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delirium elderly

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https://www.readbyqxmd.com/read/29341529/-when-the-ward-overflows%C3%A2-the-impact-of-outlying-beds-on-patient-care
#1
Valérie Mosimann, Olivier Lamy, Julien Castioni
Due to the chronic lack of beds in hospitals, patients are often hospitalized in other departments (outlier patients), with a responsible physician working in another department. This causes increased thromboembolics risks, nosocomial infections, falls and delirium in the elderly, morbidity and mortality. Outlier patients, compared to standard patients, stay longer in the emergency department and their discharge documents are available later. Outlying is used daily in the CHUV hospital and new strategies are elaborated to manage patient flow, especially during the flu epidemic...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29340963/interactions-between-drugs-and-geriatric-syndromes-in-nursing-home-and-home-care-results-from-shelter-and-ibenc-projects
#2
Graziano Onder, Silvia Giovannini, Federica Sganga, Ester Manes-Gravina, Eva Topinkova, Harriet Finne-Soveri, Vjenka Garms-Homolová, Anja Declercq, Henriëtte G van der Roest, Pálmi V Jónsson, Hein van Hout, Roberto Bernabei
AIM: Drugs may interact with geriatric syndromes by playing a role in the continuation, recurrence or worsening of these conditions. Aim of this study is to assess the prevalence of interactions between drugs and three common geriatric syndromes (delirium, falls and urinary incontinence) among older adults in nursing home and home care in Europe. METHODS: We performed a cross-sectional multicenter study among 4023 nursing home residents participating in the Services and Health for Elderly in Long-TERm care (Shelter) project and 1469 home care patients participating in the Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of community care (IBenC) project...
January 16, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29313909/peri-operative-neurological-complications
#3
REVIEW
R Hood, A Budd, F A Sorond, C W Hogue
Brain injury from cardiac surgery is an important source of patient morbidity and mortality. The relationship between risk of brain injury and advanced age portends a rising frequency of these complications due to an increasing proportion of elderly patients undergoing cardiac surgery. This review will explore the aetiology and risk factors for peri-operative stroke, postoperative cognitive dysfunction and postoperative delirium. The prevention of each of these conditions will also be discussed, with a focus on brain protection strategies and the avoidance of cerebral embolism and hypoperfusion...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29298664/the-prevention-of-delirium-in-elderly-with-obstructive-sleep-apnea-podesa-study-protocol-for-a-multi-centre-prospective-randomized-controlled-trial
#4
Jean Wong, David Lam, Stephen Choi, Mandeep Singh, Naveed Siddiqui, Sanjeev Sockalingam, Frances Chung
BACKGROUND: Delirium is a common problem that occurs in 5-50% of elderly individuals following surgery. Patients who develop delirium after surgery are at increased risk for serious complications. Recent studies suggest that patients with obstructive sleep apnea (OSA), a sleep disorder characterized by repeated episodes of complete or partial blockage of the upper airway - are at greater risk to develop delirium. OSA is more common in elderly individuals but is often undiagnosed. Identification and treatment of unrecognized OSA may reduce the incidence of postoperative delirium...
January 3, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29295719/effectiveness-of-multicomponent-interventions-on-incidence-of-delirium-in-hospitalized-older-patients-with-hip-fracture-a-systematic-review
#5
Tarandeep Oberai, Kate Laver, Maria Crotty, Maggie Killington, Ruurd Jaarsma
BACKGROUND: Delirium is the most frequent complication among the hospitalized elderly with hip fracture. Although, delirium is associated with longer hospital stay, higher mortality rates, worse functional outcomes, and higher institutionalization rates yet health service planners have hugely ignored its existence. This review aims to identify the effectiveness of multicomponent interventions to prevent delirium in hospitalized elderly patients with hip fracture. METHODS: This review includes experimental, non-experimental, and observational studies...
