TY - JOUR AU - de Freitas, SA. AU - Wong, EKC. AU - Lee, JY. AU - Reppas-Rindlisbacher, C. AU - Gabor, C. AU - Curkovic, A. AU - Patterson, CJ. PY - 2020/11/23 Y2 - 2024/03/28 TI - The Effect of Multiple Assessments on Delirium Detection: a Pilot Study* JF - Canadian Geriatrics Journal JA - Can Geriatr J VL - 23 IS - 4 SE - Original Research DO - 10.5770/cgj.23.433 UR - https://cgjonline.ca/index.php/cgj/article/view/433 SP - 277-282 AB - <p><strong>Background </strong></p><p>Delirium is characterized by fluctuating attention or arousal, with high prevalence in the orthopaedic ward. Our aim was to: 1) establish the prevalence of delirium on an orthopaedic ward, and 2) compare delirium prevalence using a single geriatrician assessment vs. multiple 3D-CAM (3-Minute Diagnostic Interview for Confusion Assessment Method) assessments during the day. We hypothesized that multiple assessments would increase the detection rate due to the fluctuating nature of delirium.</p><p><strong>Methods </strong></p><p>Comparative study conducted at an academic hospital in Hamilton, Ontario. Participants included patients 65 years and older admitted to the orthopaedic ward (n=55). After a geriatrician made the first assessment of delirium by 3D-CAM on each patient, teams with specialized geriatrics training re-assessed participants up to four times. Delirium rates based on first assessment were compared to cumulative end-of-day rates to determine if detection increased with multiple assessments.</p><p><strong>Results </strong></p><p>The prevalence of delirium was 30.9% (17 participants) usĀ­ing multiple assessments. Of these cases, 13 (76.4%) were detected in the initial geriatrician assessment. In patients with hip fractures, 70.6% (12 of 17) were identified as delirious by multiple assessments.</p><p><strong>Conclusion </strong></p><p>As symptoms fluctuate, multiple daily CAM assessments may increase the identification of delirium in orthopaedic inpatients.</p> ER -