Present research situation and prospect for delirium recognition based on electronic medical record_Journal of Biomedical Engineering

Authors：

ZHAO Yanli ^1,2 , CHEN Ling ^1,2 ,  YUE Jirong ^1,2

1. National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;
2. Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;

Corresponding author：

Keywords：

delirium; electronic medical record; identification

DOI：

10.7507/1001-5515.201909048

Video：

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Delirium is a common complication in elderly inpatients which could result in cognitive impairment, and increase the risk of disability, fall and mortality. Moreover, it could cause heavy social burden. Even with multiple bedside screening scales to detect delirium, the rate of missed diagnosis is still high. Maybe it is associated with the acute fluctuation and nocturnal onset of delirium. With the development of the intelligence and automation of the electronic medical record (EMR), previous studies have explored the use of EMR to identify delirium patients, and this method provides help for delirium diagnosis and prevention. In this paper, we reviewed and summarized the current situation of research on delirium recognition by EMR, and put forward the development prospect in this method in order to provide basis and lay a foundation for intelligent diagnosis of delirium.

Citation： ZHAO Yanli, CHEN Ling, YUE Jirong. Present research situation and prospect for delirium recognition based on electronic medical record. Journal of Biomedical Engineering, 2020, 37(1): 185-188. doi: 10.7507/1001-5515.201909048 Copy

1.	Inouye S K, Westendorp R G, Saczynski J S. Delirium in elderly people. Lancet, 2014, 383(9920): 911-922.
2.	Bellelli G, Morandi A, Di Santo S G, et al. “Delirium Day”: a nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool. BMC Med, 2016, 14: 106.
3.	Inouye S K. Delirium in older persons. N Engl J Med, 2006, 354(15): 1157-1165.
4.	Persico I, Cesari M, Morandi A, et al. Frailty and delirium in older patients: A systematic review and meta-analysis of literature. J Am Geriatr Soc, 2018, 66(10): 2022-2030.
5.	Marcantonio E R. Postoperative delirium: a 76-year-old woman with delirium following surgery. JAMA, 2012, 308(1): 73-81.
6.	Shi Z, Mei X, Li C, et al. Postoperative delirium is associated with long-term decline in activities of daily living. Anesthesiology, 2019, 131(3): 492-500.
7.	Restrepo D, Duque M, Montoya L, et al. Risk factors and hospital mortality in surgical and non-surgical patients with delirium. Rev Colomb Psiquiatr, 2018, 47(3): 148-154.
8.	Agrawal S, Turk R, Burton B N, et al. The association of preoperative delirium with postoperative outcomes following hip surgery in the elderly. J Clin Anesth, 2019, 60: 28-33.
9.	Daiello L A, Racine A M, Yun Gou R, et al. Postoperative delirium and postoperative cognitive dysfunction: overlap and divergence. Anesthesiology, 2019, 131(3): 477-491.
10.	Eide L S, Ranhoff A H, Fridlund B, et al. Delirium as a predictor of physical and cognitive function in individuals aged 80 and older after transcatheter aortic valve implantation or surgical aortic valve replacement. J Am Geriatr Soc, 2016, 64(6): 1178-1186.
