Have you misdiagnosed delirium today?

Delirium is a common problem in patients admitted to hospital as a medical emergency and is associated with an increased risk of adverse outcome. With an aging population and increased prevalence of chronic illness and dementia we are likely to see more patients with delirium in the emergency department. Recognition and appropriate treatment can improve outcomes, but accurate identification of delirium has not been investigated as thoroughly as other treatable conditions, such as myocardial infarction or subarachnoid haemorrhage. Barron and Holmes report findings from a systematic review of studies aimed at identifying delirium in emergency care. The prevalence of delirium in the study populations ranged from 7% to 20%, although variation in selection criteria may account for variation in these proportions. Detection of delirium was often poor suggesting that we may be missing an opportunity to provide appropriate care. Limitations in the study methodologies highlight the need for more high quality research in this area. …