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Delirium screening

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https://www.readbyqxmd.com/read/29773957/perioperative-predictors-of-delirium-and-incidence-factors-in-adult-patients-post-cardiac-surgery
#1
Stavros Theologou, Konstantinos Giakoumidakis, Christos Charitos
Background: Delirium is a quite common complication in adult patients post-cardiac surgery. The purpose of our study was to identify perioperative characteristics and also focus on incidence factors that could predict delirium in the cardiac surgery intensive care unit (CICU) postoperatively. Methods: We conducted a prospective study of 179 consecutive patients, who underwent open-heart surgical operation and were admitted to the CICU of a general tertiary hospital in Athens, Greece...
2018: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29769154/performance-of-the-french-version-of-the-4at-for-screening-the-elderly-for-delirium-in-the-emergency-department
#2
Anne-Julie Gagné, Philippe Voyer, Valérie Boucher, Alexandra Nadeau, Pierre-Hugues Carmichael, Mathieu Pelletier, Emilie Gouin, Simon Berthelot, Raoul Daoust, Machelle Wilchesky, Hélène Richard, Isabelle Pelletier, Stephanie Ballard, Antoine Laguë, Marcel Émond
CLINICIAN'S CAPSULE What is known about the topic? Delirium is frequent in older inpatients but often goes undetected. A short tool, the 4 A's Test (4AT), was created and validated for the detection of delirium. What did this study ask? This study compared the performance of the French version of the 4AT (4AT-F) with the Confusion Assessment Method (CAM) for the screening of delirium. What did this study find? The 4AT-F was a fast and reliable screening tool for delirium in the emergency department (ED). Why does this study matter to clinicians? Because of its quick administration time, it allows for systematic screening of patients at risk of delirium and cognitive impairment...
May 17, 2018: CJEM
https://www.readbyqxmd.com/read/29767323/prevalence-and-risk-factors-related-to-haloperidol-use-for-delirium-in-adult-intensive-care-patients-the-multinational-aid-icu-inception-cohort-study
#3
Marie O Collet, Jesús Caballero, Romain Sonneville, Fernando A Bozza, Peter Nydahl, Anna Schandl, Hilden Wøien, Giuseppe Citerio, Mark van den Boogaard, Johanna Hästbacka, Matthias Haenggi, Kirsten Colpaert, Louise Rose, Marija Barbateskovic, Theis Lange, Aksel Jensen, Martin B Krog, Ingrid Egerod, Helle L Nibro, Jørn Wetterslev, Anders Perner
PURPOSE: We assessed the prevalence and variables associated with haloperidol use for delirium in ICU patients and explored any associations of haloperidol use with 90-day mortality. METHODS: All acutely admitted, adult ICU patients were screened during a 2-week inception period. We followed the patient throughout their ICU stay and assessed 90-day mortality. We assessed patients and their variables in the first 24 and 72 h in ICU and studied their association together with that of ICU characteristics with haloperidol use...
May 16, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29764723/frailty-assessment-to-help-predict-patients-at-risk-of-delirium-when-consulting-the-emergency-department
#4
Marianne Giroux, Marie-Josée Sirois, Valérie Boucher, Raoul Daoust, Émilie Gouin, Mathieu Pelletier, Simon Berthelot, Philippe Voyer, Marcel Émond
BACKGROUND: Delirium is underdiagnosed in seniors at emergency departments (EDs) even though it is a frequent complication and is associated with functional and cognitive decline. As frailty is an independent predictor of adverse events in seniors, screening for frailty in EDs may help identify those at risk of delirium. OBJECTIVES: To assess if screening older patients for frailty in EDs could help identify those at risk of delirium. METHODOLOGY: This study was part of the multicenter prospective cohort INDEED study...
May 12, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29757064/factors-associated-with-the-effectiveness-of-intravenous-administration-of-chlorpromazine-for-delirium-in-patients-with-terminal-cancer
#5
Hideaki Hasuo, Kenji Kanbara, Ryohei Fujii, Kazuki Uchitani, Hiroko Sakuma, Mikihiko Fukunaga
BACKGROUND: Delirium in patients with terminal cancer is irreversible and increases treatment resistance, which leads to a deterioration in quality of life. OBJECTIVE: To investigate factors affecting the effectiveness and safety of intravenous chlorpromazine for irreversible delirium in patients with terminal cancer. DESIGN/MEASUREMENTS: Multiple regression analysis for factors affecting treatment effectiveness was carried out based on a retrospective comparison between responders and nonresponders to intravenous chlorpromazine...
May 14, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29754983/cognitive-impairment-in-intensive-care-unit-patients-a-pilot-mixed-methods-feasibility-study-exploring-incidence-and-experiences-for-recovering-patients
#6
Rosalind Elliott, Elizabeth Yarad, Sarah Webb, Katherine Cheung, Frances Bass, Naomi Hammond, Doug Elliott
BACKGROUND: Despite improvements in survival after critical illness and intensive care unit (ICU) treatment, some recovering patients still face ongoing challenges. There are few investigations exploring the incidence, risk factors, and trajectory for cognitive impairment (CI) in former ICU patients in Australia. OBJECTIVES: To test the feasibility of a study protocol designed to ascertain the incidence and impact of CI during recovery from a critical illness. METHODS: We conducted a mixed-methods longitudinal single-centre pilot study...
