Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source and Study Design
2.2. Study Population
2.3. Identification and Classification of Potential Incident Delirium Episodes
2.3.1. Sample Review
2.3.2. Main Review
2.4. Identification of Recorded Delirium Discharge Diagnoses within the Claims Data
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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(A) | (B) |
agress * | agress * |
aggress * | aggress * |
delir * | delir * |
desorient * | desorient * |
durcheinand * | durcheinand * |
halluzin * | halluzin * |
klingelmatte | klingelmatte |
konfus * | konfus * |
unkoperat * | unkoperat * |
unkooperat * | unkooperat * |
nestel | nestel |
orient * | nicht (…) orient * |
koperat * | nicht (…) koperat * |
kooperat * | nicht (…) kooperat * |
unruh * | |
verwirr * | verwirr * |
Study Population (n = 10,515) | |
---|---|
Male | 4683 (44.54%) |
Median length of stay in days (IQR) | 22 (10) |
Median age at admission in years (IQR) | 70 (23) |
Age at admission, years | |
<40 | 700 (6.66%) |
40–49 | 822 (7.82%) |
50–59 | 1684 (16.02%) |
60–69 | 1925 (18.31%) |
70–79 | 2913 (27.70%) |
80–89 | 2238 (21.28%) |
>90 | 233 (2.22%) |
Rehabilitation discipline | |
Angiology | 631 (6.00%) |
Cardiology | 1127 (10.72%) |
Headache program | 450 (4.28%) |
Neurology | 3458 (32.89%) |
Orthopedics | 2964 (28.19%) |
Pain program | 510 (4.85%) |
Rheumatology | 1095 (10.41%) |
Others | 280 (2.66%) |
Number of Delirium-Predictive Key Words | ≥1 Antipsychotic Drug after Index Date | Potential Incident Delirium Episodes | Classified Incident Delirium Episodes | PPV (95% CI) |
---|---|---|---|---|
≥2 | No | 554 | 125 | 0.23 (0.19–0.26) |
Yes | 152 | 80 | 0.53 (0.45–0.61) | |
≥3 | No | 312 | 100 | 0.32 (0.27–0.37) |
Yes | 110 | 63 | 0.57 (0.48–0.67) | |
≥4 | No | 197 | 85 | 0.43 (0.36–0.50) |
Yes | 88 | 57 | 0.65 (0.55–0.75) | |
≥5 | No | 141 | 68 | 0.48 (0.40–0.57) |
Yes | 68 | 46 | 0.68 (0.56–0.79) | |
≥6 | No | 105 | 58 | 0.55 (0.46–0.65) |
Yes | 61 | 42 | 0.69 (0.57–0.81) | |
≥7 | No | 78 | 43 | 0.55 (0.44–0.66) |
Yes | 51 | 33 | 0.65 (0.51–0.78) | |
≥8 | No | 61 | 33 | 0.54 (0.41–0.67) |
Yes | 42 | 27 | 0.64 (0.49–0.79) | |
≥9 | No | 53 | 29 | 0.55 (0.41–0.69) |
Yes | 38 | 24 | 0.63 (0.47–0.79) | |
≥10 | No | 42 | 22 | 0.52 (0.37–0.68) |
Yes | 30 | 18 | 0.60 (0.41–0.79) |
Rehabilitation Discipline | Rehabilitation Stays | Potential Incident Delirium Episodes | Classified Incident Delirium Episodes | Cumulative Delirium Incidence | PPV (95% CI) |
---|---|---|---|---|---|
Cardiology | 1127 | 31 | 6 | 0.53% | 0.19 (0.04–0.35) |
Neurology | 3458 | 343 | 89 | 2.57% | 0.26 (0.21–0.31) |
Orthopedics | 2964 | 111 | 19 | 0.64% | 0.17 (0.10–0.24) |
Others ** | 2966 | 69 | 11 | 0.37% | 0.16 (0.07–0.25) |
10,515 | 554 | 125 | 1.19% | 0.23 (0.19–0.26) |
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Ceppi, M.G.; Rauch, M.S.; Sándor, P.S.; Gantenbein, A.R.; Krishnakumar, S.; Albert, M.; Meier, C.R. Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method. Neurol. Int. 2021, 13, 701-711. https://doi.org/10.3390/neurolint13040067
Ceppi MG, Rauch MS, Sándor PS, Gantenbein AR, Krishnakumar S, Albert M, Meier CR. Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method. Neurology International. 2021; 13(4):701-711. https://doi.org/10.3390/neurolint13040067
Chicago/Turabian StyleCeppi, Marco G., Marlene S. Rauch, Peter S. Sándor, Andreas R. Gantenbein, Shyam Krishnakumar, Monika Albert, and Christoph R. Meier. 2021. "Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method" Neurology International 13, no. 4: 701-711. https://doi.org/10.3390/neurolint13040067