A retrospective, cross-sectional analysis of delirium in burns compared to other surgical specialities

Dr Aoife O’Brien1, Dr  Guy Stanley1, Dr  Patrick  Daly1, Prof.  Fiona Wood1, Ms  Jane Hopkins1

1Fiona Stanley Hospital, , Australia

1Waikato District Health Board, Hamilton, New Zealand, 2Centre for Person Centred Research, Auckland, New Zealand

Abstract:

Introduction
Delirium is often underdiagnosed and a significant risk for adverse outcomes (Casey et al., 2019) (Saller et al., 2019). It is the second most frequent Hospital Acquired Complication at the Western Australian State Burns Service forming 13.6% of all complications from 2018-2020. There is a lack of information in the literature about delirium in burns patients. To address this, the authors conducted a pilot audit. Findings were of non-compliance with a delirium screening tool and anecdotally, that delirious burns patients were unexpectedly younger than those from other specialities. To further characterise delirium in burns patients, the authors conducted a retrospective, cross-sectional of delirious patients in burns, comparing with other specialities.

Method
A trainee-led collaborative registered a service-evaluation to analyse 70 patients each from four specialities: Burns, plastic surgery, acute general surgery and orthopaedics from February 2015–May 2021. Analysis of injury severity, length of stay, Intensive Care Unit bed hours and number of operations included for analysis.

Results/discussion
Preliminary results show that there are both common and unique factors of burns delirium compared to other injuries. Characterising delirium amongst burns patients may allow earlier identification and treatment of it. We recommend that future studies should target the adequacy of diagnosis in burns unit settings.

References
Bellelli, G., Morandi, A., et al. (2014). Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age and Ageing, 43(4), 496–502. https://doi.org/10.1093/ageing/afu021
Casey, P., Cross, W., Mart, M. W., et al (2019). Hospital discharge data under‐reports delirium occurrence: results from a point prevalence survey of delirium in a major Australian health service. Internal Medicine Journal, 49(3), 338–344. https://doi.org/10.1111/imj.14066
Saller, T., MacLullich, et al (2019). Screening for delirium after surgery: validation of the 4 A’s test (4AT) in the post‐anaesthesia care unit. Anaesthesia, 74(10), 1260–1266. https://doi.org/10.1111/anae.14682

 


Biography:

Aoife O’Brien is an Irish RMO working in Fiona Stanley hospital for the past two years , currently completing a research degree with the Fiona Wood Foundation/Royal College of surgeons Ireland/ University of WA. She has a keen interest in burns surgery.

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