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Delirium screening

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https://www.readbyqxmd.com/read/28723773/development-and-validation-of-risk-stratification-delirium-prediction-model-for-critically-ill-patients-a-prospective-observational-single-center-study
#1
Yu Chen, Hang Du, Bao-Hua Wei, Xue-Ni Chang, Chen-Ming Dong
The objective is to develop a model based on risk stratification to predict delirium among adult critically ill patients and whether early intervention could be provided for high-risk patients, which could reduce the incidence of delirium.We designed a prospective, observational, single-center study. We examined 11 factors, including age, APACHE-II score, coma, emergency operation, mechanical ventilation (MV), multiple trauma, metabolic acidosis, history of hypertension, delirium and dementia, and application of Dexmedetomidine Hydrochloride...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28720164/the-detection-diagnosis-and-impact-of-cognitive-impairment-among-inpatients-aged-65-years-and-over-in-an-irish-general-hospital-a-prospective-observational-study
#2
Clodagh Power, Richard Duffy, Helena Bates, Mike Healy, Petrina Gleeson, Brian A Lawlor, Elaine Greene
BACKGROUND: The diagnosis of dementia remains inadequate, even within clinical settings. Data on rates and degree of impairment among inpatients are vital for service planning and the provision of appropriate patient care as Ireland's population ages. METHODS: Every patient aged 65 years and over admitted over a two-week period was invited to participate. Those who met inclusion criteria were screened for delirium then underwent cognitive screening. Demographic, functional, and outcome data were obtained from medical records, participants, and family...
July 19, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28711314/independent-predictors-of-the-duration-and-overall-burden-of-postoperative-delirium-after-cardiac-surgery-in-adults-an-observational-cohort-study
#3
Christian Cereghetti, Martin Siegemund, Sabine Schaedelin, Jens Fassl, Manfred D Seeberger, Friedrich S Eckstein, Luzius A Steiner, Nicolai Goettel
OBJECTIVE: Postoperative delirium (POD) is a common complication after cardiac surgery and is associated with increased patient morbidity and mortality. The objective of this study was to identify risk factors for long duration and overall burden of POD after cardiac surgery. DESIGN: One-year, single-center, retrospective, observational cohort study. SETTING: University hospital. PARTICIPANTS: Adult patients undergoing cardiac surgery with cardiopulmonary bypass in 2013...
March 31, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28708753/effectiveness-of-preoperative-intranasal-dexmedetomidine-compared-with-oral-midazolam-for-the-prevention-of-emergence-delirium-in-the-pediatric-patient-undergoing-general-anesthesia-a-systematic-review
#4
James FitzSimons, Laura S Bonanno, Stephanie Pierce, Jennifer Badeaux
BACKGROUND: Emergence delirium is defined as a cognitive disturbance during emergence from general anesthesia resulting in hallucinations, delusions and confusion manifested by agitation, restlessness, involuntary physical movement and extreme flailing in bed. Postoperative emergence delirium develops in 12% to 18% of all children undergoing general anesthesia for surgery. This post-anesthetic phenomenon changes cognitive and psychomotor behavior, and puts pediatric patients and health care personnel at risk of injury...
July 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28700116/an-integrative-literature-review-exploring-the-clinical-management-of-delirium-in-patients-with-advanced-cancer
#5
REVIEW
Hayley Lawley, Alistair Hewison
AIM: The aim of this paper is to present the findings of an integrative literature review of the evidence for the clinical management of delirium in patients with advanced cancer. BACKGROUND: Patients with advanced cancer frequently experience delirium which can be distressing for both patients and their families. Current guidelines recommend that underlying causes of the delirium be addressed and a course of antipsychotics considered. However the research into the effectiveness of treatments for delirium in people with advanced cancer is limited...
July 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28697802/outcomes-of-subsyndromal-delirium-in-icu-a-systematic-review-and-meta-analysis
#6
Rodrigo B Serafim, Marcio Soares, Fernando A Bozza, José R Lapa E Silva, Felipe Dal-Pizzol, Maria Carolina Paulino, Pedro Povoa, Jorge I F Salluh
BACKGROUND: Subsyndromal delirium (SSD) is a frequent condition and has been commonly described as an intermediate stage between delirium and normal cognition. However, the true frequency of SSD and its impact on clinically relevant outcomes in the intensive care unit (ICU) remains unclear. METHODS: We performed a systematic search in PubMed, Embase, CINAHL, Cochrane Library, and PsychINFO, with no language restrictions, up to 1 October 2016 to identify publications that evaluated SSD in ICU patients...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28692620/delirium-in-the-icu-what-about-the-floor
#7
Anthony Cahill, Christopher Pearcy, Vaidehi Agrawal, Phillip Sladek, Michael S Truitt
Delirium was first described in the 1800s as acute, fluctuating confusion. Recent studies note an incidence of 15% in adult intensive care unit patients. Here we present the first prospective study to evaluate the incidence and risk factors for delirium in patients admitted to the trauma surgeon (TS) in non-critical care areas (NCCAs). Patients 18 years or older admitted to any TS in the designated NCCA were evaluated and consented for participation over a 3-month period. Participants were screened with the Confusion Assessment Method (CAM) every 12 hr...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28689571/dissecting-delirium-phenotypes-consequences-screening-diagnosis-prevention-treatment-and-program-implementation
#8
REVIEW
Joseph H Flaherty, Jirong Yue, James L Rudolph
Delirium is an acute change in attention and awareness that preferentially occurs in older patients with acute illness. This review provides an overview for clinicians with descriptions of the presentations (phenotypes), consequences, diagnosis, and screening of delirium. In addition, this review provides guidance for the challenges posed by delirium in a health care system, including implementation of delirium programs, tools to address the diagnosis and differential diagnosis of delirium, and a review of preventive and treatment studies with a goal of improving clinical practice...
