What does the day of the week have to do with diagnosing delirium? Plenty, according to researchers at Penn State. In a study published in the Journal of Hospital Medicine, they say two simple questions may have the ability to identify the condition with a 93 percent success rate.

Delirium is a change in consciousness that can be frightening for both the person suffering from it and any onlookers. A sudden and severe confusion, the condition affects the entire body with symptoms ranging from differences in perception, sensation, alertness, and movement. There is a plethora of substances (legal or otherwise) that can cause delirium, especially psychedelic overdoses. Sometimes, though, delirium is a result of a different blend of environmental and biological factors.

Elderly patients, especially those in the intensive care unit, are at a particularly high risk of experiencing delirium, even if they are mentally sound when admitted. Any combination of poor sleep, medication, and underlying mental decline can launch a patient into a delirious state, and though the state can be resolved if caught early, it's been a vexing problem for health professionals.

“Delirium can be very costly and deadly — and with high-risk patients, time matters,” said Donna M. Fick, distinguished professor of nursing and co-director of the Hartford Center of Geriatric Nursing Excellence at Penn State, in a press release.

Currently, hospitals use a three-minute diagnostic test to screen for delirium, but oftentimes this method takes too long to administer, and can be more complicated than necessary. Fick and her team hoped to find a better, faster way to identify patients suffering from delirium.

The study involved 201 participants with a mean age of 84 years, 21 percent of whom had delirium based of clinical reference standards.

“We started by looking for one question that could detect delirium, but we could only get 83 percent sensitivity, which is not good,” Fick said.

They kept trying with a variety of questions and finally found a combination of two that had a satisfactory accuracy rate. They may seem relatively simple, but the inquiries managed to determine 39 of the 42 patients who were, in fact, suffering from delirium.

The first question asked the patient what day of the week it was, and the second asked them to name the months of the year, backward.

Though the results were a success, researchers warn against using the test as a finite determination just yet.

“These results still need to be validated, with a very large sample,” Fick said.

The team hopes to continue this research with hundreds more participants to determine if the test holds validity, and to recognize how feasibly it can be used in real-world situations.

Source: Fick D, Inouye S, Guess J, Ngo L, Jones R, Saczynski J, et al. Preliminary development of an ultrabrief two-item bedside test for delirium. Journal of Hospital Medicine. 2015.

Published by Medicaldaily.com