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Delirium screening

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https://www.readbyqxmd.com/read/28903083/delirium-characteristics-and-outcomes-in-medical-and-surgical-lnpatients-a-subgroup-analysis
#1
Sungmin Kim, Jae-Jin Kim, Jooyoung Oh, Jaesub Park, Jin Young Park
PURPOSE: Persistent delirium can negatively affect patients, increase healthcare costs, and extend the length of hospital stays. This investigation was undertaken to explore associations between patient characteristics and delirium outcomes. MATERIALS AND METHODS: Intensive care unit (ICU) and medical and surgical ward inpatients for whom psychiatric consultation was requested for delirium were included in this study. Delirium screening and ongoing assessments were conducted using the Confusion Assessment Method for ICU patients...
August 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28891828/poor-performance-on-a-preoperative-cognitive-screening-test-predicts-postoperative-complications-in-older-orthopedic-surgical-patients
#2
Deborah J Culley, Devon Flaherty, Margaret C Fahey, James L Rudolph, Houman Javedan, Chuan-Chin Huang, John Wright, Angela M Bader, Bradley T Hyman, Deborah Blacker, Gregory Crosby
BACKGROUND: The American College of Surgeons and the American Geriatrics Society have suggested that preoperative cognitive screening should be performed in older surgical patients. We hypothesized that unrecognized cognitive impairment in patients without a history of dementia is a risk factor for development of postoperative complications. METHODS: We enrolled 211 patients 65 yr of age or older without a diagnosis of dementia who were scheduled for an elective hip or knee replacement...
September 8, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28876970/responding-to-ten-common-delirium-misconceptions-with-best-evidence-an-educational-review-for-clinicians
#3
Mark A Oldham, Nina M Flanagan, Ariba Khan, Olga Boukrina, Edward R Marcantonio
Delirium (acute confusion) is a serious, common health condition, and it predicts poor outcomes, including greater rates of mortality, institutionalization, prolonged hospitalization, and cognitive impairment. Expedient diagnosis and management are critical to address modifiable delirium causes and improve both quality of care and outcomes. Moreover, more than a third of delirium is preventable. Despite the clear significance of delirium and our increasingly sophisticated understanding of the condition, the gap between evidence and practice persists...
September 6, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28869228/symptom-profile-as-assessed-on-delirium-rating-scale-revised-98-of-delirium-in-respiratory-intensive-care-unit-a-study-from-india
#4
Akhilesh Sharma, Savita Malhotra, Sandeep Grover, S K Jindal
AIM: This study aimed to evaluate the phenomenology of delirium in patients admitted in a Respiratory Intensive Care Unit (RICU). METHODS: Consecutive patients admitted to RICU were screened for delirium using Richmond Agitation-Sedation Scale (RASS), Confusion Assessment Method for ICU (CAM-ICU) assessment tool and those found positive for delirium were evaluated by a psychiatrist to confirm the diagnosis. Those with a diagnosis of delirium as per the psychiatrist were evaluated on Delirium Rating Scale-Revised-98 (DRS-R-98) to study phenomenology...
September 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28865447/multicenter-assessment-of-sedation-and-delirium-practices-in-the-intensive-care-units-in-poland-is-this-common-practice-in-eastern-europe
#5
Katarzyna Kotfis, Małgorzata Zegan-Barańska, Maciej Żukowski, Krzysztof Kusza, Mariusz Kaczmarczyk, E Wesley Ely
BACKGROUND: The majority of critically ill patients experience distress during their stay in the Intensive Care Unit (ICU), resulting from systemic illness, multiple interventions and environmental factors. Providing humane care should address concomitant treatment of pain, agitation and delirium. The use of sedation and approaches to ICU delirium should be monitored according to structured guidelines. However, it is unknown to what extent these concepts are followed in Eastern European countries like Poland...
September 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28864877/clinical-assessment-and-management-of-delirium-in-the-palliative-care-setting
#6
Shirley Harvey Bush, Sallyanne Tierney, Peter Gerard Lawlor
Delirium is a neurocognitive syndrome arising from acute global brain dysfunction, and is prevalent in up to 42% of patients admitted to palliative care inpatient units. The symptoms of delirium and its associated communicative impediment invariably generate high levels of patient and family distress. Furthermore, delirium is associated with significant patient morbidity and increased mortality in many patient populations, especially palliative care where refractory delirium is common in the dying phase. As the clinical diagnosis of delirium is frequently missed by the healthcare team, the case for regular screening is arguably very compelling...
September 1, 2017: Drugs
https://www.readbyqxmd.com/read/28862050/synthetic-cannabinoid-black-mamba-infidelity-in-patients-presenting-for-emergency-stabilization-in-colorado-a-p-scan-cohort
#7
Nicklaus Brandehoff, Axel Adams, Kyle McDaniel, Samuel D Banister, Roy Gerona, Andrew A Monte
BACKGROUND: Use of new psychoactive substances (NPS) has increased over the last decade. During this period, variability of both clinical presentations and chemical compositions of these compounds has increased. Synthetic cannabinoids (SCs) are the most commonly used NPS and there are more than 100 documented unique molecules in this class. "Black Mamba", often associated to ADB-FUBINACA, is the most commonly used SC in Colorado. It has been linked to kidney injury, myocardial toxicity, seizures, and death...
