John Lewandowski
Recovery in Total Knee Replacement
Surgeries - A Pilot Study
SchoolSaint Ignatius High School • Cleveland, Ohio
ProgramScience Internship
MentorRakesh Engineer, M.D., F.A.C.E.P.
DepartmentEmergency Medicine, Cleveland Clinic
- Research
- Delirium in Patients with Sepsis in the Emergency Department: A Prospective Pilot Study
- Hypothesis
- The purpose of this study was to assess the prevalence of delirium in elderly patients presenting to the Emergency Department (ED) with sepsis, and to determine association of delirium with increased risk of morbidity and mortality. It is hypothesized that use of a standard mental screening exam such as the Confusion Assessment Method (CAM) can improve diagnosis within this patient population.
- Methodology
- CAM is considered the “gold standard” for determining the presence of delirium and is designed to be completed by a healthcare provider based on observations of the patient’s mental performance. In the present study, elderly patients presenting to the ED who elected to participate in the study were assessed by CAM and were also rated on the Glasgow Coma Scale (GCS). Additionally, the patient’s attending staff physician and resident separately assessed whether they believed the patient had delirium.
- Outcomes
- 13% of the patients enrolled in this study had delirium, according to CAM, 19% as assessed by GCS, while according to the attending physician’s assessment and resident’s assessment, only 9% of the study patients were delirious. Using systematic, standardized mental assessment tools, completion of this prospective study will determine the rate at which physicians recognize delirium, and whether delirium in patients with sepsis is associated with higher morbidity and mortality.
Interpretations
