106 A Whole Hospital Delirium Audit with 20 Week Follow-Up

Abstract

Abstract Introduction Delirium is a common manifestation of acute illness, characterised by fluctuating changes in mental state. Its aetiologies and presentations are diverse. This can lead to underdiagnosis. We screened all adult inpatients at Barnet Hospital for delirium. 20 weeks follow-up data was collected, including mortality and admission to institutional care. Methods The 4AT and Clinical Frailty Score (CFS) were recorded for every adult inpatient (n = 220) in Barnet Hospital on 13/03/2019. Hospital notes were reviewed to establish whether delirium assessments were performed during admission. Electronic records were used to establish length of stay, discharge destination, mortality and readmission rate over 20 weeks. Results 30% (n = 65) of inpatients had possible delirium (4AT score ≥ 4). Delirium was more common in older, frailer patients (Table 1). Most patients with delirium were under the care of geriatric (40%) or acute medicine (26%). Only gastroenterology and gynaecology had no patients with delirium. Patients with delirium were 3 times more likely to die during their admission and were twice as likely to be discharged to institutional care (Table 1). 20 week mortality of patients with delirium was 26%. Conclusion Delirium is common in hospital inpatients. Delirium has a high morbidity and mortality. Better diagnosis of delirium in hospital may improve outcomes. Table 1: Mean(SD) unless stated. *p < 0.05 Delirium (n = 65) No Delirium (n = 155) Male: % 46 46 Age* 81(11) 71(20) Clinical Frailty Score* 5.6(1.7) 3.8(1.8) Dementia (%)* 53 10 Assisted living: n(%) o Pre-admission * 18.5 3.2 o Post Admission * 44.6 22.6 Length of stay 33 (25) 30.6 (28) Mortality (%) o Hospital * 10.7 3.9 o 20 Weeks * 26.2 14.2 Readmission rate (%) 30.8 31.