September 1, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28861418/incidence-of-postoperative-delirium-in-patients-undergoing-total-knee-arthroplasty-an-asian-perspective
#8
Juncheng Huang, Hamid Rahmatullah Bin Abd Razak, Seng Jin Yeo
BACKGROUND: Very little is known in the literature with regards to the incidence of postoperative delirium following total knee arthroplasty (TKA) in Asians and the associated surgical factors. We conducted a retrospective study on incidence of postoperative delirium following TKA in Asians. METHODS: One thousand sixteen knees of 954 consecutive patients who underwent TKA by the senior author of this study in the year 2006 were included in this review. All written and electronic medical records for patients were screened...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28843537/sophia-observation-withdrawal-symptoms-paediatric-delirium-scale-a-tool-for-early-screening-of-delirium-in-the-picu
#9
Erwin Ista, Harma Te Beest, Joost van Rosmalen, Matthijs de Hoog, Dick Tibboel, Babette van Beusekom, Monique van Dijk
BACKGROUND: Delirium in critically ill children is a severe neuropsychiatric disorder which has gained increased attention from clinicians. Early identification of delirium is essential for successful management. The Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) scale was developed to detect Paediatric Delirium (PD) at an early stage. OBJECTIVE: The aim of this study was to determine the measurement properties of the PD component of the SOS-PD scale in critically ill children...
August 23, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28841632/delirium-and-catatonia-in-critically-ill-patients-the-delirium-and-catatonia-prospective-cohort-investigation
#10
Jo E Wilson, Richard Carlson, Maria C Duggan, Pratik Pandharipande, Timothy D Girard, Li Wang, Jennifer L Thompson, Rameela Chandrasekhar, Andrew Francis, Stephen E Nicolson, Robert S Dittus, Stephan Heckers, E Wesley Ely
OBJECTIVES: Catatonia, a condition characterized by motor, behavioral, and emotional changes, can occur during critical illness and appear as clinically similar to delirium, yet its management differs from delirium. Traditional criteria for medical catatonia preclude its diagnosis in delirium. Our objective in this investigation was to understand the overlap and relationship between delirium and catatonia in ICU patients and determine diagnostic thresholds for catatonia. DESIGN: Convenience cohort, nested within two ongoing randomized trials...
August 24, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28828407/delirium-risk-of-dexmedetomidine-and-midazolam-in-patients-treated-with-postoperative-mechanical-ventilation-a-meta-analysis
#11
Wang Peng, Shan Shimin, Wang Hongli, Zhang Yanli, Zhang Ying
OBJECTIVE: To evaluate by meta-analysis the effects of dexmedetomidine versus midazolam on postoperative delirium in patients that received postoperative mechanical ventilation. METHODS: The electronic databases of PubMed, Web of Science, EMbase, CNKI, CBM, Cochrane library and WanFang were searched by two reviewers. All the clinical studies related to dexmedetomidine versus midazolam on postoperative delirium were screened and collected in this meta-analysis. The combined postoperative delirium risk between dexmedetomidine and midazolam groups was pooled by random effect model...
2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28828209/prevalence-for-delirium-in-stroke-patients-a-prospective-controlled-study
#12
Peter Nydahl, Gabriele Bartoszek, Andreas Binder, Laura Paschen, Nils G Margraf, Karsten Witt, Andre Ewers
BACKGROUND AND PURPOSE: This study investigates the prevalence of delirium in acute stroke patients on a primary stroke unit (SU) analyzing associated risk factors and clinical outcomes. METHOD: Prospective, 4-month observational study from 2015 to 2016 on patients aged ≥18 years with stroke at a German university hospital's SU. The presence of delirium as first outcome was rated at three times daily using the Confusion Assessment Method (CAM). Secondary outcome measures were duration of delirium, rehabilitation in SU, length of stay in SU and hospital, complications, and mortality...
August 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28817825/muscle-strength-and-muscle-mass-in-older-patients-during-hospitalization-the-empower-study
#13
Jeanine M Van Ancum, Kira Scheerman, Vincent D Pierik, Siger T Numans, Sjors Verlaan, Hanne E Smeenk, Monique Slee-Valentijn, Roeliene C Kruizinga, Carel G M Meskers, Andrea B Maier
BACKGROUND: Low muscle strength and muscle mass are associated with an increased length of hospital stay and higher mortality rate in inpatients. To what extent hospitalization affects muscle strength and muscle mass is unclear. OBJECTIVE: We aimed to assess muscle strength and muscle mass at admission and during hospitalization in older patients and its relation with being at risk of geriatric conditions. METHODS: The EMPOWER study included patients aged 70 years and older, admitted to 4 wards of the VU University Medical Center in the Netherlands between April and December 2015...
