Discussing Delirium During Hospitalization with Sharon K. Inouye, MD, MPH

Older adults as well as individuals dealing with intense illness while hospitalized may end up suffering from delirium due to their state at the time. This has been known to frequently occur for patients who are in the intensive care unit (ICU) of a hospital.

In a new interview, conducted on site at the 2024 American College of Physicians (ACP) Internal Medicine Meeting in Boston, Sharon K. Inouye, MD, MPH, MACP, spoke with the HCPLive editorial team on this topic, detailing the major takeaways from her presentation titled ‘Delirium During Hospitalization.’

Initially, Inouye was asked about the motivation behind her decision to pursue the topic as a conference presentation. She cited her background in geriatric medicine and several early experiences.

“I am a geriatrician, which is a physician in internal medicine who specializes in geriatric medicine, or the care of older adults,” she explained. “I got very interested in delirium, actually, when I began my career in internal medicine. So when I just finished my training, and on my very first clinical rotation as an attending…I began to see all these cases of older adults who got very confused during their hospital stay.”

Inouye explained that when she had inquired about this to the more experienced clinicians and her chief of staff, they essentially brushed it aside.

“Still, when I ask trainees in internal medicine ‘what did you learn about delirium during your training’ they'll say, ‘Oh, we got one lecture, in certain rooms, it was on psychiatry or neurology’ and it wasn't even in internal medicine,” Inouye said. “So it's not something that's heavily dwelt upon. I know it occurs in somewhere between 30 - 50% of older adults during the course of hospitalization. If you just think about that number, it's just massive.”

Inouye highlighted 6 specific cases during her presentation on delirium to illustrate her points over the course of the talk.

“When I talked about those 6 cases that I had, my first six cases, those outcomes are kind of representative of what happens to older adults who become delirious,” Inouye said. “They wind up going to the ICU, they have a high mortality rate. If they do survive the hospitalization, they wind up needing long term care, a lot of rehabilitation, a lot of homecare services. The long road to recovery. I think you can tell from the fact that it's very expensive for our healthcare system and many, millions to even billions are spent in excess health care costs worldwide, on the problem of delirium.”

For any additional information from this conference discussion, view the full interview segment above.

The quotes contained in this interview were edited for the purposes of clarity.