January 3, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29290048/screening-and-detection-of-delirium-in-older-ed-patients-performance-of-the-modified-confusion-assessment-method-for-the-emergency-department-mcam-ed-a-two-step-tool
#6
Wolfgang Hasemann, Florian F Grossmann, Rahel Stadler, Roland Bingisser, Dieter Breil, Martina Hafner, Reto W Kressig, Christian H Nickel
Delirium is frequent in older Emergency Department (ED) patients, but detection rates for delirium in the ED are low. To aid in identifying delirium, we developed and implemented a two-step systematic delirium screening and assessment tool in our ED: the modified Confusion Assessment Method for the Emergency Department (mCAM-ED). Components of the mCAM-ED include: (1) screening for inattention, the main feature of delirium, which was performed with the Months Backwards Test (MBT); (2) delirium assessment based on a structured interview with questions from the Mental Status Questionnaire by Kahn et al...
December 30, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29278266/regional-nerve-blockade-for-early-analgesic-management-of-elderly-patients-with-hip-fracture-a-narrative-review
#7
REVIEW
A Scurrah, C T Shiner, J A Stevens, S G Faux
Elderly patients with hip fracture experience high morbidity and mortality, and are often undertreated for pain. Acute pain management in the elderly is challenging, with physiological frailty, medical comorbidities and cognitive impairment commonly compounding pain assessment and treatment. Guidelines outlining current best practice for acute pain management in the elderly now exist, but evidence suggests that practice remains variable and there continues to be scope for improvement. We conducted a narrative review of the literature to examine the challenges of acute pain management in the elderly, and to evaluate evidence for the role of regional nerve blocks for acute pain associated with hip fracture in the elderly...
December 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29277298/a-pilot-analysis-of-the-association-between-types-of-monitored-anesthesia-care-drugs-and-outcomes-in-transfemoral-aortic-valve-replacement-performed-without-general-anesthesia
#8
Eric Y Chen, Nitin Sukumar, Feng Dai, Shamsuddin Akhtar, Robert B Schonberger
OBJECTIVE: The types of agents used for monitored anesthesia care (MAC) and their possible differential effects on outcomes have received less study despite increased use over general anesthesia (GA) in transfemoral aortic valve replacements (TAVRs). In this pilot analysis of patients undergoing TAVR using MAC, the authors described the anesthetic agents used and sought to investigate the possible association of anesthetic agent choice with outcomes and the extent to which total weight and time-adjusted doses of anesthetics declined with increasing 10-year age increments...
July 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29249205/attention-vigilance-and-visuospatial-function-in-hospitalized-elderly-medical-patients-relationship-to-delirium-syndromal-status-and-motor-subtype-profile
#9
Cara Daly, Maeve Leonard, Henry O'Connell, Olugbenga Williams, Fahad Awan, Chris Exton, Margaret O'Connor, Dimitrios Adamis, Colum P Dunne, Walter Cullen, David J Meagher
BACKGROUND: The early and effective detection of neurocognitive disorders poses a key diagnostic challenge. We examined performance on common cognitive bedside tests according to differing delirium syndromal status and clinical (motor) subtypes in hospitalized elderly medical inpatients. METHODS: A battery of nine bedside cognitive tests was performed on elderly medical inpatients with DSM-IV delirium, subsyndromal delirium (SSD), and no delirium (ND). Patients with delirium were compared according to clinical (motor) subtypes...
December 18, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/29230961/health-and-social-factors-associated-with-a-delayed-discharge-amongst-inpatients-in-acute-geriatric-wards-a-retrospective-observational-study
#10
George Moore, Peter Hartley, Roman Romero-Ortuno
AIM: In the English National Health Service there is an increasing interest in understanding the factors associated with delayed discharges in older hospitalized adults. The present study sought to analyze whether clinical frailty was a significant and independent risk factor for having a delayed discharge when the data were controlled for potential health and social confounders. METHODS: This was a retrospective observational study in an English National Health Service teaching hospital...
