Delirium is an acute, fluctuating syndrome of disturbed attention, awareness, and cognition that complicates hospital stays for 20–30% of older adults. It increases the risk for poor functional status and more than doubles 12-month mortality. Yet 30–40% of cases are preventable. The healthcare costs associated with delirium in older adults are approximately $150 billion each year.
Learn how AI can help to promote early diagnosis of delirium in the inpatient setting, reduce the incidence of delirium following hospitalization, and address functional decline in delirious patients. Discover how AI can help to promote early identification of delirium, predict patients at increased risk of developing delirium, and predict increased risk of functional decline.
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Delirium is an acute, fluctuating syndrome of disturbed attention, awareness, and cognition that is estimated to complicate hospital stays for 20–30% of adults aged 65 and older.¹ Patients with delirium are at increased risk for poor functional status, institutionalization, increased length of stay (LOS), and increased risk of mortality.¹ A study of delirium’s impact on mortality showed 41.6% of patients with delirium died within the 12 months following discharge, a more than twofold increase in risk, and the effect was particularly strong among patients without dementia.²
Delirium also imposes significant financial strain on the healthcare system. Annual costs attributable to delirium are estimated to range from $16,303 to $64,421 per patient, and the total cost of delirium in older adults is estimated to range from $143 billion to $152 billion nationally.³
Research has consistently demonstrated that in most cases, delirium is not detected in hospital settings and often persists after discharge.² Identification of delirium requires bedside cognitive assessments and validated diagnostic methods, but screening is inconsistent and measures are not routinely documented.⁴ Fortunately, validated algorithms have demonstrated high specificity and high positive predictive values for both detecting and predicting delirium.⁴𝄒⁵ Thus, predictive analytics leveraging these algorithms are perfectly positioned to facilitate delirium prevention and recognition.
AI enables providers to accurately identify delirious inpatients, predict patients at high risk for delirium, and initiate intervention efforts. Approximately 30–40% of all delirium episodes are considered to be preventable, and the severity of episodes can be reduced through targeted interventions.⁶ Preventive interventions that address modifiable risk factors, such as ensuring proper sleep patterns, adequate nutrition, and frequent reorientation, have all been proven to reduce the incidence of delirium regardless of the care environment.⁷ Management interventions have also been proven to reduce falls by up to 60%, lower LOS by up to two days, and save approximately $9,000 per patient in healthcare costs annually.⁸𝄒⁹
1 Siddiqi, Najma, et al. “Occurrence and outcome of delirium in medical in-patients: a systematic literature review.” Age and ageing, vol. 35, no. 4, 2006. Pp: 350-364. doi:10.1093/ageing/afl005.
2 McCusker, Jane et al. “Delirium predicts 12-month mortality.” Archives of internal medicine vol. 162, no. 4, 25 Feb. 2002, pp: 457-63. doi:10.1001/archinte.162.4.457
3 Leslie, Douglas L., and Inouye, Sharon K. “The importance of delirium: economic and societal costs.” Journal of the American Geriatrics Society, vol. 59, Nov. 2011, pp:241-243. doi:10.1111/j.1532-5415.2011.03671.x
4 Kim, Dae Hyun, et al. “Evaluation of Algorithms to Identify Delirium in Administrative Claims and Drug Utilization Database.” Pharmacoepidemiology and Drug Safety, vol. 26, no. 8, 9 May 2017, pp. 945–953, 10.1002/pds.4226.
5 Zhong, Xiaobo, et al. “Derivation and validation of a novel comorbidity-based delirium risk index to predict postoperative delirium using national administrative healthcare database.” Health Services Research, 6 Oct 2020, https://doi.org/10.1111/1475-6773.13565.
6 Ghaeli, Padideh, et al. “Preventive Intervention to Prevent Delirium in Patients Hospitalized in Intensive Care Unit.” Iranian Journal of Psychiatry, vol. 13, no. 2, 2018, pp. 142–147, www.ncbi.nlm.nih.gov/pmc/articles/PMC6037578/.
7 Kalish, Virginia B., et al. “Delirium in older persons: evaluation and management.” American family physician vol. 90, no. 3, 1 Aug. 2014, pp: 150-8.
8 Oh-Park, Mooyeon, et al. “Delirium Screening and Management in Inpatient Rehabilitation Facilities.” American Journal of Physical Medicine & Rehabilitation, vol. 97, no. 10, Oct. 2018, pp. 754–762, doi: 10.1097/PHM.0000000000000962.
9 Angle, Clay. “Standardizing Management of Adults with Delirium Hospitalized on Medical-Surgical Units.” The Permanente Journal, vol. 20, no. 4, 12 Sept. 2016, doi.org/10.7812/TPP/16-002, 10.7812/tpp/16-002.