11.	Weinrebe W, Johannsdottir E, Karaman M, et al. What does delirium cost? An economic evaluation of hyperactive delirium. Z Gerontol Geriatr, 2016, 49(1): 52-58.
12.	Schmitt E M, Gallagher J, Albuquerque A, et al. Perspectives on the delirium experience and its burden: common themes among older patients, their family caregivers, and nurses. Gerontologist, 2019, 59(2): 327-337.
13.	Tremblay P, Gold S. Prevention of post-operative delirium in the elderly using pharmacological agents. Can Geriatr J, 2016, 19(3): 113.
14.	Martocchia A, Curto M, Comite F, et al. The prevention and treatment of delirium in elderly patients following hip fracture surgery. Recent Pat CNS Drug Discov, 2015, 10(1): 55.
15.	O’Neal J B, Shaw A D. Predicting, preventing, and identifying delirium after cardiac surgery. Perioper Med (Lond), 2016, 5: 7.
16.	Abraha I, Rimland J M, Trotta F, et al. Non-pharmacological interventions to prevent or treat delirium in older patients: clinical practice recommendations the SENATOR-ONTOP series. J Nutr Health Aging, 2016, 20(9): 927.
17.	Inouye S K, van Dyck C H, Alessi C A, et al. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med, 1990, 113(12): 941-948.
18.	de la Cruz M, Fan J, Yennu S, et al. The frequency of missed delirium in patients referred to palliative care in a comprehensive cancer center. Support Care Cancer, 2015, 23(8): 2427-2433.
19.	Boucher V, Lamontagne M E, Nadeau A, et al. Unrecognized incident delirium in older emergency department patients. J Emerg Med, 2019, 57(4): 535-542.
20.	Inouye S K, Leo-Summers L, Zhang Y, et al. A chart-based method for identification of delirium: validation compared with interviewer ratings using the confusion assessment method. J Am Geriatr Soc, 2005, 53(2): 312-318.
21.	Kuhn E, Du X, McGrath K, et al. Validation of a consensus method for identifying delirium from hospital records. PLoS One, 2014, 9(11): e111823.
22.	Mikalsen K O, Soguero-Ruiz C, Jensen K, et al. Using anchors from free text in electronic health records to diagnose postoperative delirium. Comput Methods Programs Biomed, 2017, 152(10): 105-114.
23.	Richardson S J, Davis D H J, Bellelli G, et al. Detecting delirium superimposed on dementia: diagnostic accuracy of a simple combined arousal and attention testing procedure. Int Psychogeriatr, 2017, 29(10): 1585-1593.
24.	张巍, 陈俊杰. 基于Logistic模型的医疗网络舆情监控与预警系统的研究. 电脑知识与技术, 2018, 14(4): 10-11.
25.	Despins L A. Automated deterioration detection using electronic medical record data in intensive care unit patients: a systematic review. Comput Inform Nurs, 2018, 36(7): 323-330.
26.	Despins L A. Automated detection of sepsis using electronic medical record data: a systematic review. J Healthc Qual, 2017, 39(6): 322-333.
27.	Bouzille G, Morival C, Westerlynck R, et al. An automated detection system of drug-drug interactions from electronic patient records using big data analytics. Stud Health Technol Inform, 2019, 264: 45-49.
28.	黎静辉. 基于HIS数据挖掘的医疗风险预警系统设计. 科技资讯, 2017, 28: 14-16.
29.	高薇, 李想, 冯娟, 等. 医疗风险智能评估及自动预警系统的设计与实现. 中国医疗设备, 2017, 32(8): 128-130.
30.	逄锦波, 马美丽. 医院风险预警系统及预警方法在普通病房的应用研究. 世界最新医学信息文摘, 2018, 18(59): 194.

