Delirium in the Emergency Department: Novel Screening

NCT01162343 | Completed Results

• 1 other identifier: 081408
• Study Type: observational
• Target: 498
• Locations: 1 country
• Sites: 1

Brief Summary

Delirium is an acute confusional state characterized by altered or fluctuating mental status, inattention, and either disorganized thinking or an altered level of consciousness. This form of organ dysfunction occurs in up to 10% of older emergency department (ED) patients and is associated with worsening mortality, prolonged hospital length of stay, higher health care costs, and accelerated functional and cognitive decline. Despite the negative consequences of delirium, the majority of cases are unrecognized by emergency physicians because it is not routinely screened for. In an effort to facilitate delirium screening, the investigators sought to validate three brief delirium assessments in the ED setting.

Conditions

Delirium

Keywords

Delirium, diagnosis, elderly, hospitalization

Outcome Measures

Primary Outcomes (1)

• Delirium

  Delirium was diagnosed by a consultation-liaison psychiatrist assessment using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria. The psychiatrists performed a battery of bedside cognitive tests, including (but not limited to) Clock Drawing Test, Luria hand sequencing task, and tests for verbal fluency. A focused neurological examination (i.e., screening for paraphasic errors, tremors, tone, asterixis, frontal release signs etc.,) and evaluation for affective lability, hallucinations, and level of alertness were also conducted routinely. Confrontational naming, proverb interpretation or similarities, and assessments for apraxias were performed at the discretion of the reference psychiatrists, especially if the diagnosis of delirium was inconclusive.

  Within 3 hours of the study assessments.

Study Arms (1)

Older Emergency Department Patients

Patients who were 65 years or older from the emergency department were enrolled.

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The participants will be those who are Vanderbilt University Emergency Department patients 65 years or older. There will be no selection bias in regards to race or gender. Only those who meet the inclusion/exclusion criteria will be considered for study inclusion.

You may qualify if:

• years of age or greater
• In the Emergency Department for less than 12 hour at the time of enrollment

You may not qualify if:

• Severe mental retardation or dementia
• Baseline communication barriers such as aphasia, deafness, blindness, or who are unable to speak English
• Refusal of consent
• Previous enrollment
• Comatose
• Out of the hospital before the assessments are completed

Sponsors & Collaborators

• Vanderbilt University Medical Center: lead

Study Sites (1)

Vanderbilt University Medical Center

Nashville, Tennessee, 37232, United States

Location

MeSH Terms

Conditions

Delirium; Disease

Condition Hierarchy (Ancestors)

Confusion; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Neurocognitive Disorders; Mental Disorders; Pathologic Processes

Limitations and Caveats

This was a single center study and should be externally validated. Our findings cannot be generalized to those who are younger than 65 years old.

Results Point of Contact

• Title: Dr. Jin Han, MD
• Organization: Vanderbilt University Medical Center

jin.h.han@vanderbilt.edu

615-936-0253

Study Officials

• Jin H Han, MD, MSc

  Vanderbilt University Medical Center

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD

Study Record Dates

• First Submitted: July 12, 2010
• First Posted: July 14, 2010
• Study Start: July 1, 2009
• Primary Completion: February 1, 2012
• Study Completion: February 1, 2012
• Last Updated: May 3, 2018
• Results First Posted: May 3, 2018

Record last verified: 2018-05

Locations

US (1)