workup. Also, respondents mostly align with current recommendations of indications for CT head scans.

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Published

2022-09-02

How to Cite

1.
Laguë A, Boucher V, Joo P, Yadav K, Morasse C, Émond M. Survey on Current Practice of Canadian Physicians Regarding the Investigation in Older Patients with Delirium. Can Geriatr J [Internet]. 2022 Sep. 2 [cited 2023 Feb. 7];25(3):279-84. Available from: https://cgjonline.ca/index.php/cgj/article/view/580

Issue

Section

Original Research