Delirium, as a common complication of hospitalization, poses significant health problems in hospitalized patients. Though about a third of delirium cases can benefit from intervention, detecting and predicting delirium is still very limited in practice. A common characterization of delirium is change in activity level, causing patients to become hyperactive or hypoactive which is manifested in facial expressions and total body movements. This pilot study is designed to test the feasibility of a delirium detection system using movement data obtained from 3-axis wearable accelerometers and commercially available camera with facial recognition video system in conjunction with electronics medical record (EMR) data to analyze the relation of whole-body movement and facial expressions with delirium.
The aim of the study is to assess the potential of using motion and facial expression data to detect delirium in ICU patients by comparing motion and facial expression patterns in delirium and control groups. In this study, the investigators will use ActiGraph accelerometers to record each subject's movement patterns. Also, a processed video using a commercially available camera interfaces with a specialized program to identify patient facial expressions and movement patterns. A total of 60 participants will be enrolled with delirium, and 30 patients without delirium will be used as control group. Motion profiles will be compared in the motorically defined subgroups (hyperactive, hypoactive, normal) based on accelerometer and facial recognition data. Then, differences in facial expression, number of changes in postures, and percentage of time spent moving will be compared between motorically defined subgroups and in delirium and control groups. EMR data will also be used to assess the feasibility of detecting delirium by including additional information on related risk factors.
Study Type
OBSERVATIONAL
Enrollment
130
Confusion Assessment Method (CAM) score
3 accelerometers (placed on upper arm, wrist and ankle) and 1 placed on wall as ambient light sensor
As part of facial recognition video system
Monitors noise levels in the room
Cortisol level collected through self administered salivary swab
UF Health
Gainesville, Florida, United States
CAM/CAM-ICU
Confusion Assessment Method for detection of delirium
Time frame: Changes from Baseline up to 7 Days
Memorial Delirium Assessment Scale (MDAS) will be used for changes from baseline up to 7 days between the groups.
MDAS denotes motor profile and defines motor subtyping. It has 10 items which assesses several areas of cognitive functioning (memory, attention, orientation and disturbances in thinking) and psychomotor activity. The items are rated on a four point scale (0-3) based on the current interaction with the patient or by assessment of behavior. A score of 13 shows the diagnosis of delirium.
Time frame: Changes from Baseline up to 7 Days
Delirium Motor Subtyping Scale (DMSS-4) will be used for changes from baseline up to 7 days between the groups.
Scoring from DMSS-4 which has 5 hyperactive and 8 hypoactive symptoms requires at least two symptoms to be present from either the hyperactive or hypoactive list to meet subtype criteria. The higher the score the higher the delirium.
Time frame: Changes from Baseline up to 7 Days
Freedman Sleep Scale
To determine sleep quality of patient for given day.
Time frame: Changes from Baseline up to 7 Days
Number of subjects who died
Death at any time during admission
Time frame: Baseline up to 7 Days
Number of subjects on mechanical ventilation
Number of subjects requiring mechanical ventilation greater than 48 hours.
Time frame: greater than 48 hours
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