Behavioral observations reflected on consultation requests from primary medical-surgical services

Are they predictive of delirium diagnosis and outcomes?

Glen Xiong, Ilse R. Wiechers, James A. Bourgeois, Jane P. Gagliardi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: We studied 405 patients evaluated by the Psychosomatics Service to investigate whether the behavioral description as reflected on consultation request from primary medical-surgical teams could be utilized to predict the final clinical diagnosis of delirium. We explored whether outcomes differed in patient with delirium with different consultation requests. Methods: Patients with delirium (n=114) were divided into subtypes based on consultation requests for the management for cognitive dysfunction [altered mental status (AMS), n=46], for agitation or behavior disturbance (BEH, n=26), for depression (DEP, n=18), and for all other reasons (MISC, n=33). Adjusted multivariate regression models were used to examine group differences. Results: Consult requests for AMS had a high likelihood ratio (LR+=14.22) and requests for BEH had moderately high likelihood ratio (LR+=4.79) of receiving a diagnosis of delirium. The DEP group (n=18) tended to be younger and had higher 30-day readmission rates. The BEH group (n=26) had more comorbid systemic medical conditions, higher rate of being discharged to home, and lower mortality rate. Delirium subtypes did not show any significant difference in clinical outcomes. Conclusion: Behavioral observations on consultation requests as formulated by primary medical-surgical teams may be useful in the classification of patients with delirium. Whether the behavioral observations on the request may be used to predict delirium outcomes deserves further research.

Original languageEnglish (US)
Pages (from-to)177-181
Number of pages5
JournalJournal of Psychosomatic Research
Volume66
Issue number2
DOIs
StatePublished - Feb 2009

Fingerprint

Delirium
Referral and Consultation
Behavior Observation Techniques
Depression
Mortality
Research

Keywords

  • Behavioral observations
  • Delirium
  • Diagnosis
  • Likelihood ratio
  • Outcomes

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Behavioral observations reflected on consultation requests from primary medical-surgical services : Are they predictive of delirium diagnosis and outcomes? / Xiong, Glen; Wiechers, Ilse R.; Bourgeois, James A.; Gagliardi, Jane P.

In: Journal of Psychosomatic Research, Vol. 66, No. 2, 02.2009, p. 177-181.

Research output: Contribution to journalArticle

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