Grant Addresses Hospital-Delirium
|PETER YONCLAS, MD||ANNE MOSENTHAL, MD|
DELIRIUM —defined as sudden and severe confusion — is a common result of hospitalization in those 65 and older. Patients can experience hallucinations, loss of short-term memory, disorientation, difficulty speaking, agitation, trouble understanding speech, and extreme emotions, among other symptoms. The incidence is highest among post-surgical patients and those treated in an ICU; and can result in long-term disability and increased mortality both during the hospital stay and in the year following hospitalization. It also drives up healthcare costs.
Inflammation, infection, and many medications including narcotic painkillers, sedatives, sleeping pills, and certain drugs for high blood pressure, incontinence, and allergy, can trigger delirium. Since 30 to 40 percent is thought to be preventable, some hospitals are setting up programs to lessen the incidence. The Healthcare Foundation of New Jersey recently awarded $100,000 to each of four New Jersey hospitals, including UMDNJ's University Hospital (UH), to set up a delirium prevention program.
At UH, researchers are using the grant to create an interdisciplinary Hospital- Acquired Delirium Prevention & Treatment Initiative. The program's goal is to reduce hospital-acquired delirium through coordinated interventions — both pharmacologic (avoidance of medicines linked with delirium) and nonpharmacologic (provider and family education and complementary care).
Ultimately, a clinical protocol will be established for delirium risk assessment, prevention and treatment that focuses on patients over 50 who are admitted to the ICU and trauma units. Peter Yonclas, MD, director of trauma rehabilitation at UH and assistant professor of surgery and physical medicine and rehabilitation at NJMS and Kessler Institute of Rehabilitation, and Anne Mosenthal, MD, chair and professor of surgery at NJMS, are the principal investigators.