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charlson comorbidity index, delirium

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https://www.readbyqxmd.com/read/28822348/risk-factors-for-potential-drug-drug-interactions-in-intensive-care-unit-patients
#1
Slobodan M Janković, Ana V Pejčić, Miloš N Milosavljević, Valentina D Opančina, Nikola V Pešić, Tamara T Nedeljković, Goran M Babić
PURPOSE: To determine risk factors for each severity-based category of potential drug-drug interactions (DDIs) encountered at intensive care unit (ICU) patients. METHODS: This was a retrospective cohort analysis of patients treated at the ICU of the Clinical Center Kragujevac, a public tertiary care hospital in Kragujevac, Serbia. Three interaction checkers were used to reveal drug-drug interactions: Medscape, Epocrates and Micromedex. RESULTS: The study included 201 patients, 66...
August 14, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28668927/delirium-after-transcatheter-aortic-valve-replacement
#2
Jennifer L Giuseffi, Nyal E Borges, Leanne M Boehm, Li Wang, John A McPherson, Joseph L Fredi, Rashid M Ahmad, E Wesley Ely, Pratik P Pandharipande
BACKGROUND: Postoperative delirium is associated with increased mortality. Patients undergoing transcatheter aortic valve replacement are at risk for delirium because of comorbid conditions. OBJECTIVE: To compare the incidence, odds, and mortality implications of delirium between patients undergoing transcatheter replacement and patients undergoing surgical replacement. METHODS: The Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the Intensive Care Unit were used to assess arousal level and delirium prospectively in all patients with severe aortic stenosis who had transcatheter or surgical aortic valve replacement at an academic medical center...
July 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28655417/-functional-impairment-associated-with-cognitive-impairment-in-hospitalised-elderly
#3
José Mauricio Ocampo-Chaparro, José Ignacio Mosquera-Jiménez, Annabelle S Davis, Carlos A Reyes-Ortiz
INTRODUCTION: The aim of this study was to analyse the effect of cognitive impairment on functional decline in hospitalised patients aged ≥60 years. METHODS: Measurements at admission included demographic data, Charlson's comorbidity index, and cognitive impairment (according to education level). Data were also collected on hospital length of stay, depression, and delirium developed during hospitalisation. The outcome, Barthel Index (BI), was measured at admission, discharge, and 1-month post-discharge...
June 24, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28421731/intraoperative-dexmedetomidine-sedation-reduces-the-postoperative-agitated-behaviour-in-elderly-patients-undergoing-orthopaedic-surgery-compared-to-the-propofol-sedation-a-retrospective-analysis-of-855-patients
#4
Hyun-Jung Shin, Bon-Wook Koo, Seung-Uk Bang, Jin-Hee Kim, Jung-Won Hwang, Sang-Hwan DO, Hyo-Seok Na
BACKGROUND: Postoperative agitation or confusion is one of the symptoms of hyperactive delirium in elderly patients. We retrospectively evaluated the incidence of postoperative abnormal psychomotor behaviour in elderly surgical patients according to the use of different intraoperative sedative agents: dexmedetomidine vs. propofol. METHODS: The medical records of 855 elderly patients, who underwent orthopaedic surgery with regional anaesthesia between July 2012 and September 2015, were divided into two groups-the dexmedetomidine group (n=263) and the propofol group (n=592)-and evaluated...
April 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28329149/prediction-of-long-term-cognitive-decline-following-postoperative-delirium-in-older-adults
#5
Elizabeth E Devore, Tamara G Fong, Edward R Marcantonio, Eva M Schmitt, Thomas G Travison, Richard N Jones, Sharon K Inouye
Background: Increasing evidence suggests that postoperative delirium may result in long-term cognitive decline among older adults. Risk factors for such cognitive decline are unknown. Methods: We studied 126 older participants without delirium or dementia upon entering the Successful AGing After Elective Surgery (SAGES) study, who developed postoperative delirium and completed repeated cognitive assessments (up to 36 months of follow-up). Pre-surgical factors were assessed preoperatively and divided into nine groupings of related factors ("domains")...
March 15, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28291765/cervical-spine-surgery-complications-and-risks-in-the-elderly
#6
Kris Radcliff, Kevin L Ong, Scott Lovald, Edmund Lau, Mark Kurd
STUDY DESIGN: Cervical decompression (CD) and cervical fusion (CF) patients in 5% Medicare Part B claims data. OBJECTIVE: Evaluate the complication rate and associated risk factors after cervical spine surgery using a national sample of elderly patients. SUMMARY OF BACKGROUND DATA: The number of cervical spine procedures in the United States has risen along with associated hospital costs. Postoperative complications lead to longer hospitalizations and greater costs...