1. Inouye S K, Westendorp R G, Saczynski J S. Delirium in elderly people. Lancet, 2014, 383(9920): 911-922.
2. Bellelli G, Morandi A, Di Santo S G, et al. “Delirium Day”: a nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool. BMC Med, 2016, 14: 106.
3. Inouye S K. Delirium in older persons. N Engl J Med, 2006, 354(15): 1157-1165.
4. Persico I, Cesari M, Morandi A, et al. Frailty and delirium in older patients: A systematic review and meta-analysis of literature. J Am Geriatr Soc, 2018, 66(10): 2022-2030.
5. Marcantonio E R. Postoperative delirium: a 76-year-old woman with delirium following surgery. JAMA, 2012, 308(1): 73-81.
6. Shi Z, Mei X, Li C, et al. Postoperative delirium is associated with long-term decline in activities of daily living. Anesthesiology, 2019, 131(3): 492-500.
7. Restrepo D, Duque M, Montoya L, et al. Risk factors and hospital mortality in surgical and non-surgical patients with delirium. Rev Colomb Psiquiatr, 2018, 47(3): 148-154.
8. Agrawal S, Turk R, Burton B N, et al. The association of preoperative delirium with postoperative outcomes following hip surgery in the elderly. J Clin Anesth, 2019, 60: 28-33.
9. Daiello L A, Racine A M, Yun Gou R, et al. Postoperative delirium and postoperative cognitive dysfunction: overlap and divergence. Anesthesiology, 2019, 131(3): 477-491.
10. Eide L S, Ranhoff A H, Fridlund B, et al. Delirium as a predictor of physical and cognitive function in individuals aged 80 and older after transcatheter aortic valve implantation or surgical aortic valve replacement. J Am Geriatr Soc, 2016, 64(6): 1178-1186.
11. Weinrebe W, Johannsdottir E, Karaman M, et al. What does delirium cost? An economic evaluation of hyperactive delirium. Z Gerontol Geriatr, 2016, 49(1): 52-58.
12. Schmitt E M, Gallagher J, Albuquerque A, et al. Perspectives on the delirium experience and its burden: common themes among older patients, their family caregivers, and nurses. Gerontologist, 2019, 59(2): 327-337.
13. Tremblay P, Gold S. Prevention of post-operative delirium in the elderly using pharmacological agents. Can Geriatr J, 2016, 19(3): 113.
14. Martocchia A, Curto M, Comite F, et al. The prevention and treatment of delirium in elderly patients following hip fracture surgery. Recent Pat CNS Drug Discov, 2015, 10(1): 55.
15. O’Neal J B, Shaw A D. Predicting, preventing, and identifying delirium after cardiac surgery. Perioper Med (Lond), 2016, 5: 7.
16. Abraha I, Rimland J M, Trotta F, et al. Non-pharmacological interventions to prevent or treat delirium in older patients: clinical practice recommendations the SENATOR-ONTOP series. J Nutr Health Aging, 2016, 20(9): 927.
17. Inouye S K, van Dyck C H, Alessi C A, et al. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med, 1990, 113(12): 941-948.
18. de la Cruz M, Fan J, Yennu S, et al. The frequency of missed delirium in patients referred to palliative care in a comprehensive cancer center. Support Care Cancer, 2015, 23(8): 2427-2433.
19. Boucher V, Lamontagne M E, Nadeau A, et al. Unrecognized incident delirium in older emergency department patients. J Emerg Med, 2019, 57(4): 535-542.
20. Inouye S K, Leo-Summers L, Zhang Y, et al. A chart-based method for identification of delirium: validation compared with interviewer ratings using the confusion assessment method. J Am Geriatr Soc, 2005, 53(2): 312-318.
21. Kuhn E, Du X, McGrath K, et al. Validation of a consensus method for identifying delirium from hospital records. PLoS One, 2014, 9(11): e111823.
22. Mikalsen K O, Soguero-Ruiz C, Jensen K, et al. Using anchors from free text in electronic health records to diagnose postoperative delirium. Comput Methods Programs Biomed, 2017, 152(10): 105-114.
23. Richardson S J, Davis D H J, Bellelli G, et al. Detecting delirium superimposed on dementia: diagnostic accuracy of a simple combined arousal and attention testing procedure. Int Psychogeriatr, 2017, 29(10): 1585-1593.
24. 张巍, 陈俊杰. 基于Logistic模型的医疗网络舆情监控与预警系统的研究. 电脑知识与技术, 2018, 14(4): 10-11.
25. Despins L A. Automated deterioration detection using electronic medical record data in intensive care unit patients: a systematic review. Comput Inform Nurs, 2018, 36(7): 323-330.
26. Despins L A. Automated detection of sepsis using electronic medical record data: a systematic review. J Healthc Qual, 2017, 39(6): 322-333.
27. Bouzille G, Morival C, Westerlynck R, et al. An automated detection system of drug-drug interactions from electronic patient records using big data analytics. Stud Health Technol Inform, 2019, 264: 45-49.
28. 黎静辉. 基于HIS数据挖掘的医疗风险预警系统设计. 科技资讯, 2017, 28: 14-16.
29. 高薇, 李想, 冯娟, 等. 医疗风险智能评估及自动预警系统的设计与实现. 中国医疗设备, 2017, 32(8): 128-130.
30. 逄锦波, 马美丽. 医院风险预警系统及预警方法在普通病房的应用研究. 世界最新医学信息文摘, 2018, 18(59): 194.

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