August 18, 2017: Gerontology
https://www.readbyqxmd.com/read/28806561/delirium-and-exposure-to-psychoactive-medications-in-critically-ill-adults-a-multi-centre-observational-study
#14
Lisa D Burry, David R Williamson, Sangeeta Mehta, Marc M Perreault, Ioanna Mantas, Ranjeeta Mallick, Dean A Fergusson, Orla Smith, Eddy Fan, Sebastien Dupuis, Margaret Herridge, Louise Rose
PURPOSE: Investigate the relationship between psychoactive drugs and delirium. MATERIALS AND METHODS: Prospective observational study of 520 critically ill adult patients admitted ≥24h to 6 intensive care units (ICUs). Data were collected on psychoactive drug exposure, use of sedation administration strategies, and incident delirium (Intensive Care Delirium Screening Checklist score≥4). RESULTS: Delirium was detected in 260 (50%) patients, median (IQR) duration 2 (1-5) days, and time to onset 3 (2-5) days...
August 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28806234/delirium-in-the-critically-ill-child
#15
REVIEW
Sharon Norman, Asma A Taha, Helen N Turner
PURPOSE/OBJECTIVE: The purposes of this article are to describe the scientific literature on assessment, prevention, and management of delirium in critically ill children and to articulate the implications for clinical nurse specialists, in translating the evidence into practice. DESCRIPTION: A literature search was conducted in 4 databases-OvidMEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, and Web of Science-using the terms "delirium," "child," and "critically ill" for the period of 2006 to 2016...
September 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/28801871/pediatric-delirium-evaluation-management-and-special-considerations
#16
REVIEW
Nasuh Malas, Khyati Brahmbhatt, Cristin McDermott, Allanceson Smith, Roberto Ortiz-Aguayo, Susan Turkel
Delirium describes a syndrome of acute brain dysfunction with severe consequences on patient outcomes, medical cost, morbidity, and mortality. It represents a final common pathway of numerous pathophysiologic disturbances disrupting cerebral homeostasis. The diagnosis is predicated on recognition of the clinical features of the syndrome through ongoing clinical assessment. Early identification can be aided by routine screening, particularly in high-risk populations. Evaluation and management are continuous and simultaneous processes involving a multidisciplinary care team including child psychiatry consultation...
August 12, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28750835/validation-of-a-nurse-based-delirium-screening-tool-for-hospitalized-patients
#17
Anita Hargrave, Jesse Bastiaens, James A Bourgeois, John Neuhaus, S Andrew Josephson, Julia Chinn, Melissa Lee, Jacqueline Leung, Vanja Douglas
BACKGROUND: Guidelines recommend daily delirium monitoring of hospitalized patients. Available delirium-screening tools have not been validated for use by nurses among diverse inpatients. OBJECTIVE: We sought to validate the Nursing Delirium-Screening Scale (Nu-DESC) under these circumstances. METHODS: A blinded cross-sectional and quality-improvement study was conducted from August 2015-February 2016. Nurses׳ Nu-DESC scores were compared to delirium diagnosis according to Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) criteria...
July 24, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28743102/incidence-of-delirium-after-cardiac-surgery-protocol-for-the-delirium-cs-canada-cross-sectional-cohort-study
#18
(no author information available yet)
BACKGROUND: Delirium is a recognized complication of cardiac surgery and is the focus of increasing attention owing to its negative effect on postoperative outcomes. However, little is known about the actual incidence of delirium following cardiac surgery, with published rates ranging widely, from 3%-78%. We describe the protocol for the DELIRIUM-CS Canada study, which will use validated and easily implementable bedside tools to determine the incidence of postoperative delirium in a contemporary cardiac surgery population...
July 13, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28738033/how-can-i-implement-accurate-delirium-screening-and-prevention-practices
#19
Kimberly Sanchez
As a clinical nurse specialist (CNS), I am tasked with improving patient outcomes through collaborative research, evidence-based practice, and process improvement efforts that affect the quality and safety of patient care. However, I have learned over time that it is not enough to simply incorporate the latest evidence into organizational policies and procedures; it has to be followed in practice. 
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August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28733841/analgosedation-of-adult-patients-with-elevated-intracranial-pressure-survey-of-current-clinical-practice-in-austria
#20
Guenther Herzer, Claudia Mirth, Udo M Illievich, Wolfgang G Voelckel, Helmut Trimmel
BACKGROUND: Analgesia and sedation are key items in intensive care. Recently published S3 guidelines specifically address treatment of patients with elevated intracranial pressure. METHODS: The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine carried out an online survey of neurointensive care units in Austria in order to evaluate the current state of practice in the areas of analgosedation and delirium management in this high-risk patient group...
July 21, 2017: Wiener Klinische Wochenschrift
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