Impact of a system-wide multicomponent intervention on administrative diagnostic coding for delirium and other cognitive frailty syndromes: observational prospective study

Journal article

Background: We determined the impact of a system-wide multicomponent intervention to improve recognition and documentation of cognitive 

Methods: A multicomponent intervention including introduction of structured patient assessment including cognitive/delirium screen, regular audit/feedback and educational seminars was undertaken (2012–17). Sensitivity and specificity of administrative 

Results: Among 1,281 consecutive unselected admissions to acute medicine overall (mean / standard deviation age = 70.0/19.2 years; n=615 (48.0%) male), 320 had clinical delirium diagnosis (n=220 delirium only; n=100 delirium on dementia). Sensitivity of delirium coding increased from 12.8% (95% confidence interval (CI) 5.6–26.7) in 2010 to 60.2% (95% CI 50.1–69.7; p

Conclusion: A multicomponent intervention increased sensitivity of hospital administrative diagnostic coding for delirium almost six-fold without increasing the false positive diagnosis rate.

Authors: Pendlebury, ST; Lovett, NG; Thomson, RJ; Smith, SC

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: Clinical Medicine
• Volume: 20
• Issue: 5
• Pages: 454-464
• Publication date: 2020-09-15
• DOI: 10.7861/clinmed.2019-0470
• EISSN: 1473-4893
• ISSN: 1470-2118
• Pmid: 32934037
• Language: English
• Keywords: delirium; dementia; cognitive frailty; ICD-10 diagnostic coding; sensitivity/specificity