December 12, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29213524/delirium-in-the-elderly-a-systematic-review-of-pharmacological-and-non-pharmacological-treatments
#11
Cecília Carboni Tardelli Cerveira, Cláudia Cristina Pupo, Sigrid De Sousa Dos Santos, José Eduardo Mourão Santos
Delirium is a common disorder associated with poor prognosis, especially in the elderly. The impact of different treatment approaches for delirium on morbimortality and long-term welfare is not completely understood. OBJECTIVE: To determine the efficacy of pharmacological and non-pharmacological treatments in elderly patients with delirium. METHODS: This systematic review compared pharmacological and non-pharmacological treatments in patients over 60 years old with delirium...
July 2017: Dementia & Neuropsychologia
https://www.readbyqxmd.com/read/29213507/sundown-syndrome-and-symptoms-of-anxiety-and-depression-in-hospitalized-elderly
#12
Marcello Weynes Barros Silva, Rilva Lopes Sousa-Muñoz, Heitor Cabral Frade, Priscilla Alencar Fernandes, Andrêssa de Oliveira Magalhães
Sundown syndrome is characterized by the sudden appearance of neuropsychiatric symptoms such as agitation, confusion and anxiety in a chronologic fashion, usually during late afternoon or early evening. Objective: To evaluate the prevalence of sundown syndrome in university hospital wards and its relationship with anxiety/depression symptoms, cognitive decline, and clinical and demographic variables. Methods: We evaluated 70 patients admitted to the Lauro Wanderley University Hospital (HULW), João Pessoa-PB, Brazil...
April 2017: Dementia & Neuropsychologia
https://www.readbyqxmd.com/read/29203991/postoperative-delirium-in-indian-patients-following-major-abdominal-surgery-for-cancer-risk-factors-and-associations
#13
Vibhawari Dhakharia, Subir Sinha, Jaydip Bhaumik
Postoperative delirium (POD) is not uncommon following major abdominal surgery with its incidence ranging between five and 51%. As cancer affects disproportionately, the population older than 65 years and as delirium is more common in the elderly, surgical oncology patients are at a higher risk of developing POD. The present study was undertaken to explore the impact and associations of POD in Indian patients undergoing oncological major abdominal surgery. A retrospective review of the electronic medical records in a tertiary cancer care institution of all postoperative patients who had undergone major gastrointestinal gynaecological and urological abdominal surgery for cancer and required psycho-oncology referral was performed...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29192572/-recognising-postoperative-delirium-in-the-elderly
#14
T Numan, M van den Boogaard, A M Kampen, P J T Rood, L M Peelen, A J C Slooter
OBJECTIVE: To determine the degree of agreement between delirium experts on the diagnosis of delirium based on exactly the same information, and to assess the sensitivity of delirium screening methods used by clinical nurses. DESIGN: Prospective observational longitudinal study. METHOD: Older patients (≥ 60 years) who underwent major surgery were included. During the first three days after surgery they had a standardised cognitive screening test which was recorded on video...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29187413/impact-of-inhalational-versus-intravenous-anaesthesia-on-early-delirium-and-long-term-survival-in-elderly-patients-after-cancer-surgery-study-protocol-of-a-multicentre-open-label-and-randomised-controlled-trial
#15
Yue Zhang, Hui-Juan Li, Dong-Xin Wang, Hui-Qun Jia, Xu-De Sun, Ling-Hui Pan, Qing-Shan Ye, Wen Ouyang, Zhen Jia, Fang-Xiang Zhang, Yong-Qing Guo, Yan-Qiu Ai, Bin-Jiang Zhao, Xu-Dong Yang, Qin-Gong Zhang, Ning Yin, Hong-Yu Tan, Zhi-Heng Liu, Jian-Bo Yu, Daqing Ma
INTRODUCTION: Elderly patients who have solid organ cancer often receive surgery. Some of them may develop delirium after surgery and delirium development is associated with worse outcomes. Furthermore, despite all of the advances in medical care, the long-term survival in cancer patients is far from optimal. Evidences suggest that choice of anaesthetics during surgery, that is, either inhalational or intravenous anaesthetics, may influence outcomes. However, the impact of general anaesthesia type on the occurrence of postoperative delirium is inconclusive...
