Advantages of score-based delirium detection compared to a clinical delirium assessment—a retrospective, monocentric cohort study
| Titel: | Advantages of score-based delirium detection compared to a clinical delirium assessment—a retrospective, monocentric cohort study |
|---|---|
| Verfasser: | ; ; ; ; ; ; ; ; ; ; ; |
| Veröffentlicht: | Freiburg : Universität, 2021 |
| Umfang: | 1 Online-Ressource |
| Format: | E-Book |
| Sprache: | Englisch |
X
alg: 48927087 001A $06000:06-01-22 001B $01999:07-01-22 $t22:39:14.000 001D $06000:06-01-22 001U $0utf8 001X $00 002@ $0Oax 002C $aText $btxt $2rdacontent 002D $aComputermedien $bc $2rdamedia 002E $aOnline-Ressource $bcr $2rdacarrier 003@ $0489270875 004P $010.1371/journal.pone.0259841 004U $0urn:nbn:de:bsz:25-freidok-2229726 006G $0124743298X 006U $022,O01 $f20211213 007A $0124743298X $aDNB 009Q $uhttps://doi.org/10.1371/journal.pone.0259841 $xR 009Q $uhttps://nbn-resolving.org/urn:nbn:de:bsz:25-freidok-2229726 $xR 009Q $qzip $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $xH 010@ $aeng 010E $erda 011@ $a2021 $n2021 021A $aAdvantages of score-based delirium detection compared to a clinical delirium assessment—a retrospective, monocentric cohort study 028A $BVerfasser $#Jäckel, M. $4aut $71167322290 $8Jäckel, Markus$Z1986- [Tp3] $943670367X 028C $aAicher $BVerfasser $dNico $4aut 028C $BVerfasser $4aut $71140601652 $8Bemtgen, Xavier [Tp3] $9417308620 028C $BVerfasser $4aut $71101389443 $8Rilinger, Jonathan$Z1987- [Tp3] $9380736780 028C $BVerfasser $4aut $7130618934 $8Zotzmann, Viviane$Z1979- [Tp3] $9160769515 028C $BVerfasser $#Biever, Paul M. $#Biever, Paul Marc $4aut $71058993356 $8Biever, Paul$Z1980- [Tp3] $9348058969 028C $BVerfasser $#Supady, Alexander Mark $#Supady, A. $4aut $7139700897 $8Supady, Alexander$Z1981- [Tp3] $9217637655 028C $BVerfasser $4aut $71011160471 $8Stachon, Peter [Tp3] $9244888841 028C $BVerfasser $#Dürschmied, Daniel $#Dürschmied, D. $#Duerschmied, D. $#Duerschmied, Daniel $4aut $7129152196 $8Dürschmied, Daniel Frank$Z1976- [Tp3] $9159531373 028C $BVerfasser $4aut $7129286907 $8Wengenmayer, Tobias$Z1977- [Tp3] $9159642442 028C $BVerfasser $#Bode, C. $4aut $7137596677 $8Bode, Christoph [Tp3] $9209998423 028C $BVerfasser $#Staudacher, Dawid L. $#Staudacher, Leander $#Staudacher, Dawid Leander $4aut $7102757937X $8Staudacher, Dawid [Tp3] $9311905188 033A $pFreiburg $nUniversität 034D $a1 Online-Ressource 037A $aPLOS ONE. - 16, 11 (2021) , e0259841, ISSN: 1932-6203 037I $uhttp://rightsstatements.org/page/InC/1.0 $fIN COPYRIGHT 037J $aKein Open Access $2star $uhttp://purl.org/coar/access_right/c_16ec $fOnline access with authorization 045B $a616.028 $ADNB $e23kdnb $Emaschinell gebildet $K0,80091 045E $c610 046X $aArchivierung/Langzeitarchivierung gewährleistet $5DE-101 047I $aAbstract: Purpose
Delirium is an underdiagnosed complication on intensive care units (ICU). We hypothesized that a score-based delirium detection using the Nudesc score identifies more patients compared to a traditional diagnosis of delirium by ICU physicians.
Methods
In this retrospective study, all patients treated on a general medical ICU with 30 beds in a university hospital in 2019 were analyzed. Primary outcome was a documented physician diagnosis of delirium, or a delirium score ≥2 using the Nudesc.
Results
In 205/943 included patients (21.7%), delirium was diagnosed by ICU physicians compared to 438/943 (46.4%; ratio 2.1) by Nudesc≥2. Both assessments were independent predictors of ICU stay (p<0.01). The physician diagnosis however was no independent predictor of mortality (OR 0.98 (0.57–1.72); p = 0.989), in contrast to the score-based diagnosis (OR 2.31 (1.30–4.10); p = 0.004). Subgroup analysis showed that physicians underdiagnosed delirium in case of hypoactive delirium and delirium in patients with female gender and in patients with an age below 60 years.
