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Delirium assessment

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https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#1
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
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/29340154/the-impact-of-sepsis-delirium-and-psychological-distress-on-self-rated-cognitive-function-in-icu-survivors-a-prospective-cohort-study
#3
Emily Brück, Anna Schandl, Matteo Bottai, Peter Sackey
Background: Many intensive care unit (ICU) survivors develop psychological problems and cognitive impairment. The relation between sepsis, delirium, and later cognitive problems is not fully elucidated, and the impact of psychological symptoms on cognitive function is poorly studied in ICU survivors. The primary aim of this study was to examine the relationship between sepsis, ICU delirium, and later self-rated cognitive function. A second aim was to investigate the association between psychological problems and self-rated cognitive function 3 months after the ICU stay...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29337447/-geriatric-medicine
#4
Gabriel Gold, Christophe Büla, Pierre Olivier Lang, Philippe Chassagne
2017 highlights benefits of prevention. Better control of cardiovascular risk reduces the incidence of dementia and monthly high-dose vitamin D the incidence of respiratory infections in nursing home. Pre-operative geriatric assessment lowers by 20% the rate of delirium after hip-fracture surgery and complications in vascular surgery. Deleterious effects are also reported. High-dose vitamin D triples the rate of falls in supplemented residents and doesn't improve gait speed in sedentary men. Widely used in cardiovascular prevention, antithrombotic therapy is associated with an astonishing risk of subdural bleeding that further increases with the number of drugs combined together...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29336972/general-anesthesia-for-transcatheter-aortic-valve-replacement-total-intravenous-anesthesia-is-associated-with-less-delirium-as-compared-to-volatile-agent-technique
#5
Allie E Goins, Alan Smeltz, Cassandra Ramm, Paula D Strassle, Emily G Teeter, John P Vavalle, Lavinia Kolarczyk
OBJECTIVE: Investigate the effect of volatile anesthesia versus total intravenous anesthesia on the incidence of postoperative delirium and length of stay in patients undergoing transcatheter aortic valve replacement under general anesthesia. DESIGN: Retrospective study. SETTING: Single institution, academic medical center. PARTICIPANTS: Adult patients who underwent transcatheter aortic valve replacement under general anesthesia between November 2014 and February 2017...
December 11, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29333531/patient-reported-outcome-measures-prom-as-a-preoperative-assessment-tool
#6
Sunghye Kim, Pamela W Duncan, Leanne Groban, Hannah Segal, Rica Moonyeen Abbott, Jeff D Williamson
Aim of review: Patient-reported outcomes (PRO) on functional, social, and behavioral factors might be important preoperative predictors of postoperative outcomes. We conducted a literature review to explore associations of preoperative depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, and nutritional status with surgical outcomes. Methods: Two electronic data bases, including PubMed and Google Scholar, were searched linking either depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, or nutritional status with surgery, postoperative complications, or perioperative period within the past 2 decades...
November 28, 2017: Journal of anesthesia and perioperative medicine
https://www.readbyqxmd.com/read/29317807/pain-assessment-in-impaired-cognition-paic-content-validity-of-the-dutch-version-of-a-new-and-universal-tool-to-measure-pain-in-dementia
#7
Annelore H van Dalen-Kok, Wilco P Achterberg, Wieke E Rijkmans, Sara A Tukker-van Vuuren, Suzanne Delwel, Henrica Cw de Vet, Frank Lobbezoo, Margot Wm de Waal
Objectives: Detection and measurement of pain in persons with dementia by using observational pain measurement tools is essential. However, the evidence for the psychometric properties of existing observational tools remains limited. Therefore, a new meta-tool has been developed: Pain Assessment in Impaired Cognition (PAIC), as a collaborative EU action. The aim is to describe the translation procedure and content validity of the Dutch version of the PAIC. Methods: Translation of the PAIC into Dutch followed the forward-backward approach of the Guidelines for Establishing Cultural Equivalence of Instruments...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29315375/improving-patient-safety-for-older-people-in-acute-admissions-implementation-of-the-frailsafe-checklist-in-12-hospitals-across-the-uk
#8
Chrysanthi Papoutsi, Alan Poots, Jake Clements, Zoe Wyrko, Natalie Offord, Julie E Reed
Background: checklists are increasingly proposed as a means to enhance safety and quality of care. However, their use has been met with variable levels of success. The Frailsafe project focused on introducing a checklist with the aim to increase completion of key clinical assessments and to facilitate communication for the care of older patients in acute admissions. Objectives: to examine the use of the Frailsafe checklist, including potential to contribute to improved safety, quality and reliability of care...
