"Delirium Day": a nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

New scoring system for predicting percutaneous coronary intervention of chronic total occlusion success: Impact of operator’s experience

Background: Several scoring systems have been developed in order to predict percutaneous coronary intervention (PCI) result of chronic total occlusion (CTO). The scores principally include anatomic and clinical variables. Operator experience is a decisive factor for achieving successful result. We sought to assess the real impact of operator growing experience on CTO-PCI success. Methods: The angiographic and clinical variables of CTO-PCIs performed in our center between May 2007 and April 2021 were collected, and variables with potential association with procedural result were thoroughly reviewed. The influence of operator experience based on the number of previous CTO-PCIs was statistically assessed. A scoring system with combination of anatomic variables and operator experience was devised. Results: A total of 540 PCIs in 457 patients were performed in our institution. The scoring model was developed from the derivation set (2/3 of the cohort). The final variables in logistic regression model were CTO length ≥ 20 mm, blunt stump, vessel tortuosity > 45o and operator experience < 100 PCIs. The model showed good performance in the derivation set (area under curve [AUC]: 0.768; confidence interval [CI]: 0706–0.830; p < 0.001) with no significant shrinkage in the validation set (AUC: 0.704; CI: 0.613–0.796; p < 0.001). Conclusions: This new score (E-CTO score) adequately predict the probability of CTO-PCI failure. The model includes a variable representing operator experience along with other anatomic variables

Estratégias de aprendizagem utilizadas por graduandos e pós-graduandos em disciplinas semipresenciais da área de saúde

Este estudio tuvo como objetivo investigar los hábitos y las estrategias de aprendizaje de los estudiantes universitarios y de posgrado en una universidad brasileña, matriculados en las asignaturas semi-presenciales del área de la salud. Fueron invitados a todos los 220 estudiantes graduados, de los cuales 67,27% aceptaron participar de la investigación. Se utilizó una metodología exploratoria, que analizó los datos cuantitativos recogidos por un instrumento estructurado. Se pudo observar una similitud entre los estudiantes universitarios y de posgrado acerca de los de la mayoría de los hábitos de enseñanza y estrategias de aprendizaje, así como una mayor proporción de los que leyeron más de la mitad del contenido, de los que prefieren estudiar solos, además de la elevada utilización por la mayoría, de las estrategias evaluadas. Llegamos a la conclusión de que ambos los grupos presentaron hábitos adecuados de estudio y se utilizaron de manera satisfactoria de las estrategias de aprendizaje investigadas.Este estudo teve por objetivo investigar os hábitos e estratégias de aprendizagem de graduandos e pós-graduandos em uma universidade brasileira, matriculados em disciplinas semipresenciais da área de saúde. Foram convidados todos os 220 alunos concluintes, dos quais 67,27% aceitaram participar da pesquisa. Foi utilizada metodologia exploratória, que analisou dados quantitativos, coletados por um instrumento estruturado. Pôde-se observar semelhança entre graduandos e pós-graduandos quanto à maioria dos hábitos de ensino e estratégias de aprendizagem, assim como maior proporção daqueles que leram mais da metade do conteúdo, dos que preferem estudar sozinhos, além do elevado uso da maioria das estratégias avaliadas. Conclui-se que ambos os grupos apresentaram hábitos de estudo adequados e utilizaram satisfatoriamente as estratégias de aprendizagens investigadas.This study aimed to investigate the learning habits and strategies of undergraduate and post-graduate students matriculated in hybrid courses in the area of healthcare at a Brazilian university. 220 graduate students were invited to participate in the research, of whom 67.27% accepted. An exploratory methodology was utilized, which analyzed quantitative data collected by a structured instrument. A similarity may be observed between undergraduate and postgraduate students concerning the majority of education habits and learning strategies, such as the large proportion of those who read more than half of the course content and of those who preferred to study alone, as well as in the high use of the majority of strategies evaluated. It is concluded that both the groups present appropriate study habits and satisfactorily used the learning strategies investigated

Estrategias de aprendizaje utilizadas por estudiantes universitarios y de posgrado en asignaturas semi-presenciales en el área de la salud

Este estudo teve por objetivo investigar os hábitos e estratégias de aprendizagem de graduandos e pós-graduandos em uma universidade brasileira, matriculados em disciplinas semipresenciais da área de saúde. Foram convidados todos os 220 alunos concluintes, dos quais 67,27% aceitaram participar da pesquisa. Foi utilizada metodologia exploratória, que analisou dados quantitativos, coletados por um instrumento estruturado. Pôde-se observar semelhança entre graduandos e pós-graduandos quanto à maioria dos hábitos de ensino e estratégias de aprendizagem, assim como maior proporção daqueles que leram mais da metade do conteúdo, dos que preferem estudar sozinhos, além do elevado uso da maioria das estratégias avaliadas. Conclui-se que ambos os grupos apresentaram hábitos de estudo adequados e utilizaram satisfatoriamente as estratégias de aprendizagens investigadas. ____________________________________________________________________________________________________________ ABSTRACTThis study aimed to investigate the learning habits and strategies of undergraduate and post-graduate students matriculated in hybrid courses in the area of healthcare at a Brazilian university. 220 graduate students were invited to participate in the research, of whom 67.27% accepted. An exploratory methodology was utilized, which analyzed quantitative data collected by a structured instrument. A similarity may be observed between undergraduate and postgraduate students concerning the majority of education habits and learning strategies, such as the large proportion of those who read more than  half of the  course content and of those who preferred to study alone, as well as in the high use of the majority of strategies evaluated. It is concluded that both the groups present appropriate study habits and satisfactorily used the learning strategies investigated. ____________________________________________________________________________________________________________ RESUMENEste estudio tuvo como objetivo investigar los hábitos y las estrategias de aprendizaje de los estudiantes universitarios y de posgrado en una universidad brasileña, matriculados en las asignaturas semi-presenciales del área de la salud. Fueron invitados a todos los 220 estudiantes graduados, de los cuales 67,27% aceptaron participar de la investigación. Se utilizó una metodología exploratoria, que analizó los datos cuantitativos recogidos por un instrumento estructurado. Se pudo observar una similitud entre los estudiantes universitarios y de posgrado acerca de los de la mayoría de los hábitos de enseñanza y estrategias de aprendizaje, así como una mayor proporción de los que leyeron más de la mitad del contenido, de los que prefieren estudiar solos, además de la elevada utilización por la mayoría, de las estrategias evaluadas. Llegamos a la conclusión de que ambos los grupos presentaron hábitos adecuados de estudio y se utilizaron de manera satisfactoria de las estrategias de aprendizaje investigadas