Conclusion
Delirium in patients with hypoactive delirium, female patients and those below 60 years was underdiagnosed by physicians. The score-based delirium diagnosis detected delirium more frequently and correlated with ICU mortality and stay lok: 48927087 3 exp: 48927087 3 1 #EPN 201B/01 $007-01-22 $t22:39:14.784 201C/01 $007-01-22 201U/01 $0utf8 203@/01 $01175995681 208@/01 $a07-01-22 $bl 209S/01 $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $XH lok: 48927087 5 exp: 48927087 5 1 #EPN 201B/01 $007-01-22 $t22:39:14.791 201C/01 $007-01-22 201U/01 $0utf8 203@/01 $0117599569X 208@/01 $a07-01-22 $bl 209S/01 $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $XH lok: 48927087 8 exp: 48927087 8 1 #EPN 201B/01 $007-01-22 $t22:39:14.796 201C/01 $007-01-22 201U/01 $0utf8 203@/01 $01175995703 208@/01 $a07-01-22 $bl 209S/01 $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $XH lok: 48927087 10 exp: 48927087 10 1 #EPN 201B/01 $007-01-22 $t22:39:14.802 201C/01 $007-01-22 201U/01 $0utf8 203@/01 $01175995711 208@/01 $a07-01-22 $bl 209S/01 $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $XH lok: 48927087 11 exp: 48927087 11 1 #EPN 201B/01 $007-01-22 $t22:39:14.807 201C/01 $007-01-22 201U/01 $0utf8 203@/01 $0117599572X 208@/01 $a07-01-22 $bl 209S/01 $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $XH lok: 48927087 20 exp: 48927087 20 1 #EPN 201B/01 $007-01-22 $t22:39:14.812 201C/01 $007-01-22 201U/01 $0utf8 203@/01 $01175995738 208@/01 $a07-01-22 $bl 209S/01 $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $XH lok: 48927087 21 exp: 48927087 21 1 #EPN 201B/01 $007-01-22 $t22:39:14.817 201C/01 $007-01-22 201U/01 $0utf8 203@/01 $01175995746 208@/01 $a07-01-22 $bl 209S/01 $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $XH lok: 48927087 23 exp: 48927087 23 1 #EPN 201B/01 $007-01-22 $t22:39:14.822 201C/01 $007-01-22 201U/01 $0utf8 203@/01 $01175995754 208@/01 $a07-01-22 $bl 209S/01 $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $XH lok: 48927087 25 exp: 48927087 25 1 #EPN 201B/01 $007-01-22 $t22:39:14.828 201C/01 $007-01-22 201U/01 $0utf8 203@/01 $01175995762 208@/01 $a07-01-22 $bl 209S/01 $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $XH lok: 48927087 108 exp: 48927087 108 1 #EPN 201B/01 $007-01-22 $t22:39:14.833 201C/01 $007-01-22 201U/01 $0utf8 203@/01 $01175995770 208@/01 $a07-01-22 $bl 209S/01 $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $XH lok: 48927087 204 exp: 48927087 204 1 #EPN 201B/01 $007-01-22 $t22:39:14.838 201C/01 $007-01-22 201U/01 $0utf8 203@/01 $01175995789 208@/01 $a07-01-22 $bl 209S/01 $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $XH lok: 48927087 205 exp: 48927087 205 1 #EPN 201B/01 $007-01-22 $t22:39:14.844 201C/01 $007-01-22 201U/01 $0utf8 203@/01 $01175995797 208@/01 $a07-01-22 $bl 209S/01 $S0 $uhttps://freidok.uni-freiburg.de/data/222972 $XH
| LEADER | 00000cam a22000002c 4500 | ||
|---|---|---|---|
| 001 | 489270875 | ||
| 003 | DE-603 | ||
| 005 | 20220107223914.0 | ||
| 007 | cr|||||||||||| | ||
| 008 | 220106s2021 xx |||| o| u00||u|eng | ||
| 015 | |a 22,O01 |2 dnb | ||
| 016 | 7 | |2 DE-101 |a 124743298X | |
| 024 | 7 | |a 10.1371/journal.pone.0259841 |2 doi | |
| 024 | 7 | |a urn:nbn:de:bsz:25-freidok-2229726 |2 urn | |
| 035 | |a (DE-599)DNB124743298X | ||
| 040 | |a DE-603 |b ger |c DE-603 |d DE-603 |e rda | ||
| 041 | |a eng | ||
| 082 | 7 | |8 1\p |a 616.028 |2 23kdnb | |
| 084 | |a 610 |q DE-101 |2 sdnb | ||
| 100 | 1 | |a Jäckel, Markus |d 1986- |e Verfasser |4 aut |0 (DE-603)43670367X |0 (DE-588)1167322290 |2 gnd | |
| 245 | 0 | 0 | |a Advantages of score-based delirium detection compared to a clinical delirium assessment—a retrospective, monocentric cohort study |
| 264 | 1 | |a Freiburg |b Universität |c 2021 | |
| 300 | |a 1 Online-Ressource | ||
