Delirium documentation in hospitalized pediatric patients with cancer.
Delirium documentation in hospitalized pediatric patients with cancer.
复制标题
住院癌症儿科患者的谵妄记录。
DOI：
10.1017/s1478951521000171
复制
发表时间：
2021
影响因子：
2.2
通讯作者：
DelFabbro,Egidio
中科院分区：
文献类型：
--
作者：
Lastrapes,Kelly;Dang,Malisa;Cassel,JBrian;Orr,Tamara;Proffitt,Tracye;DelFabbro,Egidio
谵妄筛查工具在儿科重症监护中的使用更加一致。然而，筛查并不是普遍的，谵妄可能被诊断不足，误诊，或在住院患者中无记录。我们评估了小儿肿瘤和骨髓移植patients.MethodA回顾性图表审查所有住院小儿肿瘤和骨髓移植患者承认学术癌症中心之间的识别和文件谵妄2013年和2016年。纳入了年龄小于21岁的活动性癌症患者。患有严重精神疾病、发育迟缓或自闭症的患者被排除在外。收集数据，以表征文件有关的识别和诊断delirium.ResultsOf 201住院记录，54（26.9%）从109个独特的患者入院谵妄的文件。谵妄的总体记录发生率为3.2%的住院患者或8.2%的独特患者。处方阿片类药物和苯二氮卓类药物的患者更可能有谵妄记录。ICD编码低估了谵妄的报告，而医生的文件是不准确的，在26%（53/201）的图表review.Significance的结果谵妄是经常记录或错误编码。实施一个有效的，通用的谵妄筛查工具，可以提高识别和临床结果。
ObjectiveScreening tools for delirium are being used more consistently in pediatric critical care. However, screening is not universal, and delirium may be underdiagnosed, misdiagnosed, or undocumented in hospitalized patients. We evaluated the identification and documentation of delirium in pediatric oncology and bone marrow transplant patients.MethodA retrospective chart review on all hospitalized pediatric oncology and bone marrow transplant patients admitted to an Academic Cancer center between 2013 and 2016. Patients aged less than 21 years of age with active cancer were included. Patients with major psychiatric conditions, developmental delays, or autism were excluded. Data were collected to characterize documentation concerning the identification and diagnosis of delirium.ResultsOf 201 hospitalization records, 54 (26.9%) admissions from 109 unique patients had documentation of delirium. The overall documented incidence of delirium was 3.2% of hospitalizations or 8.2% of unique patients. Patients prescribed opioids and benzodiazepines were more likely to have documentation of delirium. ICD coding under-reported delirium while physician documentation was inaccurate in 26% (53/201) when compared with the chart review.Significance of resultsDelirium was frequently undocumented or miscoded. Implementing a validated, universal screening tool for delirium may improve identification and clinical outcomes.