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Tribune News Network
In recognition of World Delirium Awareness Day on March 11 (today), Hamad Medical Corporation’s (HMC) Geriatric and Long-Term Care Department is leading a month-long campaign to inform and educate the general public and healthcare professionals about the common condition.
Dr Anand Kartha, senior consultant, General Medicine at HMC, said delirium is a sudden mental change or decline in brain function that is mostly caused by acute illnesses, injuries such as a hip fracture, major surgery or drug-adverse effects or withdrawal.
“Delirium is a life-threatening medical emergency and is an independent risk factor for increased mortality, morbidity and healthcare expenditure. Delirium can result in increased lengths of hospitalisation and long-term care requirements,” said Dr Kartha.
According to Dr Kartha, every 48 hours spent with delirium increases an individual’s mortality rate by 11 percent.
He said, on average, one in five adult patients in hospital experiences delirium, with older patients, especially those with dementia, at greatest risk.
Dr Kartha said it is important that healthcare providers and the general public can recognise the difference between delirium and dementia.
“Delirium represents a very rapid decline in brain function, which usually develops over hours or days. It is temporary, usually lasting a few days and is often reversible when identified and effectively managed,” Dr Kartha added.
According to the International Federation of Delirium Societies, delirium occurs in up to 25 percent of medical inpatients, 50 percent of surgery patients, and 75 percent of intensive care patients. There are no approved medications for delirium; clinicians treat the condition by identifying and treating the underlying causes.
“Delirium is much more common than people realise and affects up to 40 percent of older hospitalised patients. It is a common post-operative complication, occurring in around 15 percent of elderly patients following general surgery. It is often poorly identified and managed because the diagnosis of delirium is complicated as it is often linked with other chronic conditions that may have overlapping symptoms,” said Professor Stephen Thomas, chairman of Emergency Services at HMC.
Professor Thomas added that the detection and prevention of delirium is a top priority for hospitals, specifically for emergency physicians, as many patients will first present at Emergency Departments.
He said delirium can easily be treated if detected early, underscoring the importance of ongoing delirium education for Emergency Department staff.
Dr Ibrahim Mohamed Fawzy, director of Critical Care at HMC, said delirium is also common in patients admitted to the ICU but noted it is frequently under-diagnosed and can negatively influence prognosis.
“Approximately two out of three patients contract delirium in the ICU setting and seven out of 10 patients develop delirium while they are on a breathing machine or soon after,” said Dr Fawzy, who is part of the recently formed National Delirium Steering Committee.
The Committee is working to unify delirium care across medical and surgical units and in the ICU setting.
Dr Nicola Ryley, chief Nursing Officer at HMC, said nurses are integral to preventing and identifying delirium, noting that they play a vital role in assessing patients, identifying risk factors and symptoms, and implementing prevention strategies.
Dr Hanadi al Hamad, chairperson of Geriatrics and Long Term Care at HMC and the National Health Strategy Lead for Healthy Aging, said delirium is complex and often multi-factorial and must be a global public health priority.
“Here in HMC, under the remit of the ministry’s National Health Strategy 2018-2022, delirium care is given due priority and it is recognised that awareness is key to effective management. We have well-established awareness and training programmes. During the last year, we ran 55 education events and activities across Qatar, training 3,840 healthcare staff and raising awareness in upwards of 4,500 people in the community,” said Dr Hamad.
“Delirium awareness is an ongoing priority for HMC and we will continue to work with colleagues in different disciplines and the public to help educate them about this issue so we can help reduce the number of cases, and through early intervention, decrease the risk of future complications,” added Dr Hamad.
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