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a PLOS ONE. - 16, 11 (2021) , e0259841, ISSN: 1932-6203 | ||
| 520 | |a Abstract: Purpose<br>Delirium is an underdiagnosed complication on intensive care units (ICU). We hypothesized that a score-based delirium detection using the Nudesc score identifies more patients compared to a traditional diagnosis of delirium by ICU physicians.<br><br>Methods<br>In this retrospective study, all patients treated on a general medical ICU with 30 beds in a university hospital in 2019 were analyzed. Primary outcome was a documented physician diagnosis of delirium, or a delirium score ≥2 using the Nudesc.<br><br>Results<br>In 205/943 included patients (21.7%), delirium was diagnosed by ICU physicians compared to 438/943 (46.4%; ratio 2.1) by Nudesc≥2. Both assessments were independent predictors of ICU stay (p<0.01). The physician diagnosis however was no independent predictor of mortality (OR 0.98 (0.57–1.72); p = 0.989), in contrast to the score-based diagnosis (OR 2.31 (1.30–4.10); p = 0.004). Subgroup analysis showed that physicians underdiagnosed delirium in case of hypoactive delirium and delirium in patients with female gender and in patients with an age below 60 years.<br><br>Conclusion<br>Delirium in patients with hypoactive delirium, female patients and those below 60 years was underdiagnosed by physicians. The score-based delirium diagnosis detected delirium more frequently and correlated with ICU mortality and stay | ||
| 700 | 1 | |a Aicher, Nico |e Verfasser |4 aut | |
| 700 | 1 | |a Bemtgen, Xavier |e Verfasser |4 aut |0 (DE-603)417308620 |0 (DE-588)1140601652 |2 gnd | |
| 700 | 1 | |a Rilinger, Jonathan |d 1987- |e Verfasser |4 aut |0 (DE-603)380736780 |0 (DE-588)1101389443 |2 gnd | |
| 700 | 1 | |a Zotzmann, Viviane |d 1979- |e Verfasser |4 aut |0 (DE-603)160769515 |0 (DE-588)130618934 |2 gnd | |
| 700 | 1 | |a Biever, Paul |d 1980- |e Verfasser |4 aut |0 (DE-603)348058969 |0 (DE-588)1058993356 |2 gnd | |
| 700 | 1 | |a Supady, Alexander |d 1981- |e Verfasser |4 aut |0 (DE-603)217637655 |0 (DE-588)139700897 |2 gnd | |
| 700 | 1 | |a Stachon, Peter |e Verfasser |4 aut |0 (DE-603)244888841 |0 (DE-588)1011160471 |2 gnd | |
| 700 | 1 | |a Dürschmied, Daniel Frank |d 1976- |e Verfasser |4 aut |0 (DE-603)159531373 |0 (DE-588)129152196 |2 gnd | |
| 700 | 1 | |a Wengenmayer, Tobias |d 1977- |e Verfasser |4 aut |0 (DE-603)159642442 |0 (DE-588)129286907 |2 gnd | |
| 700 | 1 | |a Bode, Christoph |e Verfasser |4 aut |0 (DE-603)209998423 |0 (DE-588)137596677 |2 gnd | |
| 700 | 1 | |a Staudacher, Dawid |e Verfasser |4 aut |0 (DE-603)311905188 |0 (DE-588)102757937X |2 gnd | |
| 856 | |u https://doi.org/10.1371/journal.pone.0259841 |x Resolving-System | ||
| 856 | |u https://nbn-resolving.org/urn:nbn:de:bsz:25-freidok-2229726 |x Resolving-System | ||
| 856 | |q zip |u https://freidok.uni-freiburg.de/data/222972 |x Verlag |z kostenfrei | ||
| 883 | 0 | |8 1\p |a maschinell gebildet |c 0,80091 |q DE-101 | |
| 924 | 1 | |9 603 |a (DE-603)1175995681 |b DE-603 |c HES |d d | |
| 924 | 1 | |9 603 |a (DE-603)117599569X |b DE-603 |c HES |d d | |
| 924 | 1 | |9 603 |a (DE-603)1175995703 |b DE-603 |c HES |d d | |
| 924 | 1 | |9 603 |a (DE-603)1175995711 |b DE-603 |c HES |d d | |
| 924 | 1 | |9 603 |a (DE-603)117599572X |b DE-603 |c HES |d d | |
| 924 | 1 | |9 603 |a (DE-603)1175995738 |b DE-603 |c HES |d d | |
| 924 | 1 | |9 603 |a (DE-603)1175995746 |b DE-603 |c HES |d d | |
| 924 | 1 | |9 603 |a (DE-603)1175995754 |b DE-603 |c HES |d d | |
| 924 | 1 | |9 603 |a (DE-603)1175995762 |b DE-603 |c HES |d d | |
| 924 | 1 | |9 603 |a (DE-603)1175995770 |b DE-603 |c HES |d d | |
| 924 | 1 | |9 603 |a (DE-603)1175995789 |b DE-603 |c HES |d d | |
| 924 | 1 | |9 603 |a (DE-603)1175995797 |b DE-603 |c HES |d d | |