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Hypoactive delirium

Jukka Puustinen, Liisa Luostarinen, Markku Luostarinen, Veijo Pulliainen, Heini Huhtala, Marjo Soini, Jaana Suhonen
OBJECTIVE: To examine the prevalence and effect of cognitive impairment on treatment outcomes in elderly patients undergoing arthroplasty and to describe the feasibility of cognitive tests. MATERIALS AND METHODS: The participants were 52 patients with a mean age of 78 years 11 months (SD: 3.3), waiting for primary arthroplasty. We translated Montreal Cognitive Assessment (MoCA) into Finnish and compared it with Mini-Mental State Examination (MMSE), Mini-Cog, and clock-drawing tests prior to and 3 months after the surgery...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Hasan Hüseyin Kozak, Faruk Uğuz, İbrahim Kılınç, Ali Ulvi Uca, Osman Serhat Tokgöz, Zehra Akpınar, Nejla Özer
BACKGROUND: Stroke patients with development of delirium have unfavorable outcomes, higher mortality, longer hospitalizations, and a greater degree of dependence after discharge. Studies suggest that delirium is associated with abnormal immunological responses and a resultant increase in inflammatory markers. OBJECTIVE: Our aim was to determine whether there is an entity relationship between delirium, inflammation and acute ischemic stroke (AIS). METHODS: Sixty AIS patients admitted to the hospital were consecutively recruited...
October 24, 2016: Neurologia i Neurochirurgia Polska
Rostislav Horacek, Barbora Krnacova, Jan Prasko, Klara Latalova
BACKGROUND: The aim of this study was to examine the impact of somatic illnesses, electrolyte imbalance, red blood cell count, hypotension, and antipsychotic and opioid treatment on the duration of delirium in Central Intensive Care Unit for Surgery. PATIENTS AND METHODS: Patients who were admitted to the Department of Central Intensive Care Unit for Surgery in the University Hospital Olomouc from February 2004 to November 2008 were evaluated using Riker sedation-agitation scale...
2016: Neuropsychiatric Disease and Treatment
Charles H Brown, Andrew LaFlam, Laura Max, Julie Wyrobek, Karin J Neufeld, Khaled M Kebaish, David B Cohen, Jeremy D Walston, Charles W Hogue, Lee H Riley
OBJECTIVES: To characterize the incidence, risk factors, and consequences of delirium in older adults undergoing spine surgery. DESIGN: Prospective observational study. SETTING: Academic medical center. PARTICIPANTS: Individuals aged 70 and older undergoing spine surgery (N = 89). MEASUREMENTS: Postoperative delirium and delirium severity were assessed using validated methods, including the Confusion Assessment Method (CAM), CAM for the Intensive Care Unit, Delirium Rating Scale-Revised-98, and chart review...
October 2016: Journal of the American Geriatrics Society
T Saller, V V Dossow, K Hofmann-Kiefer
BACKGROUND: Delirium is a common complication in critical care. The syndrome is often underestimated due to its potentially no less dangerous course as a hypoactive delirium. Therefore, current guidelines ask for a structured, regular and routine screening in all intensive care units. If delirium is diagnosed, symptomatic therapy should be initiated promptly. OBJECTIVES: The aim of the current study was to evaluate recent German anesthetists' strategies regarding delirium care compared to the German guidelines for sedation and delirium in intensive care...
October 2016: Der Anaesthesist
Giuseppe Bellelli, Alessandro Morandi, Simona G Di Santo, Andrea Mazzone, Antonio Cherubini, Enrico Mossello, Mario Bo, Angelo Bianchetti, Renzo Rozzini, Ermellina Zanetti, Massimo Musicco, Alberto Ferrari, Nicola Ferrara, Marco Trabucchi
BACKGROUND: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy...