November 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29181397/preoperative-c-reactive-protein-as-a-risk-factor-for-postoperative-delirium-in-elderly-patients-undergoing-laparoscopic-surgery-for-colon-carcinoma
#16
Dong Xiang, Hailin Xing, Huiyu Tai, Guozhu Xie
Background: Postoperative delirium (POD) is a very common complication in operative disciplines, especially in those elderly patients after cardiac surgery. This study aimed to investigate the relationship between C-reactive protein (CRP) and POD in elderly patients undergoing laparoscopic surgery for colon carcinoma. Methods: 160 elderly patients scheduled to undergo selective laparoscopic surgery for colon carcinoma were prospectively recruited in this present study...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29179627/delirium-is-associated-with-increased-mortality-in-the-geriatric-population
#17
Pinar Tosun Tasar, Sevnaz Sahın, Nur Ozge Akcam, Cıgdem Dınckal, Merve Gulsah Ulusoy, Ozan Fatih Sarıkaya, Soner Duman, Fehmi Akcıcek, Aysin Noyan
OBJECTIVE: The aim of this study was to investigate the prevalence of delirium and its association with mortality rates in elderly inpatients. METHODS: The medical records of 1435 patients over 65 years old who were treated at a regional university hospital and were referred to the university's Consultation and Liaison Psychiatry Clinic for psychological evaluation were retrospectively analyzed. Patients with and without a diagnosis of delirium were compared. The National Survival Database was used to determine mortality rates...
November 27, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/29178096/-risk-factors-and-outcomes-of-postoperative-delirium-in-colorectal-cancer-patients-over-60-years
#18
Haitao Zhang, Yuanzhi Tang, Ying Qin
OBJECTIVE: To determine the incidence, risk factors and clinical outcomes of postoperative delirium in colorectal cancer patients over 60 years. METHODS: Consecutive 382 patients older than 60 years undergoing colorectal cancer surgery at Shenzhen Second People's Hospital from June 2013 to June 2016 were recruited prospectively in this study. These patients were evaluated daily after surgery for 7 days by confusion assessment method. Clinical outcomes were compared between patients with and without postoperative delirium, including postoperative complications, length of hospital stay, and mortality within 30 days...
November 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29174758/a-proactive-approach-to-high-risk-delirium-patients-undergoing-total-joint-arthroplasty
#19
Andres F Duque, Zachary D Post, Fabio R Orozco, Rex W Lutz, Alvin C Ong
BACKGROUND: Delirium is a common complication among elderly patients undergoing total joint arthroplasty (TJA). Its incidence has been reported from 4% to 53%. The Centers for Medicare and Medicaid Services consider delirium following TJA a "never-event." The purpose of this study is to evaluate a simple perioperative protocol used to identify delirium risk patients and prevent its incidence following TJA. METHODS: Our group developed a protocol to identify and prevent delirium in patients undergoing TJA...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29171993/prevalence-of-delirium-in-a-population-of%C3%A2-elderly-outpatients-with-dementia-a%C3%A2-retrospective-study
#20
Desirée Addesi, Raffaele Maio, Nicoletta Smirne, Valentina Laganà, Natalia Altomari, Gianfranco Puccio, Rosanna Colao, Chiara Cupidi, Francesco Perticone, Amalia Cecilia Bruni
BACKGROUND: Delirium is a multifactorial geriatric syndrome and often occurs in patients with cognitive impairment. It also remains under-recognized, specifically in elderly outpatients, because signs of delirium might overlap with symptoms of dementia. OBJECTIVE: The aim of the present study is to retrospectively apply the chart-based delirium instrument on a cohort of elderly outpatients with dementia, to assess prevalence and features of delirium in this population...
November 20, 2017: Journal of Alzheimer's Disease: JAD
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