Experts say delirium is a common condition, especially among older hospitalised patients.
DOHA: In recognition of World Delirium Awareness Day, being observed today, Hamad Medical Corporation’s (HMC) Geriatric and Long-Term Care Department is leading a month-long campaign to inform and educate the general public, and health care professionals about the common condition.
Dr. Anand Kartha, Senior Consultant, General Medicine, at HMC, said delirium is a sudden mental change or decline in brain function that is mostly caused by acute illnesses, injuries (such as a hip fracture), major surgery, or drug-adverse effects or withdrawal.
“Delirium is a life-threatening medical emergency and is an independent risk factor for increased mortality, morbidity, and health care expenditure. Delirium can result in increased lengths of hospitalisation and long-term care requirements,” said Dr. Kartha.
According to Dr. Kartha, every 48 hours spent with delirium increases an individual’s mortality rate by 11%. He says, on average, one in five adult patients in hospital experiences delirium, with older patients, and especially those with dementia, at greatest risk. Dr. Kartha says it is important that health care providers, and the general public, can recognise the difference between delirium and dementia.
According to the International Federation of Delirium Societies, delirium occurs in up to 25% of medical inpatients, 50% of surgery patients, and 75% of intensive care patients.
There are no approved medications for delirium; clinicians treat the condition by identifying and treating the underlying causes.
“Delirium is much more common than people realise and affects up to 40% of older hospitalised patients. It is a common post-operative complication, occurring in around 15% of elderly patients following general surgery. It is often poorly identified and managed because the diagnosis of delirium is complicated as it is often linked with other chronic conditions that may have overlapping symptoms,” said Professor Stephen Thomas, Chairman of Emergency Services at HMC.
Professor Thomas added the detection and prevention of delirium is a top priority for hospitals, and specifically for emergency physicians, as many patients will first present at Emergency Departments. He says delirium can easily be treated if detected early, underscoring the importance of ongoing delirium education for Emergency Department staff.
Dr. Ibrahim Mohamed Fawzy, Director of Critical Care at HMC, says delirium is also common in patients admitted to the ICU but notes it is frequently under-diagnosed and can negatively influence prognosis.
“Approximately two out of three patients contract delirium in the ICU setting and seven out of ten patients develop delirium while they are on a breathing machine or soon after,” said Dr. Fawzy, who is part of the recently formed National Delirium Steering Committee. The Committee is working to unify delirium care across medical and surgical units and in the ICU setting.
Dr. Nicola Ryley, Chief Nursing Officer at HMC says nurses are integral to preventing and identifying delirium, noting they play a vital role in assessing patients, identifying risk factors and symptoms, and implementing prevention strategies.
Dr. Hanadi Al Hamad, Chairperson of Geriatrics and Long Term Care at HMC, and the National Health Strategy Lead for Healthy Aging, says delirium is complex and often multi-factorial and must be a global public health priority.
“Here in HMC, under the remit of the Ministry’s National Health Strategy 2018-2022, delirium care is given due priority and it is recognised that awareness is key to effective management. We have well-established awareness and training programmes.
"During the last year, we ran 55 education events and activities across Qatar, training 3,840 health care staff and raising awareness in upwards of 4,500 people in the community,” said Dr. Al Hamad.