July 18, 2016: BMC Medicine
Sanjay Lahariya, Sandeep Grover, Shiv Bagga, Akhilesh Sharma
AIM: To study the phenomenology and motor sub-types of delirium in patients admitted in a Coronary Care Unit (CCU). METHODS: Three hundred and nine consecutive patients were screened for delirium, and those found positive for the same were evaluated by a psychiatrist on DSM-IVTR criteria to confirm the diagnosis. Those with a diagnosis of delirium were evaluated on the DRS-R-98 to study the phenomenology and on the amended Delirium Motor Symptom Scale (DMSS) to study the motor sub-types...
November 2016: Nordic Journal of Psychiatry
HyeYoun Park, Ki Woong Kim, In-Young Yoon
OBJECTIVES: The acute cessation of smoking often induces symptoms that are similar to those associated with delirium. We aimed to evaluate effects of sudden nicotine abstinence on the development of delirium and its motoric subtypes in hospitalized patients. METHODS: The present study included patients who were referred to psychiatrists by ward physicians due to confusion. The presence of delirium was defined using the Confusion Assessment Method and the Delirium Rating Scale Revised-98, which was also used to assess the severity of delirium...
October 2016: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Helene Korvenius Nedergaard, Hanne Irene Jensen, Mette Stylsvig, Jørgen T Lauridsen, Palle Toft
BACKGROUND: The effects of non-sedation on cognitive function in critically ill patients on mechanical ventilation are not yet certain. This trial is a substudy of the NONSEDA trial where critically ill patients are randomized to non-sedation or to sedation with a daily wake-up attempt during mechanical ventilation in the intensive care unit (ICU). The aim of this substudy is to assess the effects of non-sedation versus sedation with a daily wake-up attempt on long-term cognitive function...
2016: Trials
Martin G Cole, Jane Mccusker
Delirium is defined as a neurocognitive disorder characterized by sudden onset, fluctuating course, and disturbances in level of consciousness, attention, orientation, memory, thought, perception, and behavior (American Psychiatric Association, 2013). It occurs in hyperactive, hypoactive, or mixed forms in up to 50% of older hospital patients (Inouye et al., 2014) and 70% of older long-term care residents (McCusker et al., 2011), many with pre-existing dementia (Fick et al., 2002).
August 2016: International Psychogeriatrics
Lan N Bui, Vy P Pham, Beverly A Shirkey, Joshua T Swan
This study compares the proportions of surgical intensive care unit (ICU) patients with delirium detected using the Confusion Assessment Method for the ICU (CAM-ICU) who received administrative documentation for delirium using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, stratified by delirium motoric subtypes. This retrospective cohort study was conducted at a surgical ICU from 06/2012 to 05/2013. Delirium was assessed twice daily and was defined as having ≥1 positive CAM-ICU rating...
April 23, 2016: Journal of Clinical Monitoring and Computing
Weiying Zhang, Wenlin Hu, Meifang Shen, Xiaofei Ye, Yan Huang, Yan Sun
AIMS AND OBJECTIVES: To explore the profiles of delirium in coronary artery bypass grafting patients and identify related patient outcomes. BACKGROUND: Delirium was assessed previously as a binary result, i.e. present or absent, but little attention was paid to the profiles of delirium, e.g. the subtype, severity, duration and the first episode, and little was known about clinical outcomes. DESIGN: A prospective study. METHODS: Ninety-five delirious patients who underwent coronary artery bypass grafting were included...
March 2016: Journal of Clinical Nursing
Yasuyuki Okumura, Kotaro Hatta, Ken Wada, Takashi Takeuchi, Yasuhiro Kishi
BACKGROUND: There is little expert consensus as to which drugs should comprise the first-line pharmacological treatment for delirium. We sought to assess experts' opinions on the first-line oral and injection drugs for delirium associated with a diverse range of clinical features using a rating-based conjoint analysis. METHODS: We conducted a cross-sectional study. We mailed a questionnaire to all consultation-liaison psychiatrists/educators certified by the Japanese Society of General Hospital Psychiatry...
