Abstract：
OBJECTIVE: Delirium is an acute brain dysfunction associated with an increased risk of mortality and future dementia.
OBJECTIVE: To describe the prevalence of clinically documented delirium in the United States on World Delirium Awareness Day 2023.
METHODS: Sub-analysis of a prospective, cross-sectional, online, international survey.
METHODS: All healthcare settings were eligible with the exception of operating rooms and outpatient clinics.
METHODS: Healthcare clinicians, administrators, and researchers completed the survey.
METHODS: Prevalence of clinically documented delirium at 8:00 a.m. and 8:00 p.m. on March 15, 2023. Secondary outcomes were related to healthcare delivery. Descriptive statistics are reported. Differences between unit types (non-ICU vs ICU) were examined for all outcomes.
RESULTS: Ninety-one hospital units reported on 1,318/1,213 patients. The prevalence of clinically documented delirium was 16.4% (n=216/1,318) at 8:00 a.m., 17.9% (n=217/1,213) at 8:00 p.m. (p= 0.316) and significantly differed between age groups, reported discipline, unit, and hospital types. Significant differences were identified between non-ICU and ICU settings in the use of delirium-related protocols, non-pharmacologic and pharmacologic management, educational processes, and barriers to evidence-based delirium care.
CONCLUSIONS: To our knowledge, this is the first epidemiologic survey of clinically documented delirium across two time points in the U.S.. Delirium remains a significant burden and challenge for healthcare systems. The high percentage of units using delirium management protocols suggests administrator and clinician awareness of evidence-based strategies for its detection and mitigation. We provide recommendations for future studies and quality improvement projects to improve clinical recognition and management of delirium.
OBJECTIVE: To describe the prevalence of clinically documented delirium in the United States on World Delirium Awareness Day 2023.
METHODS: Sub-analysis of a prospective, cross-sectional, online, international survey.
METHODS: All healthcare settings were eligible with the exception of operating rooms and outpatient clinics.
METHODS: Healthcare clinicians, administrators, and researchers completed the survey.
METHODS: Prevalence of clinically documented delirium at 8:00 a.m. and 8:00 p.m. on March 15, 2023. Secondary outcomes were related to healthcare delivery. Descriptive statistics are reported. Differences between unit types (non-ICU vs ICU) were examined for all outcomes.
RESULTS: Ninety-one hospital units reported on 1,318/1,213 patients. The prevalence of clinically documented delirium was 16.4% (n=216/1,318) at 8:00 a.m., 17.9% (n=217/1,213) at 8:00 p.m. (p= 0.316) and significantly differed between age groups, reported discipline, unit, and hospital types. Significant differences were identified between non-ICU and ICU settings in the use of delirium-related protocols, non-pharmacologic and pharmacologic management, educational processes, and barriers to evidence-based delirium care.
CONCLUSIONS: To our knowledge, this is the first epidemiologic survey of clinically documented delirium across two time points in the U.S.. Delirium remains a significant burden and challenge for healthcare systems. The high percentage of units using delirium management protocols suggests administrator and clinician awareness of evidence-based strategies for its detection and mitigation. We provide recommendations for future studies and quality improvement projects to improve clinical recognition and management of delirium.
摘要：
目的：谵妄是一种与死亡率和未来痴呆风险增加相关的急性脑功能障碍。
目的：描述2023年世界谵妄意识日美国临床记录的谵妄患病率。
方法：对前瞻性，横截面,在线,国际调查。
方法：除手术室和门诊部外，所有医疗机构均符合条件。
方法：医疗保健临床医生，管理员,研究人员完成了调查。
方法：2023年3月15日上午8:00和下午8:00临床记录的谵妄患病率。次要结果与医疗服务相关。报告了描述性统计数据。检查了所有结局的单位类型（非ICUvsICU）之间的差异。
结果：91个医院单位报告了1,318/1,213名患者。上午8:00时，临床记录的谵妄患病率为16.4％（n=216/1,318），下午8:00时的17.9%(n=217/1,213)(p=0.316)，各年龄组之间存在显著差异，举报纪律,unit,医院类型。在使用谵妄相关方案方面，非ICU和ICU设置之间存在显著差异。非药物和药物管理，教育过程,以及循证谵妄护理的障碍。
结论：据我们所知，这是在美国两个时间点对临床记录的谵妄进行的首次流行病学调查。谵妄仍然是医疗保健系统的重大负担和挑战。使用谵妄管理协议的单位比例很高，这表明管理员和临床医生意识到基于证据的检测和缓解策略。我们为未来的研究和质量改进项目提供建议，以提高谵妄的临床认识和管理。
目的：描述2023年世界谵妄意识日美国临床记录的谵妄患病率。
方法：对前瞻性，横截面,在线,国际调查。
方法：除手术室和门诊部外，所有医疗机构均符合条件。
方法：医疗保健临床医生，管理员,研究人员完成了调查。
方法：2023年3月15日上午8:00和下午8:00临床记录的谵妄患病率。次要结果与医疗服务相关。报告了描述性统计数据。检查了所有结局的单位类型（非ICUvsICU）之间的差异。
结果：91个医院单位报告了1,318/1,213名患者。上午8:00时，临床记录的谵妄患病率为16.4％（n=216/1,318），下午8:00时的17.9%(n=217/1,213)(p=0.316)，各年龄组之间存在显著差异，举报纪律,unit,医院类型。在使用谵妄相关方案方面，非ICU和ICU设置之间存在显著差异。非药物和药物管理，教育过程,以及循证谵妄护理的障碍。
结论：据我们所知，这是在美国两个时间点对临床记录的谵妄进行的首次流行病学调查。谵妄仍然是医疗保健系统的重大负担和挑战。使用谵妄管理协议的单位比例很高，这表明管理员和临床医生意识到基于证据的检测和缓解策略。我们为未来的研究和质量改进项目提供建议，以提高谵妄的临床认识和管理。