March 15, 2017: Spine
https://www.readbyqxmd.com/read/28260868/the-diagnosis-of-delirium-in-an-acute-care-hospital-in-moscow-what-does-the-pandora-s-box-contain
#7
Olga N Tkacheva, Nadezda K Runikhina, Arkadiy L Vertkin, Irina V Voronina, Natalia V Sharashkina, Elen A Mkhitaryan, Valentina S Ostapenko, Elena A Prokhorovich, Tamar Freud, Yan Press
BACKGROUND: Delirium, a common problem among hospitalized elderly patients, is not usually diagnosed by doctors for various reasons. The primary aim of this study was to evaluate the effect of a short training course on the identification of delirium and the diagnostic rate of delirium among hospitalized patients aged ≥65 years. The secondary aim was to identify the risk factors for delirium. METHODS: A prospective study was conducted in an acute-care hospital in Moscow, Russia...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28259697/antipsychotic-use-and-physical-morbidity-in-parkinson-disease
#8
Daniel Weintraub, Claire Chiang, Hyungjin Myra Kim, Jayne Wilkinson, Connie Marras, Barbara Stanislawski, Eugenia Mamikonyan, Helen C Kales
OBJECTIVE: To determine if antipsychotic (AP) use in Parkinson disease (PD) patients is associated with increased physical morbidity. METHODS: Veterans Health Administration data (1999-2010) was used to examine physical morbidity risk associated with AP use in idiopathic PD patients with stable recent physical health. We compared 180-day morbidity rates in patients initiating an AP with matched non-AP users who survived for 180 days (matched on age, sex, race, index year, presence and duration of dementia, PD duration, delirium, hospitalization, Charlson Comorbidity Index, and new non-psychiatric medications; covarying for psychosis)...
February 2, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28252537/daily-lowest-hemoglobin-and-risk-of-organ-dysfunctions-in-critically-ill-patients
#9
Sarah J Hemauer, Adam J Kingeter, Xue Han, Matthew S Shotwell, Pratik P Pandharipande, Liza M Weavind
OBJECTIVES: To determine the association between hemoglobin levels and the daily risk of individual organ dysfunctions in critically ill patients. DESIGN: Post hoc analysis of prospectively collected data. SETTING: Vanderbilt University Medical Center and Saint Thomas Hospital Medical and Surgical ICUs. PATIENTS: Medical and surgical ICU patients admitted with respiratory failure or shock. INTERVENTIONS: Baseline demographic data, and detailed in-ICU and hospital data, including daily lowest hemoglobin, were collected up to hospital day 30...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27984252/perioperative-complications-of-spinal-metastases-surgery
#10
Panya Luksanapruksa, Jacob M Buchowski, Lukas P Zebala, Christopher K Kepler, Weerasak Singhatanadgige, David B Bumpass
The incidence of symptomatic spinal metastasis has increased due to treatment improvements and longer patient survival. More patients with spinal tumors are choosing operative treatment with an associated increased rate of perioperative complications. Operative metastatic disease treatment complication rates have also increased with overall rates ranging from 5.3% to 76.20%. The common surgical-related complications are iatrogenic dural injury and wound complications. The most common postoperative medical complications are delirium, pneumonia, and deep vein thrombosis...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27943245/variability-of-delirium-motor-subtype-scale-defined-delirium-motor-subtypes-in-elderly-adults-with-hip-fracture-a-longitudinal-study
#11
Rikie M Scholtens, Barbara C van Munster, Dimitrios Adamis, Annemarieke de Jonghe, David J Meagher, Sophia E J A de Rooij
OBJECTIVES: To examine changes in motor subtype profile in individuals with delirium. DESIGN: Observational, longitudinal study; substudy of a multicenter, randomized controlled trial. SETTING: Departments of surgery and orthopedics, Academic Medical Center and Tergooi Hospital, the Netherlands. PARTICIPANTS: Elderly adults acutely admitted for hip fracture surgery who developed delirium according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, for 2 days or longer (n = 76, aged 86...
February 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27902744/delirium-detection-and-impact-of-comorbid-health-conditions-in-a-post-acute-rehabilitation-hospital-setting
#12
Julija Stelmokas, Nicolette Gabel, Jennifer M Flaherty, Katherine Rayson, Kathileen Tran, Jason R Anderson, Linas A Bieliauskas
Misdiagnosis and under-detection of delirium may occur in many medical settings. This is important to address as delirium clearly increases risk of morbidity and mortality in such settings. This study assessed whether Veterans who screened positive on a delirium severity measure (Memorial Delirium Assessment Scale; MDAS) differed from those with and without corresponding medical documentation of delirium in terms of cognitive functioning, psychiatric/medical history, and medication use. A medical record review of 266 inpatients at a VA post-acute rehabilitation unit found that 10...
