Patients with heart failure (HF) accompanied by delirium are at risk of rehospitalization and death, thus early detection and appropriate treatment is imperative. Palliative care for patients with HF is an important issue, particularly for patients who also have delirium. This retrospective study examined the accuracy of delirium assessment by cardiologists treating patients with HF, identified factors related to the detection of delirium, and recorded the initial treatment. This was a retrospective chart survey of 165 patients with HF referred to a consultation liaison (C-L) service during treatment in the cardiology wards of a general hospital over a 6-year period. Diagnosis of delirium by the C-L psychiatrists was based on DSM-IV-TR. Cases in which cardiologists had stated “delirium” in the medical records were classified as an accurate assessment of delirium (Agreement group). Cases in which cardiologists did not state “delirium” were classified as Disagreement. Among 81 patients with delirium (51 [62.9%] male; 74.7 ± 13.3 years old), the ratio of accurate assessment of delirium by cardiologists was 50.6% (n = 41; Agreement group). Age, sex, and HF severity did not differ significantly between the two groups. Although disquietedness was identified most frequently (n = 59, 73%), only 33 of these 59 patients (55.9%) were recognized as having delirium by cardiologists. Inappropriate initial treatments were only noted in the Disagreement group. In both groups, most cases were referred to a C-L service without new medication for psychiatric symptoms. An accurate assessment of the delirium of inpatients with HF by cardiologists was found in only around half of all cases. Accurate detection is important to avoid harmful drug administration and to provide appropriate palliative care.

中文翻译：

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心脏病专家治疗心力衰竭住院患者谵妄评估的准确性：一项单中心回顾性调查。

伴有谵妄的心力衰竭（HF）患者有再住院和死亡的风险，因此早期发现和适当治疗势在必行。心衰患者的姑息治疗是一个重要问题，特别是对于同时患有谵妄的患者。这项回顾性研究检查了心脏病专家治疗 HF 患者的谵妄评估的准确性，确定了与谵妄检测相关的因素，并记录了初始治疗。这是对 165 名 HF 患者的回顾性图表调查，该患者在 6 年期间在一家综合医院的心脏病病房接受咨询联络 (CL) 服务。CL 精神科医生对谵妄的诊断基于 DSM-IV-TR。心脏病专家在病历中指出“谵妄”的病例被归类为谵妄的准确评估（协议组）。心脏病专家没有说明“谵妄”的病例被归类为不同意。在 81 名谵妄患者中（51 名 [62.9%] 男性；74.7 ± 13.3 岁），心脏病专家准确评估谵妄的比例为 50.6%（n = 41；同意组）。两组之间的年龄、性别和心衰严重程度没有显着差异。尽管最常发现不安（n = 59, 73%），但这 59 名患者中只有 33 名（55.9%）被心脏病专家认定为谵妄。仅在分歧组中注意到不适当的初始治疗。在这两组中，大多数病例都被转诊到 CL 服务，而没有针对精神症状的新药物。心脏病专家仅在大约一半的病例中发现了对心衰住院患者谵妄的准确评估。准确的检测对于避免有害的药物给药和提供适当的姑息治疗很重要。