Screening methods for delirium: early diagnosis by means of objective quantification of motor activity patterns using wrist-actigraphy

Interact Cardiovasc Thorac Surg. 2009 Mar;8(3):344-8; discussion 348. doi: 10.1510/icvts.2008.192278. Epub 2008 Dec 22.

Abstract

Delirium after cardiac surgery is a risk factor for adverse outcome and even death. Disturbance of motor activity is a core feature of delirium, but hypoactive delirium often remains unrecognized. We explored wrist-actigraphy as a tool to objectively quantify postoperative recovery of 24-h rest-activity patterns to improve the early recognition of delirium after surgery. Motor activity was recorded by wrist-actigraphy after cardiac surgery in 88 patients over 65 years of age. Patients were assessed daily by using the CAM-ICU. Our final analyses were based on 32 non-delirious patients and 38 patients who were delirious on the first day after surgery. The delirious patients showed lower mean activity levels during the first postoperative night (P<0.05), reduced restlessness during the first day (P<0.05), and a lower mean activity of the 5 h with lowest activity within the first 24 h (P=0.01), as compared to the non-delirious patients. Already at a very early stage after cardiac surgery, a difference in motor activity was observed between patients with and without a delirium. As an unobtrusive method, actigraphy has the potential to be a screening method that may lead to early diagnosis and treatment of delirium.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acceleration
  • Aged
  • Biomechanical Phenomena
  • Cardiac Surgical Procedures / adverse effects*
  • Delirium / diagnosis*
  • Delirium / etiology
  • Delirium / physiopathology
  • Early Diagnosis
  • Female
  • Humans
  • Male
  • Monitoring, Physiologic / methods*
  • Motor Activity*
  • Postoperative Period
  • Predictive Value of Tests
  • Time Factors
  • Wrist / physiopathology*