2016: PloS One
https://www.readbyqxmd.com/read/27893697/morbidity-and-mortality-predictivity-of-nutritional-assessment-tools-in-the-postoperative-care-unit
#13
Şule Özbilgin, Volkan Hanc, Dilek Ömür, Mücahit Özbilgin, Mine Tosun, Serhan Yurtlu, Semih Küçükgüçlü, Atalay Arkan
The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27749567/morbidity-and-mortality-predictivity-of-nutritional-assessment-tools-in-the-postoperative-care-unit
#14
Şule Özbilgin, Volkan Hancı, Dilek Ömür, Mücahit Özbilgin, Mine Tosun, Serhan Yurtlu, Semih Küçükgüçlü, Atalay Arkan
The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27650453/a-simple-tool-to-predict-development-of-delirium-after-elective-surgery
#15
Andy Dworkin, David S H Lee, Amber R An, Sarah J Goodlin
OBJECTIVES: To identify a quick clinical tool to assess the risk of delirium after elective surgery. DESIGN: Prospective observational study. SETTING: Preoperative assessment clinic at the Veterans Affairs Portland Health Care System. PARTICIPANTS: Community-living veterans aged 65 and older scheduled for elective surgery requiring general or major anesthesia. MEASUREMENTS: Confusion Assessment Method (CAM) or Family Confusion Assessment Method (FAM-CAM)...
November 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27576950/longitudinal-patterns-of-delirium-severity-scores-in-long-term-care-settings
#16
Antonio Ciampi, Chun Bai, Alina Dyachenko, Jane McCusker, Martin G Cole, Eric Belzile
BACKGROUND: The delirium index (DI) is a valid measure of delirium severity. We proposed to describe longitudinal patterns of severity scores in older long-term care (LTC) residents. METHODS: A prospective cohort study of 280 residents in seven LTC facilities in Montreal and Quebec City, Canada, was conducted. DI, Barthel Index, Mini-Mental State Examination, Charlson Comorbidity Index, Cornell Scale for Depression in Dementia, dementia assessment by an MD, and prevalent or incident probable delirium defined according to the Confusion Assessment Method were completed at baseline...
January 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/27463247/postoperative-delirium-in-patients-after-pancreaticoduodenectomy
#17
Yasuhiro Ito, Yuta Abe, Kan Handa, Shintaro Shibutani, Tomohisa Egawa, Atsushi Nagashima, Minoru Kitago, Osamu Itano, Yuko Kitagawa
BACKGROUND/AIMS: Postoperative delirium (POD) is one of the most common complications after various types of surgery. The aim of this study was to investigate the incidence and risk factors for delirium after pancreaticoduodenectomy (PD). METHODS: This was a retrospective study of 146 consecutive patients who underwent PD between April 2007 and June 2015 at Saiseikai Yokohamashi Tobu Hospital. RESULTS: Twenty-nine patients (19.9%) were diagnosed with delirium...
2017: Digestive Surgery
https://www.readbyqxmd.com/read/27105460/medical-complications-after-adult-spinal-deformity-surgery-incidence-risk-factors-and-clinical-impact
#18
Alex Soroceanu, Douglas C Burton, Jonathan Haim Oren, Justin S Smith, Richard Hostin, Christopher I Shaffrey, Behrooz A Akbarnia, Christopher P Ames, Thomas J Errico, Shay Bess, Munish C Gupta, Vedat Deviren, Frank J Schwab, Virginie Lafage
STUDY DESIGN: Retrospective review of a prospective multicenter database evaluating surgical adult spinal deformity (ASD) patients. OBJECTIVE: This study aims to identify risk factors for medical complications in ASD patients undergoing surgery. SUMMARY OF BACKGROUND DATA: ASD surgery is known for its high complication rate. This study examines baseline patient characteristics for predictors of medical complications in surgical ASD patients...
November 15, 2016: Spine
https://www.readbyqxmd.com/read/27088157/endothelial-activation-and-blood-brain-barrier-injury-as-risk-factors-for-delirium-in-critically-ill-patients
#19
Christopher G Hughes, Pratik P Pandharipande, Jennifer L Thompson, Rameela Chandrasekhar, Lorraine B Ware, E Wesley Ely, Timothy D Girard
OBJECTIVES: During critical illness, impaired endothelial vascular reactivity predicts prolonged acute brain dysfunction, but relationships between endothelial activation, blood-brain barrier/neurological injury, and acute brain dysfunction, including delirium, remain unexamined. We tested the hypothesis that elevated plasma markers of endothelial activation and blood-brain barrier/neurological injury are associated with delirium duration during critical illness. DESIGN: Prospective cohort study...
September 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26999262/association-of-antipsychotic-use-with-mortality-risk-in-patients-with-parkinson-disease
#20
Daniel Weintraub, Claire Chiang, Hyungjin Myra Kim, Jayne Wilkinson, Connie Marras, Barbara Stanislawski, Eugenia Mamikonyan, Helen C Kales
IMPORTANCE: As many as 60% of patients with Parkinson disease (PD) experience psychosis, 80% develop dementia, and the use of antipsychotics (APs) in the population with PD is common. The use of APs by patients with dementia in the general population is associated with increased mortality, but whether this risk extends to patients with PD remains unknown. OBJECTIVE: To determine whether AP use in patients with PD is associated with increased mortality. DESIGN, SETTING, AND PARTICIPANTS: This retrospective matched-cohort study used data from a Veterans Health Administration database from fiscal years 1999 to 2010 to examine the risk associated with AP use in a cohort of patients with idiopathic PD and recent stable physical health...
May 1, 2016: JAMA Neurology
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