January 5, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29314374/falls-and-delirium-in-an-acute-care-setting-a-retrospective-chart-review-before-and-after-an-organization-wide-interprofessional-education
#9
Rhonda L Babine, Kristiina E Hyrkäs, Sarah Hallen, Heidi R Wierman, Deborah A Bachand, Joanne L Chapman, Valerie J Fuller
AIM AND OBJECTIVES: To describe and compare identification of delirium, length of stay, and discharge locations in two patient samples of falls, before and after an organization wide interprofessional delirium education and practice change along with implementation of a policy. BACKGROUND: Delirium is a common and severe problem for hospitalized patients, with occurrence ranging from 14-56%, morbidity and mortality from 25-33%. Recent studies report that 73-96% of patients who fell during a hospital stay had symptoms of delirium; however the delirium went undiagnosed and untreated in 75% of the cases...
January 4, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29306752/turning-education-into-action-impact-of-a-collective-social-education-approach-to-improve-nurses-ability-to-recognize-and-accurately-assess-delirium-in-hospitalized-older-patients
#10
Catherine Travers, Amanda Henderson, Fred Graham, Elizabeth Beattie
BACKGROUND: Although cognitive impairment including dementia and delirium is common in older hospital patients, it is not well recognized or managed by hospital staff, potentially resulting in adverse events. This paper describes, and reports on the impact of a collective social education approach to improving both nurses' knowledge of, and screening for delirium. METHODS: Thirty-four experienced nurses from six hospital wards, became Cognition Champions (CogChamps) to lead their wards in a collective social education process about cognitive impairment and the assessment of delirium...
December 29, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/29304923/potentially-modifiable-risk-factors-for-long-term-cognitive-impairment-after-critical-illness-a-systematic-review
#11
REVIEW
Amra Sakusic, John C O'Horo, Mikhail Dziadzko, Dziadzko Volha, Rashid Ali, Tarun D Singh, Rahul Kashyap, Ann M Farrell, John D Fryer, Ronald Petersen, Ognjen Gajic, Alejandro A Rabinstein
Long-term cognitive impairment is common in survivors of critical illness. Little is known about the etiology of this serious complication. We sought to summarize current scientific knowledge about potentially modifiable risk factors during intensive care unit (ICU) treatment that may play a substantial role in the development of long-term cognitive impairment. All searches were run on October 1, 2017. The search strategy included Ovid MEDLINE, Ovid Embase, Ovid CDR, Cochrane Central Register of Controlled Trials and Database of Abstracts of Reviews of Effect, Scopus, and Web of Science, and included MeSH headings and keywords related to intensive care, critical care, and cognitive disorders...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29299599/association-of-integrated-care-coordination-with-postsurgical-outcomes-in-high-risk-older-adults-the-perioperative-optimization-of-senior-health-posh-initiative
#12
Shelley R McDonald, Mitchell T Heflin, Heather E Whitson, Thomas O Dalton, Michael E Lidsky, Phillip Liu, Cornelia M Poer, Richard Sloane, Julie K Thacker, Heidi K White, Mamata Yanamadala, Sandhya A Lagoo-Deenadayalan
Importance: Older adults undergoing elective surgery experience higher rates of preventable postoperative complications than younger patients. Objective: To assess clinical outcomes for older adults undergoing elective abdominal surgery via a collaborative intervention by surgery, geriatrics, and anesthesia focused on perioperative health optimization. Design, Setting, and Participants: Perioperative Optimization of Senior Health (POSH) is a quality improvement initiative with prospective data collection...
