Cleveland Clinic is investigating whether there are better ways to detect delirium in geriatric emergency patients.
Here are four things to know:
1. Delirium is a mental state of confusion and disorientation that can develop suddenly over hours or days. Older adults are vulnerable to this condition and it can lead to permanent, long-term problems when treatment is delayed, according to a Dec. 19 health system news release.
2. The traditional method of screening for delirium and cognitive impairment is deployed only if the patient shows changes in mental status.
"To reliably say that a patient's delirium was developed in the ED, a solid delirium screening must be performed at the time of ED entry," Cleveland Clinic geriatrician Saket Saxena, MD, co-director of Cleveland Clinic's geriatric emergency department, said in the release. "However, the fast-paced nature of the ED, exacerbated by time constraints and staffing shortages, can make these assessments difficult to do."
3. A study led by Dr. Saxena and presented at the 2024 Annual Scientific Meeting of the American Geriatric Society screened 24 geriatric patients who boarded for an average of 20.4 hours in the emergency department.
4. The study used the 4AT assessment tool, which is considered easy to learn, administer and score, according to the release. Of study participants surveyed with 4AT screening, 17% were found to be delirious.
"Our results confirmed that traditional screening approaches underestimated the prevalence of delirium," Dr. Saxena said. "It's incumbent on hospitals to develop a reliable process like the 4AT that enables them to systematically screen highest-risk older adults for the disorder and intervene in a timely manner."