June 2016: International Psychogeriatrics
Elke Detroyer, Fabienne Dobbels, Deborah Debonnaire, Kate Irving, Andrew Teodorczuk, Donna M Fick, Etienne Joosten, Koen Milisen
BACKGROUND: Studies investigating the effectiveness of delirium e-learning tools in clinical practice are scarce. The aim of this study is to determine the effect of a delirium e-learning tool on healthcare workers' delirium recognition, delirium knowledge and care strain in delirium. METHODS: A pilot pre-posttest study in a convenience sample of 59 healthcare workers recruited from medical, surgical, geronto-psychiatric and rehabilitation units of a university hospital...
January 15, 2016: BMC Medical Education
Gülcin Şenel, Neşe Uysal, Gonca Oguz, Mensure Kaya, Nihal Kadioullari, Nesteren Koçak, Serife Karaca
INTRODUCTION: Delirium is a complex but common disorder in palliative care with a prevalence between 13% and 88% but a particular frequency at the end of life yet often remains insufficiently diagnosed and managed. The aim of our study is to determine the frequency of delirium and identify factors associated with delirium at palliative care unit. METHODS: Two hundred thirteen consecutive inpatients from October 1, 2012, to March 31, 2013, were studied prospectively...
December 31, 2015: American Journal of Hospice & Palliative Care
Nicholas Farina, Pamela Smithburger, Sandra Kane-Gill
Delirium is highly prevalent in the critically ill population and has been associated with numerous negative outcomes including increased mortality. The presentation of a delirious patient in the intensive care unit (ICU) is characterized by a fluctuating cognitive status and inattention that varies dramatically among patients. Delirium can present in 3 different motoric subtypes: hyperactive, hypoactive, and mixed. Two tools, the Intensive Care Delirium Screening Checklist and Confusion Assessment ICU, are validated and recommended for the detection of delirium in critically ill patients...
September 2015: Hospital Pharmacy
James Fitzgerald, Niamh O'Regan, Dimitrios Adamis, Suzanne Timmons, Colum Dunne, Paula Trzepacz, David Meagher
BACKGROUND: Delirium is a common neuropsychiatric syndrome that includes clinical subtypes identified by the Delirium Motor Subtyping Scale (DMSS). We explored the concordance between the DMSS and an abbreviated 4-item version in elderly medical inpatients. METHODS: Elderly general medical admissions (n = 145) were assessed for delirium using the Revised Delirium Rating scale (DRS-R98). Clinical subtype was assessed with the DMSS (which includes the four items included in the DMSS-4)...
May 2016: International Psychogeriatrics
Paul S García, Elizabeth W Duggan, Ian L McCullough, Simon C Lee, David Fishman
PURPOSE: As the general population lives longer, the perioperative physician is more likely to encounter disease states that increase in incidence in an aging population. This review focuses on anesthetic considerations for rational drug choices during the perioperative care of elderly patients. The primary aim of the review was to identify intraoperative and postanesthetic considerations for diseases associated with advancing age; it includes highlights of the commonly impaired major organs (eg, cardiovascular, pulmonary, neurologic, renal, hepatic systems)...
December 1, 2015: Clinical Therapeutics
Wei-Li Lin, Yi-Fan Chen, Jeng Wang
BACKGROUND: High prevalence rates of delirium have been found in intensive care units (ICUs), ranging from 20% to 80%. The development of delirium may prolong length of stay, impair cognition, and result in placement in a nursing home for the patient. PURPOSE: There is a lack of research focused on the aging population, so the purpose of this study was to establish the incidence rate of delirium among ICU elderly patients and to identify its risk factors. METHODS: An observational design with repeated measures was used...
December 2015: Journal of Nursing Research: JNR
Matthew K Whalin, Matthias Kreuzer, Kevin M Halenda, Paul S García
PURPOSE: Postoperative delirium is a common and costly state of brain dysfunction that complicates postsurgical management in some patients. The purpose of this report was to describe a case of prolonged postoperative delirium and to review the appropriate identification and management of this condition. METHODS: A 56-year-old female patient who presented with newly diagnosed diabetes mellitus and dry gangrene underwent a vascular bypass procedure while under general anesthesia...
December 1, 2015: Clinical Therapeutics
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