Science-- there's something for everyone

Tuesday, December 27, 2011

Hospital isolation and delirium


Some hospital patients must be kept in isolation, either for their own safety or for the safety of others. They might be severely immuno-compromised, or extremely contagious. In either case, keeping such patients apart can save lives.  Unfortunately, such precautions may come at a cost.  It turns out that patients who become isolated are 1.75 times as likely to develop delirium.

For this retrospective study, Hannah Day and her colleagues from the University of Maryland School of Medicine examined the records of over 42,000 non-psychiatric patients admitted to a hospital over a two-year period.  Those that had to be transferred to isolation wards suffered from delirium more often than their non-isolated cohorts.  Interestingly, patients who began their hospital stay with contact precautions were not more likely to develop delirium.

There are a number of possibilities for this finding.  First, patients who are transferred to isolation wards midstay may be sicker than those who are isolated at admission.  After all, patients who require such a transfer have evidently taken a turn for the worse.  Second, it may be more traumatic for patients to suddenly find themselves in isolation when they weren’t expecting to need those precautions.  By the way, delirium is not a permanent condition like dementia.  It's a temporary state of confusion.

In any case, I wonder if the Trinity Medical Center’s duct tape system would be able to alleviate some of these problems.