May 10, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29751986/delirium-after-cardiac-surgery-incidence-phenotypes-predisposing-and-precipitating-risk-factors-and-effects
#7
Gianfranco Sanson, Yuliya Khlopenyuk, Sara Milocco, Massimiliano Sartori, Lorella Dreas, Adam Fabiani
BACKGROUND: In cardiac surgical patients little is known about different phenotypes of delirium and how the symptoms fluctuate over time. OBJECTIVES: Evaluate risk factors, incidence, fluctuations, phenotypic characteristics and impact on patients' outcomes of delirium. METHODS: Prospective longitudinal study. In postoperative intensive care unit 199 patient were assessed three-times a day through an adapted versions of the Intensive Care Delirium Screening Checklist...
May 8, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29742533/delirium-screening-and-management-in-inpatient-rehabilitation-facilities
#8
Mooyeon Oh-Park, Peii Chen, Vickie Romel-Nichols, Kimberly Hreha, Olga Boukrina, A M Barrett
Delirium is an acute and fluctuating disturbance in cognition attention, and awareness that is often a reflection of abnormal physiological condition of an individual. Delirium is highly prevalent among an older population and is associated with high mortality, poor medical and functional outcomes and high healthcare cost. Delirium often has iatrogenic triggers and it has been recognized as a quality indicator of healthcare organizations. In spite of its high prevalence and significance, more than 50% of the delirium cases are underrecognized by healthcare professionals and remained untreated...
May 7, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29738102/validation-of-the-brief-confusion-assessment-method-for-screening-delirium-in-elderly-medical-patients-in-a-german-emergency-department
#9
Verena Baten, Hans-Jörg Busch, Caroline Busche, Bonaventura Schmid, Miriam Heupel-Reuter, Evgeniy Perlov, Jochen Brich, Stefan Klöppel
BACKGROUND: Delirium is frequent in elderly patients presenting in the emergency department (ED). Despite the severe prognosis, the majority of delirium cases remain undetected by emergency physicians (EPs). At the time of our study there was no valid delirium screening tool available for EDs in German-speaking regions. We aimed to evaluate the brief Confusion Assessment Method (bCAM) for a German ED during the daily work routine. METHODS: We implemented the bCAM into practice in a German interdisciplinary high volume ED, and evaluated the bCAM's validity in a convenience sample of medical patients aged ≥70 years...
May 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29735284/music-intervention-to-prevent-delirium-among-older-patients-admitted-to-a-trauma-intensive-care-unit-and-a-trauma-orthopaedic-unit
#10
Kari Johnson, Julie Fleury, Darya McClain
PURPOSE: Evaluate music listening for delirium prevention among patients admitted to a Trauma Intensive Care and Trauma Orthopaedic Unit. The Roy Adaptation Model provided the theoretical framework focusing on modifying contextual stimuli. METHODS: Randomised controlled trial, 40 patients aged 55 and older. INTERVENTION: Participants randomly assigned to receive music listening or usual care for 60 minutes, twice a day, over three days. Pre-recorded self-selected music using an iPod and headsets, with slow tempo, low pitch and simple repetitive rhythms to alter physiologic responses...
May 4, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29730630/delirium-as-a-predictor-of-mortality-in-us-medicare-beneficiaries-discharged-from-the-emergency-department-a-national-claims-level-analysis-up-to-12-months
#11
Juhi Israni, Adriane Lesser, Tyler Kent, Kelly Ko
BACKGROUND: Delirium is common among seniors discharged from the emergency department (ED) and associated with increased risk of mortality. Prior research has addressed mortality associated with seniors discharged from the ED with delirium, however has generally relied on data from one or a small number of institutions and at single time points. OBJECTIVES: Analyse mortality rates among seniors discharged from the ED with delirium up to 12 months at the national level...
May 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29730622/early-rehabilitation-to-prevent-postintensive-care-syndrome-in-patients-with-critical-illness-a-systematic-review-and-meta-analysis
#12
Ryota Fuke, Toru Hifumi, Yutaka Kondo, Junji Hatakeyama, Tetsuhiro Takei, Kazuma Yamakawa, Shigeaki Inoue, Osamu Nishida
INTRODUCTION: We examined the effectiveness of early rehabilitation for the prevention of postintensive care syndrome (PICS), characterised by an impaired physical, cognitive or mental health status, among survivors of critical illness. METHODS: We performed a systematic literature search of several databases (Medline, Embase and Cochrane Central Register of Controlled Trials) and a manual search to identify randomised controlled trials (RCTs) comparing the effectiveness of early rehabilitation versus no early rehabilitation or standard care for the prevention of PICS...
