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Delirium screening

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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
#1
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/29298664/the-prevention-of-delirium-in-elderly-with-obstructive-sleep-apnea-podesa-study-protocol-for-a-multi-centre-prospective-randomized-controlled-trial
#2
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
#3
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/29287809/a-novel-scoring-system-to-predict-delirium-and-its-relationship-with-the-clinical-course-in-patients-with-acute-decompensated-heart-failure
#4
Taiki Sakaguchi, Mayumi Watanabe, Chika Kawasaki, Itomi Kuroda, Haruhiko Abe, Motoo Date, Yasunori Ueda, Yoshio Yasumura, Yukihiro Koretsune
BACKGROUND: Delirium is known to be a poor prognostic factor in patients with acute decompensated heart failure (ADHF). The purpose of this study was to determine predictors of delirium on admission of ADHF patients, and to establish a scoring formula to identify patients at high risk for delirium. METHODS AND RESULTS: We recorded the Intensive Care Delirium Screening Checklist (ICDSC) score in 120 ADHF patients during their stay in the coronary care unit (CCU)...
December 26, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29287124/impact-of-delirium-on-postoperative-frailty-and-long-term-cardiovascular-events-after-cardiac-surgery
#5
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/29278890/prevalence-of-potentially-inappropriate-medication-use-in-older-inpatients-with%C3%A2-and%C3%A2-without-cognitive-impairment-a%C3%A2-systematic-review
#6
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/29259935/dexmedetomidine-based-sedation-for-post-surgery-critically-ill-adults-a-meta-analysis-of-randomized-controlled-trials
#7
REVIEW
Heng Fan, Yu Zhao, Min Sun, Ji-Hui Ye, Guo-Dong Chen, Jian-Hua Zhu
Background: Using dexmedetomidine (Dex) as a sedative agent may benefit the clinical outcomes of post-surgery patients. We reviewed randomized controlled trials (RCTs) to assess whether use of a Dex could improve the outcomes in post-surgery critically ill adults. Methods: We searched Medline, Embase, PubMed, and the Cochrane databases for RCTs comparing Dex with propofol or a placebo in post-operative patients, all included RCTs should be published in English before Jul 2016...
December 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/29246814/neuroborreliosis-and-acute-encephalopathy-the-use-of-cxcl13-as-a-biomarker-in-cns-manifestations-of-lyme-borreliosis
#8
Matthias Karrasch, Volker Fingerle, Katharina Boden, Andreas Darr, Michael Baier, Eberhard Straube, Igor Nenadic
We report the case of an 80-year-old patient with acute onset confusion initially suspected to reflect delirium in incipient Alzheimer's disease. Cerebrospinal fluid tests revealed an unusually severe form of neuroborreliosis, which resolved following antibiotic treatment. This was mirrored in the measurement of CXCL13, which is suggested as a complementary biomarker. Clinical implications for screening, differential diagnosis and treatment are discussed.
December 11, 2017: Ticks and Tick-borne Diseases
https://www.readbyqxmd.com/read/29237068/screening-for-frailty-in-older-emergency-department-patients-the-utility-of-the-survey-of-health-ageing-and-retirement-in-europe-frailty-instrument-share-fi
#9
Aoife Fallon, Lorna Kilbane, Robert Briggs, Adam Dyer, Shamis Nabeel, Paul McElwaine, Ronan Collins, Tara Coughlan, Des O'Neill, Dan Ryan, Sean P Kennelly
Background: Greater numbers of older patients are accessing hospital services. Specialist geriatric input at presentation may improve outcomes for at-risk patients. The SHARE-FI (Survey of Health, Ageing and Retirement in Europe Frailty Instrument) frailty measure, developed for use in the community, has also been used in the emergency department (ED). Aim: To measure frailty, review its prevalence in older patients presenting to ED and compare characteristics and outcomes of frail patients with their non-frail counterparts...
December 11, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29227367/practice-patterns-and-outcomes-associated-with-early-sedation-depth-in-mechanically-ventilated-patients-a-systematic-review-and-meta-analysis
#10
Robert J Stephens, Matthew R Dettmer, Brian W Roberts, Enyo Ablordeppey, Susan A Fowler, Marin H Kollef, Brian M Fuller
OBJECTIVES: Emerging data suggest that early deep sedation may negatively impact clinical outcomes. This systematic review and meta-analysis defines and quantifies the impact of deep sedation within 48 hours of initiation of mechanical ventilation, as described in the world's literature. The primary outcome was mortality. Secondary outcomes included hospital and ICU lengths of stay, mechanical ventilation duration, and delirium and tracheostomy frequency. DATA SOURCES: The following data sources were searched: MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews and Effects, Cochrane Database of Systematic Reviews databases, ClinicalTrials...
December 8, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29192572/-recognising-postoperative-delirium-in-the-elderly
#11
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/29189383/sinai-abbreviated-geriatric-evaluation-development-and-validation-of-a-practical-test
#12
Mark R Katlic, JoAnn Coleman, Kamran Khan, Susan E Wozniak, Joseph H Abraham
OBJECTIVE: To develop and validate a simple geriatric screening tool that performs as well as more complex assessments BACKGROUND:: Many tools that predict treatment risk in older adults are impractical for routine clinical use. METHODS: We prospectively conducted comprehensive preoperative evaluations on 1025 patients age ≥75 years who presented to Sinai Hospital of Baltimore for major elective surgery, then retrospectively reviewed patients' medical records for occurrence of postoperative outcomes...
