11 Aug Radiology at Home can Prevent Delirium in Elderly Patients

At-home x-rays may reduce the delirium elderly patients can suffer during the procedure, new research suggests.

A pilot study of 69 patients found that 17% of those who had x-rays in the hospital — but none of those treated at home — suffered delirium and required treatment.

“Modern portable x-ray units are light enough to be easily transported and used in the home and may spare frail patients the trauma of transportation and unfamiliar surroundings as well as other hospital-associated adverse effects,” said Dr. Vittoria Tibaldi at the University of Torino, Italy, and her team in a research letter published online August 8 in Archives of Internal Medicine.

The research supports a body of evidence showing that home care can reduce in-patient symptoms, including delirium, nosocomial infection, falls, and complications that healthcare workers can inadvertently cause.

Dr. Tibaldi’s team enrolled the 69 patients from a group of 123 who met their eligibility criteria in a home care program at a single hospital. Criteria included being immobilized or chair bound, acutely ill, and at intermediate or high risk of delirium, plus in need of x-rays of the chest, pelvis, hips, joints, upper or lower limbs, hands, or feet.

The researchers randomized 34 patients to a home care group and 35 to hospital care. In most cases, the x-rays were used to monitor suspected congestive heart failure, chronic obstructive pulmonary disease, or pneumonia. The quality of at-home imaging was similar to that of the hospital, and the x-rays confirmed 70% of clinical suspicions in both groups.

While 17% of the patients in the hospital suffered delirium within a few hours after the x-ray, none of the home-care patients experienced the condition, and 94% rated their procedures as “very good” or “excellent.”

The result, the researchers warn, may be skewed because of the small sample size and the high experience level of the home-care teams in this study.

“Nevertheless, this pilot trial suggests that healthcare is going home,” Dr. Tibaldi’s team concludes.