January 3, 2018: JAMA Surgery
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
#13
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/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
#14
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/29287124/impact-of-delirium-on-postoperative-frailty-and-long-term-cardiovascular-events-after-cardiac-surgery
#15
Masato Ogawa, Kazuhiro P Izawa, Seimi Satomi-Kobayashi, Yasunori Tsuboi, Kodai Komaki, Yasuko Gotake, Yoshitada Sakai, Hiroshi Tanaka, Yutaka Okita
BACKGROUND: Postoperative delirium (POD) is a common and critical complication after cardiac surgery. However, the relationship between POD and postoperative physical frailty and the effect of both on long-term clinical outcomes have not been fully explored. OBJECTIVE: We aimed to examine the associations among POD, postoperative frailty, and major adverse cardiac events (MACE). DESIGN: This was a prospective cohort study. METHODS: We studied 329 consecutive patients undergoing elective cardiac surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29284416/preoperative-medication-use-and-postoperative-delirium-a-systematic-review
#16
Gizat M Kassie, Tuan A Nguyen, Lisa M Kalisch Ellett, Nicole L Pratt, Elizabeth E Roughead
BACKGROUND: Medications are frequently reported as both predisposing factors and inducers of delirium. This review evaluated the available evidence and determined the magnitude of risk of postoperative delirium associated with preoperative medication use. METHODS: A systematic search in Medline and EMBASE was conducted using MeSH terms and keywords for postoperative delirium and medication. Studies which included patients 18 years and older who underwent major surgery were included...
December 29, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29282410/cerebrospinal-fluid-s100b-and-alzheimer-s-disease-biomarkers-in-hip-fracture-patients-with-delirium
#17
Karen Roksund Hov, Nils Bolstad, Ane-Victoria Idland, Henrik Zetterberg, Kaj Blennow, Farrukh A Chaudhry, Frede Frihagen, Johan Ræder, Torgeir Bruun Wyller, Leiv Otto Watne
Objectives: This study aimed to investigate the relationship between cerebrospinal fluid (CSF) S100B astrocyte-derived protein and delirium and to perform stratified analyses according to clinical and CSF markers of dementia. Methods: We performed a prospective cohort study in a university hospital setting. The participants were patients admitted for hip fracture (n = 98) or for elective surgery (n = 50). Delirium was assessed daily perioperatively in hip fracture patients using the Confusion Assessment Method...
September 2017: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/29278890/prevalence-of-potentially-inappropriate-medication-use-in-older-inpatients-with%C3%A2-and%C3%A2-without-cognitive-impairment-a%C3%A2-systematic-review
#18
Mitchell R Redston, Sarah N Hilmer, Andrew J McLachlan, Alexander J Clough, Danijela Gnjidic
BACKGROUND: Older people with cognitive impairment, including dementia and delirium, are high users of acute care services internationally. Potentially inappropriate medication (PIM) use may be associated with adverse outcomes, including hospital re-admission, functional disability, and mortality. OBJECTIVE: This systematic review aimed to quantify and compare the prevalence of PIMs in older inpatients with and without cognitive impairment. METHODS: A systematic search of observational studies was performed independently assessed by two reviewers in Embase, Medline, PsycINFO, International Pharmaceutical Abstracts, Scopus, and Informit...
December 16, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29278266/regional-nerve-blockade-for-early-analgesic-management-of-elderly-patients-with-hip-fracture-a-narrative-review
#19
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/29276990/bright-light-and-oxygen-therapies-decrease-delirium-risk-in-critically-ill-surgical-patients-by-targeting-sleep-and-acid-base-disturbances
#20
Sirimas Potharajaroen, Sookjaroen Tangwongchai, Thavatchai Tayjasanant, Thammasak Thawitsri, George Anderson, Michael Maes
This study examined the effects of bright light therapy (BLT) on the incidence of delirium in post-operative patients admitted to a surgical intensive care unit (SICU) and delineates risk and protective factors. We included 62 patients in a single-blind, randomized controlled study. The intervention group was treated with care as usual plus BLT for three consecutive days. Delirium was diagnosed by DSM-5 criteria with the Confusion Assessment Method-Intensive Care Unit (CAM-ICU). Risk factors for delirium were measured, including the APACHE II score, Insomnia Severity Index (ISI), as well as hematocrit and bicarbonate levels...
December 18, 2017: Psychiatry Research
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