May 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29728150/delirium-prediction-in-the-intensive-care-unit-comparison-of-two-delirium-prediction-models
#13
Annelies Wassenaar, Lisette Schoonhoven, John W Devlin, Frank M P van Haren, Arjen J C Slooter, Philippe G Jorens, Mathieu van der Jagt, Koen S Simons, Ingrid Egerod, Lisa D Burry, Albertus Beishuizen, Joaquim Matos, A Rogier T Donders, Peter Pickkers, Mark van den Boogaard
BACKGROUND: Accurate prediction of delirium in the intensive care unit (ICU) may facilitate efficient use of early preventive strategies and stratification of ICU patients by delirium risk in clinical research, but the optimal delirium prediction model to use is unclear. We compared the predictive performance and user convenience of the prediction  model for delirium (PRE-DELIRIC) and early prediction model for delirium (E-PRE-DELIRIC) in ICU patients and determined the value of a two-stage calculation...
May 5, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29727363/benzodiazepines-and-development-of-delirium-in-critically-ill-children-estimating-the-causal-effect
#14
Kalgi Mody, Savneet Kaur, Elizabeth A Mauer, Linda M Gerber, Bruce M Greenwald, Gabrielle Silver, Chani Traube
OBJECTIVES: Benzodiazepine use may be associated with delirium in critically ill children. However, benzodiazepines remain the first-line sedative choice in PICUs. Objectives were to determine the temporal relationship between administration of benzodiazepines and delirium development, control for time-varying covariates such as mechanical ventilation and opiates, and evaluate the association between dosage of benzodiazepines and subsequent delirium. DESIGN: Retrospective observational study...
May 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29717689/advancing-our-diagnostic-tools-and-treatment-options-for-delirium
#15
Dan G Blazer
Delirium is one of the most prevalent and disabling conditions impacting older adults in hospitals and long-term care settings. The estimates of frequency of delirium in hospitals and nursing homes among older adults range widely, yet it is safe to assume that perhaps as many as 25-30% of elderly individuals in hospitals experience an episode of delirium, often undetected unless a regular screening process is implemented. Until the past couple of decades, actual research into delirium had been sparse and done little to inform clinical practice...
April 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29699898/an-evaluation-of-single-question-delirium-screening-tools-in-older-emergency-department-patients
#16
Jin H Han, Amanda Wilson, John F Schnelle, Robert S Dittus, E Wesley Ely
OBJECTIVES: To determine the diagnostic performances of several single question delirium screens. To the patient we asked: "Have you had any difficulty thinking clearly lately?" To the patient's surrogate, we asked: "Is the patient at his or her baseline mental status?" and "Have you noticed the patient's mental status fluctuate throughout the course of the day?" METHODS: This was a prospective observational study that enrolled English speaking patients 65 years or older...
March 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29697753/attention-arousal-and-other-rapid-bedside-screening-instruments-for-delirium-in-older-patients-a-systematic-review-of-test-accuracy-studies
#17
D W P Quispel-Aggenbach, G A Holtman, H A H T Zwartjes, S U Zuidema, H J Luijendijk
Objective: delirium occurs frequently in frail patients but is easily missed. Screening with a rapid, easy-to-use and highly sensitive instrument might help improve recognition. The aim of this study was to review attention, arousal and other rapid bedside screening instruments for delirium in older patients. Methods: a literature search was performed in PubMed, PsycINFO and Embase. We scrutinized forward citations in Google Scholar, and references of included articles and prior reviews...
April 25, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29680484/postoperative-delirium
#18
Kimberly F Rengel, Pratik P Pandharipande, Christopher G Hughes
Delirium in the perioperative period is a wide-reaching problem that directly affects important clinical outcomes. It is essential that anesthesiologists understand how to define and diagnose delirium, identify patients at high risk for developing delirium, recognize precipitating factors to appropriately adjust care plans, and manage patients who develop delirium in the acute postoperative period. Importantly, delirium remains underdiagnosed in the perioperative setting, but many screening and assessment tools are readily available to aid non-psychiatric trained personnel in identifying delirium...
April 18, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29677175/are-antipsychotics-effective-for-the-prevention-of-postoperative-delirium
#19
Viviana Castro, Rami Guinguis, Marcela Carrasco
INTRODUCTION: Antipsychotics have been proposed as a pharmacological alternative to prevent postoperative delirium. Nonetheless, their actual clinical benefits and harms are a matter of debate. METHODS: To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the chosen systematic reviews, reanalyzed the data from the primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach...
April 20, 2018: Medwave
https://www.readbyqxmd.com/read/29671281/validation-of-caregiver-centered-delirium-detection-tools-a-systematic-review
#20
REVIEW
Brianna Rosgen, Karla Krewulak, Danielle Demiantschuk, E Wesley Ely, Judy E Davidson, Henry T Stelfox, Kirsten M Fiest
OBJECTIVES: To summarize the validity of caregiver-centered delirium detection tools in hospitalized adults and assess associated patient and caregiver outcomes. DESIGN: Systematic review. SETTING: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus from inception to May 15, 2017. PARTICIPANTS: Hospitalized adults. INTERVENTION: Caregiver-centered delirium detection tools. MEASUREMENTS: We drafted a protocol from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
April 18, 2018: Journal of the American Geriatrics Society
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