November 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29178096/-risk-factors-and-outcomes-of-postoperative-delirium-in-colorectal-cancer-patients-over-60-years
#13
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
#14
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/29173309/delirium-in-hospitalized-children-with-cancer-incidence-and-associated-risk-factors
#15
Chani Traube, Sydney Ariagno, Francesca Thau, Lynne Rosenberg, Elizabeth A Mauer, Linda M Gerber, David Pritchard, Julia Kearney, Bruce M Greenwald, Gabrielle Silver
OBJECTIVE: To assess the incidence of delirium and its risk factors in hospitalized children with cancer. STUDY DESIGN: In this cohort study, all consecutive admissions to a pediatric cancer service over a 3-month period were prospectively screened for delirium twice daily throughout their hospitalization. Demographic and treatment-related data were collected from the medical record after discharge. RESULTS: A total of 319 consecutive admissions, including 186 patients and 2731 hospital days, were included...
December 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29155938/cerebral-autoregulation-in-cardiopulmonary-bypass-surgery-a-systematic-review
#16
Juliana R Caldas, Victoria J Haunton, Ronney B Panerai, Ludhmila A Hajjar, Thompson G Robinson
Cardiopulmonary bypass surgery is associated with a high incidence of neurological complications, including stroke, delirium and cognitive impairment. The development of strategies to reduce the incidence of such neurological events has been hampered by the lack of a clear understanding of their pathophysiology. Cerebral autoregulation (CA), which describes the ability of the brain to maintain a stable cerebral blood flow over a wide range of cerebral perfusion pressures despite changes in blood pressure, is known to be impaired in various neurological disorders...
November 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155289/the-diagnostic-sensitivity-of-the-memorial-delirium-assessment-scale-mdas-spanish-version
#17
Elena Barahona, Rita Pinhao, Victoria Galindo, Antonio Noguera
Although Memorial Delirium Assessment Scale (MDAS) is a successful tool for delirium evaluation and monitoring, it is nevertheless important to determine whether cut-off scores vary according to the studied population. The main objective of this study is to evaluate the diagnostic sensitivity of the recently validated Spanish version of the MDAS. The secondary objective is to analyze possible diagnostic differences when used in a hospice or general hospital setting. METHODOLOGY: A prospective study was conducted with advanced cancer patients in two settings (hospice & general hospital)...
November 15, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29153005/screening-for-delirium-development-and-validation-of-the-buffalo-delirium-scale-for-use-in-a-home-based-hospice-setting
#18
Jennifer M Breier, Scott T Meier, Christopher W Kerr, Scott T Wright, Pei C Grant, Rachel M Depner
BACKGROUND: Delirium is a challenging occurrence among people at end of life. It can be difficult to detect and treat because of its episodic nature. The Buffalo Delirium Scale (BDS) was designed to identify risk factors for hospice patients in the prodromal stage of delirium. OBJECTIVE: This study evaluated the psychometric properties of items assessing delirium risk factors related to cognitive problems, psychological distress, and sleep problems. METHODS: Hospice nursing staff assessed patients with the 11-item BDS over a 6-month period as part of standard weekly visits to monitor for emerging signs of delirium, for example, sleep patterns, cognition, and behavior...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29137628/hypertonic-saline-for-prevention-of-delirium-in-geriatric-patients-who-underwent-hip-surgery
#19
Xi Xin, Fei Xin, Xuguang Chen, Qi Zhang, Yanan Li, Shuping Huo, Chongfu Chang, Qiujun Wang
BACKGROUND: Postoperative delirium (POD) is a common disorder in the elderly patients, and neuroinflammation is the possible underlying mechanism. This study is designed to determine whether or not hypertonic saline (HS) pre-injection can alleviate POD in aged patients. METHODS: This prospective study recruited 120 geriatric patients who underwent hip surgery. The patients were randomly divided into two groups: control group (NS group) and HS group. Patients in the NS group were pre-injected with 4 mL/kg isotonic saline, and those in the HS group were pre-injected with 4 mL/kg 7...
November 14, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29132782/midterm-outcomes-after-postoperative-delirium-on-cognition-and-mood-in-patients-after-cardiac-surgery
#20
Quyen Nguyen, Kelsey Uminski, Brett M Hiebert, Navdeep Tangri, Rakesh C Arora
OBJECTIVE: Delirium is a common neurologic complication after cardiac surgery. Our primary objective was to determine the impact of delirium on self-reported problems with midterm cognitive functioning and mood postcardiac surgery. METHODS: A single-center, prospective cohort study was conducted, enrolling 197 patients undergoing coronary artery bypass grafting or valve replacement. Baseline cognition and mood were assessed preoperatively in elective patients as a part of routine care using the Montreal Cognitive Assessment and Patient Health Questionnaire 9, respectively...
October 20, 2017: Journal of Thoracic and Cardiovascular Surgery
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