Neurological diagnostic tests for patients with and without delirium: a prospective observational study.
Détails
ID Serval
serval:BIB_B1744ACD31C3
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Neurological diagnostic tests for patients with and without delirium: a prospective observational study.
Périodique
GeroScience
ISSN
2509-2723 (Electronic)
ISSN-L
2509-2723
Statut éditorial
Publié
Date de publication
12/2024
Peer-reviewed
Oui
Volume
46
Numéro
6
Pages
6383-6393
Langue
anglais
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Publication Status: ppublish
Résumé
Since most of the precipitating factors of delirium are not due to neurological disorders, neurological diagnostic tests (NDTs) may be of limited value. We hypothesized that delirium has a high burden of NDTs with a low diagnostic yield. All patients admitted to the internal medicine wards of a single secondary teaching hospital between November 2019 and January 2020 were eligible. Within the first 48 h of their admission, they had a formal evaluation by a neuropsychologist to screen for presence of delirium. NDTs (brain MRI, brain CT, electroencephalography (EEG), and lumbar puncture) performed during the hospital stay were compared between patients with and without delirium using a logistic regression model stratified by a propensity score. The proportions of diagnostic yield (acute anomalies that changed the treatment management) provided by each type of examination were compared. Of 217 patients included, 19/32 patients (61%) with delirium had one or more NDTs, compared to 48/185 (26%) without delirium (adjusted OR 2.7; 95%CI 1.1-6.7; p = 0.027). The proportions of NDT results affecting management for patients with and without delirium were 13 and 20% for brain CT scans (p = 0.71), 29 and 38% for brain MRI (p = 0.99), and 20 and 10% for EEGs (p = 0.99), respectively. The higher proportion of NDTs performed on patients with delirium was associated with a low diagnostic yield, although not statistically different from those performed among inpatients without delirium. There is a need for restrictive, evidence-based guidelines to help with the work-up for patients with delirium.
Mots-clé
Humans, Delirium/diagnosis, Delirium/diagnostic imaging, Male, Female, Prospective Studies, Aged, Magnetic Resonance Imaging, Aged, 80 and over, Electroencephalography, Tomography, X-Ray Computed, Diagnostic Techniques, Neurological, Spinal Puncture/methods, Middle Aged, CT scan, Delirium, Lumbar puncture, MRI
Pubmed
Web of science
Open Access
Oui
Création de la notice
28/06/2024 11:27
Dernière modification de la notice
29/10/2024 7:21