Elderly patients with neurological disorders are significantly more likely to develop delirium soon after hospitalization.
A new study has found that a delayed transfer to a hospital floor is associated with a greater short-term risk of delirium in patients 65 years of age and older, and for those arriving in the emergency department ( SU) days at higher risk of extended length of stay – found to be Sunday and Tuesday.
Delirium is an acute cognitive disorder characterized by impaired consciousness, attention deficits, confusion, and disorientation. Current estimates of newly-onset delirium highlight the fact that delirium grows massively in medical settings (up to 82% in intensive care settings) compared to the general community (between 1% and 2%) . Research has shown that between 30 and 40 percent of all cases of delirium are preventable.
Written by Valdery Moura Junior, executive research doctoral student at the Business School (formerly Cass), the study explores whether a combination of emergency room care and delayed implementation of delirium prevention measures contributes to increased risk of trouble. For example, it is possible that bright lights and the high ambient noise level of the emergency department for 24 hours a day contribute to an increased risk in the short term.
The results showed that of the 858 patients who presented to the emergency room for a neurological emergency, delirium was documented in 234 (30%) patients within 72 hours of arriving at the emergency room.
This study also found that there was a link between the onset of delirium and the day the patient arrived in the emergency room. Those who arrived on Sunday and Tuesday were more likely to show symptoms more quickly. The occasional factors suggested include fewer hospital beds, a delayed floor admission – a wait time of more than 13 hours – and a higher proportion of elective pre-surgical admissions.
Mr. Moura described several steps that can be taken to help prevent the likelihood of delirium occurring in these settings, as well as to reduce expenses. These include earlier initiation of delirium prevention measures; faster transfer from the emergency department to the hospital bed; and improving communication between health care managers in primary care, emergency rooms, operating rooms and post-acute services.
Valdery Moura Junior, who is also a computer scientist and technical lead at Mass General Brigham, a Boston-based nonprofit hospital and physician network that includes Brigham and Women’s Hospital (BWH) and Massachusetts General Hospital (MGH), two of the Harvard Universities Medical School’s Most Prestigious Teaching Hospitals, Said:
“The recent onset delirium in older patients will alone mean a high price for the healthcare system and pose a global challenge for healthcare managers, providers and payers. Managing hospital capacity has been a huge challenge throughout the pandemic, with many admissions processes revised accordingly in an effort to improve patient outcomes. Our study can help identify achievable targets to improve processes between the emergency department and the rest of the hospital.
Professor Feng Li, President of Information Management at the Business School, said, “This is a great example where routine operational data in a hospital can be used to identify an anomaly and improve outcomes for patients. patients. Valdery’s research has shown that more systematic use of this data can lead to significant improvements in the management of hospital capacity and operational processes, and most importantly, the quality of patient care. “
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