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delirium improved significantly. Recorded sharing of information on

deliriumdiagnosis with patients/relatives and the General Practitioner

improved from nil and 30% respectively in the initial audit to 98%

and 78% respectively in the pilot study.


Formal identification of delirium using validated assess-

ment tools like CAM, 4AT (Assessment Test) and SQiD (Single Question

in Delirium) significantly improves diagnosis, identification and

treatment of underlying causes, provision of information to patients,

relatives and communication amongst health care professionals.

Promoting their use will improve the quality of care for older people

with delirium. Disclosure No significant relationships


Acute confusional state syndrome in hospitalized patients

suffering from hip fracture

M.I. Porras-Guerra


, T. Porras-Guerra


, M.A. De La Torre-Alonso



C.E. Benitez-González


, M.N. Gómez-Gónzalez




Servicio de Geriatría.



I.E.S. Tomás Bretón. Salamanca,


Servicio de Psiquiatria. CAULE


Delirium is a frequent complication in hospitalized



Determining characteristic of admitted patients suffering

from hip fracture and delirium during their hospitalized period.

Material and methods:

Observational, longitudinal and retrospective

study of admitted patients medical records that suffer from hip

fracture and have delirium during hospitalization period. Variables:

sex, age, hospitalized period, domicile, type of delirium, beginning and

duration, associated pathologies and consumed medicines. Tracing:

60 days. Statistical treatment: SPPSv.15.


n = 66. Males: 27,3%. Female: 72,7%. Average age 85,1 years. No

sex differences. Average stay: 14,1 days. Males 20,5 days. Female: 12

days. Double stay for male. Domicile: Family 71,2%, Alone 6,1%,

Residence 22,7%. Delirium: Hyperactive: 66,1%. Hypoactive: 16,7%.

Mixed: 16,7%. Beginning of delirium: 1st day: 24,2%, 2nd day: 16,7%,

3rd day: 13,6%, 4th day: 10,6%, 5th day: 1,5%, 6th day: 13,6%, 6th day

more than: 7,5%. Delirium duration: Average duration: 2,4 days. 40,9%

1 day. 25,7% 2 days. 10,6% 3 days. 3,6% 4 days, 5 or more days 9%.

Associated pathologies: Average pathologies: 3,1. Hypertension: 66.7%,

heart disease: 34,8%, neurological disease: 34,8%, diabetes: 28,8%,

dyslipidemia: 25,7%, psychiatric disease: 19,7%. respiratory disease

10,6%, renal failure: 9,1%. Average consumption of drugs: 4,8.

Treatment: Surgery:90,9%. Conservative 9,1%.


The most common type is the hyperactive delirium lasts

an average of 2,4 days and is presented in the first 24 hours. The

comorbidity associated with delirium was hypertension, heart and

neurological disease. The patient


with hip fracturewho suffered

delirium during hospitalization is a woman of 85 years with heart and

neurological disease, which has an overactive delirium in the first 24

hours, lives in the family home, taking an average of 4 drugs, receives

surgical treatment and remains hospitalized about 14 days.


Implementing a delirium prevention programme can reduce falls

in hospital geriatric medicine wards

A. Solomonsz


, L. Charalambous


, R. Taylor


, E. Blackshaw


, A. Ali



R. Morris


, R. Moorchilot


, M. Poon


, A. Blundell


, R. Harwood



T. Masud




Nottingham University Hospitals NHS Trust, United Kingdom


Delirium is a common problem in older hospital

inpatients and is associated with morbidity including an increased

risk of falls. The aim of this analysis was to determine if implementing

a delirium prevention service improvement intervention reduced falls

in geriatric medicine wards.


A delirium prevention package was implemented over

a three month period on two 28 bedded female geriatric wards at a

large teaching hospital. The intervention included specialised training

for staff on assessment and management of cognitive impairment,

mobility, pain, nutrition, sensory impairment, sleep disturbance,

medications, dehydration, hypoxia and infection in addition to

developing new ward systems to increase delirium awareness. The

established hospital adverse incident reporting system (Datix) was

used to compare the falls per month in the six month periods before

and after implementing the intervention.


The mean fall rate before the intervention was 4.9/month

(95%CI = 4.5

5.7) which fell to 2.5/month (95%CI = 1.5

3.4), the mean

difference being 2.4/month (95%CI = 1.2

3.7) [p = 0.001]. There was

no significant change in mean length of stay with the intervention

[pre-intervention 13.3 days (95%CI = 12.4

14.1) vs post-intervention

14.8 days (95%CI = 13.5

16.0), NS].


Delirium and falls share many of the same risk factors

and the former is an independent risk factor for the latter. These data

show that better prevention and earlier diagnosis and treatment for

delirium reduced falls by almost a half in geriatric medicine wards,

although length of stay was not changed.


An embedded research project improves recognition of delirium in

older hospital inpatients

C. Welch, T.A. Jackson.

University of Birmingham


There is evidence that research activity can improve

patient outcomes in hospital [1]. Delirium is a severe acute

neuropsychiatric syndrome affecting mainly older people in hospital.

Delirium affects 15

25% of acute admissions to hospitals, yet is under-

recognised. Our aimwas to assess if an embedded research project on

an acute admissions unit would improve delirium recognition.


125 patients admitted to hospital with a diagnosis of DSM-

IV deliriumwere recruited to a prospective cohort study over a period

of 21 months. Delirium was diagnosed independently after the initial

admission assessment. We recorded whether the delirium diagnosis

was (1) recognised by the admitting assessment and (2) commu-

nicated in the discharge letter. Differences between these proportions

were tested.


Delirium recognition by the admitting team improved over

the course of the study. More delirium cases were recognised in the

second half than in the first half of recruitment (47.6% vs 71%, p = 0.01).

A similar trend was seen through analysis of quartiles (41.9%, 51.6%,

74.2%, 68.8%, p = 0.034). There was no difference between the

recording of delirium as a diagnosis in discharge summaries (41.3%

vs 56.5%, p = 0.11). No other delirium recognition improvement

projects took place during project recruitment.


Embedding a research project on an acute admissions

unit improved recognition of delirium on admission but not at

discharge. This suggests clinical research has wider systems benefits

on patients as improved recognition of delirium can improve patient

outcomes. This improvement may be due to the Hawthorn Effect.


1. Ozdemir BA, K.A., Sinha S, Poloniecki JD, Hinchliffe RJ, Thompson

MM, Gower JD, Boaz A, Holt PJ. Research activity and the associa-

tion with mortality.

PLoS One

, 2015. 10(2).

Area: Ethics and end of life care


The importance of the integration of palliative care on geriatrics

wards at general hospitals

B. Svirsky, E. Kaykov.

Western Galilee Medical Center, affiliated to Faculty

of Medicine in the Galilee, Bar-Ilan University. Israel

The Geriatrics ward of our general hospital house elderly patients

with acute illnesses and complex geriatric histories, requiring

careful evaluation and treatment. Many of these patients suffer from

advanced dementia and advanced-stage chronic illnesses such as

heart failure, respiratory failure or chronic system failure

all of which

Poster presentations / European Geriatric Medicine 7S1 (2016) S29