Abstract
Importance: Delirium affects up to 15% of hospitalised inpatients but prevalence rates vary by speciality. Outcomes for patients with delirium remain poor, but to improve care for patients having a full understanding of the burden of delirium within inpatients is an essential first step.
Objective: To identify the prevalence of delirium on admission at a single hospital site across all specialities over a two-year period.
Design: A retrospective analysis of all non-elective admissions 4A's Test (4AT) scores using Electronic Patient Records (EPR) data. Setting: A 600-bed urban teaching hospital in the Northwest of England Participants: All non-elective admissions in patients over 70 years old with a length of stay greater than 24 hours.
Main Outcome and Measures: Data was collected on 4AT scores, admission location based on admission speciality, and prevalence of delirium as defined by positive 4AT scores as a percentage of total admissions.
Results: Out of 33,275, 16,059 4AT scores were completed and of these 4491 screened positive for Delirium representation a total prevalence of 14%. Breaking down by speciality, Acute Medicine had the highest prevalence of delirium at 17%, and Neurosurgery had the highest prevalence among surgical specialities at 14%. Cardiology had the lowest prevalence of delirium at 3%.
Conclusions and Relevance: Out of 40 specialities studied, 28 had data on delirium screening however screening rates and prevalence varied significantly between specialities. Whilst overall prevalence was at 14% across the site, given the low overall rate of screening amongst specialities this likely represented a significant underreporting of delirium rates and therefore this study highlights the need for increased uptake of delirium screening across all specialities.