Delirium: Prevention is the key - 30/01/15
Résumé |
The incidence of delirium in the elderly in general hospitals is up to 20 to 89%. Delirium is associated with high mortality, increased morbidity, increased need for nursing surveillance, longer hospital stays, a high rate of institutionalization following discharge and increased prevalence of dementia. Delirium is not recognized by clinicians in one- to two-thirds of all cases and is commonly overlooked or misattributed to dementia, depression, or senescence; confusional states in the hospitalized elderly are considered the rule, rather than the exception and cognitive function is rarely assessed. For prevention of delirium it is necessary to look for patients “at-risk” for delirium and to use instruments for screenings and severity. Also should the medical and nursing staff be made aware of prodromal symptoms for delirium, indicating a delirium is developing. Prevention requires multidisciplinary action with pharmacological and non-pharmacological interventions (multifactor intervention). A pro-active consultation team (doctors and nurses) resulting in good basic medical- and nursing care have the best results concerning the prevention of delirium, reducing delirium incidence with more than 25%. In the last 10 years our research team in the Netherlands researched risk factors for delirium and developed assessment scales to detect patients at risk for delirium. We developed and implemented instruments to detect and measure severity of delirium and developed both pharmacological and non-pharmacological strategies to prevent delirium and we analysed and studied the long-term consequences of delirium in the elderly. In serum and CSF we looked for parameters that might predict delirium in patients at risk for delirium.
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Vol 6 - N° 1
P. 95 - février 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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