Authors (including presenting author) :
Au YK,Chow ML, Mak WP, Esther CHANG, Yu WS
Affiliation :
Orthopaedics & Traumatology, Yan Chai Hospital
Introduction :
Delirium is common problem among hospitalized geriatric patients especially contained a high incidence rate (10- 61%) in patients having fracture hip surgery. Identifying high-risk patients in pre-operative care and provided interventions may prevent or reduce the severity of post-operation delirium. 4AT is a screening instrument designed for rapid initial assessment of delirium and cognitive impairment. Timely diagnosis of delirium and non-pharmacological prevention and management strategies can improve patient outcomes. The 4AT has reasonable sensitivity and specificity to detect delirium in a clinical routine setting.
Objectives :
To determine the effectiveness of the 4AT delirium assessment tools among geriatric patient with hip fracture.
Methodology :
A prospective study employed for hip fracture patients who were aged 60 or above in orthopedic wards in Yan Chai Hospital. The data collection started from Oct 2020 to Feb 2021. Patients who could communicate with background history of dementia were also recruited. 4AT assessment was performed by nurses on patient admission and the profile will be revised daily. The results collected aims at estimates and determines if 4AT is sensitive to detect general cognitive impairment and predict delirium in the early stage.
Result & Outcome :
Total 110 fracture hip patients were included. The overall compliance rate of 4AT assessment on admission was 92%, immediate post operation was 90%, and discharge was 84%. There were 16 patients with 4AT score ≥4 on admission and 20 patients achieved score ≥4 after operation. Based on 4AT score ≥4 was found in 1 (6.25%) with diagnosed delirium, in 5 (31.25%) of those diagnosed dementia, in 1 (6.25%) with diagnosed mild cognitive impairment and 1 (6.25%) patient diagnosed electrolyte imbalance. However, there was 1 patient diagnosed delirium with 4AT score as 3. Overall delirium occurrence was 0.9% (n=110).