August 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28688161/identification-of-patients-with-cancer-with-a-high-risk-to-develop-delirium
#9
Elisabeth C W Neefjes, Maurice J D L van der Vorst, Bertha A T T Verdegaal, Aartjan T F Beekman, Johannes Berkhof, Henk M W Verheul
Delirium deteriorates the quality of life in patients with cancer, but is frequently underdiagnosed and not adequately treated. In this study, we evaluated the occurrence of delirium and its risk factors in patients admitted to the hospital for treatment or palliative care in order to develop a prediction model to identify patients at high risk for delirium. In a period of 1.5 years, we evaluated the risk of developing delirium in 574 consecutively admitted patients with cancer to our academic oncology department with the Delirium Observation Screening Scale...
July 7, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28675451/rates-of-delirium-diagnosis-do-not-improve-with-emergency-risk-screening-results-of-the-emergency-department-delirium-initiative-trial
#10
Glenn Arendts, Jennefer Love, Yusuf Nagree, David Bruce, Malcolm Hare, Ian Dey
OBJECTIVES: To determine whether a bundled risk screening and warning or action card system improves formal delirium diagnosis and person-centered outcomes in hospitalized older adults. DESIGN: Prospective trial with sequential introduction of screening and interventional processes. SETTING: Two tertiary referral hospitals in Australia. PARTICIPANTS: Individuals aged 65 and older presenting to the emergency department (ED) and not requiring immediate resuscitation (N = 3,905)...
July 4, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28668768/low-brain-tissue-oxygenation-contributes-to-the-development-of-delirium-in-critically-ill-patients-a-prospective-observational-study
#11
Michael D Wood, David M Maslove, John G Muscedere, Andrew G Day, J Gordon Boyd
PURPOSE: To test the hypothesis that poor brain tissue oxygenation (BtO2) during the first 24h of critical illness correlates with the proportion of time spent delirious. We also sought to define the physiological determinants of BtO2. MATERIALS AND METHODS: Adult patients admitted to the ICU within the previous 24h were considered eligible for enrollment if they required mechanical ventilation, and/or vasopressor support. BtO2 was measured using near-infrared spectroscopy, for 24h after enrollment...
June 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28666930/delirium-following-transcatheter-aortic-valve-replacement-national-inpatient-sample-analysis
#12
Amritha Soundhar, Reshmi Udesh, Amol Mehta, John Schindler, Vinodh Jeevanantham, Thomas Gleason, Parthasarathy D Thirumala
OBJECTIVE: To investigate the risk factors for postoperative delirium and the impact of delirium on mortality and morbidity following transcatheter aortic valve implantation (TAVI). DESIGN: Patients who underwent TAVI were identified using the International Classification of Diseases, 9th revision clinical modification codes from the National Inpatient Sample database. Statistical analysis of preoperative and perioperative risk factors was done to identify the independent risk factors for delirium after TAVI...
March 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28639340/impact-of-frailty-and-residual-subsyndromal-delirium-on-1-year-functional-recovery-a-prospective-cohort-study
#13
Justin Chew, Wee Shiong Lim, Mei Sian Chong, Yew Yoong Ding, Laura Tay
AIM: To investigate the association between frailty and incomplete delirium recovery at discharge (residual subsyndromal delirium [RSSD]), and to examine the mediating role of RSSD in the relationship between frailty and functional recovery at 12 months post-delirium. METHODS: This was a prospective observational study of 234 individuals aged ≥65 years admitted to a specialized delirium unit. A 20-item frailty index was derived using items from a comprehensive geriatric assessment...
June 22, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28624753/treatment-of-asymptomatic-uti-in-older-delirious-medical-in-patients-a-prospective-cohort-study
#14
Monidipa Dasgupta, Chris Brymer, Sameer Elsayed
BACKGROUND: Despite clinical practice guidelines, asymptomatic bacteriuria (ASB) in older people is frequently treated. A common reason for treating ASB is a change in mental status. OBJECTIVE: To determine how often asymptomatic UTI is treated in older medically ill delirious individuals and its association with functional recovery. METHODS: Consecutive older medical in-patients were screened for delirium, and followed in hospital. Treatment for asymptomatic UTI was defined as documented treatment for a possible urinary tract infection with antibiotics, without concurrent infectious or urinary symptoms...
May 31, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28622167/statin-and-its-association-with-delirium-in-the-medical-icu
#15
Jeffrey F Mather, John P Corradi, Christine Waszynski, Adam Noyes, Yinghui Duan, James Grady, Robert Dicks
OBJECTIVES: To examine the association between statin use and the risk of delirium in hospitalized patients with an admission to the medical ICU. DESIGN: Retrospective propensity-matched cohort analysis with accrual from September 1, 2012, to September 30, 2015. SETTING: Hartford Hospital, Hartford, CT. PATIENTS: An initial population of patients with an admission to a medical ICU totaling 10,216 visits were screened for delirium by means of the Confusion Assessment Method...
June 15, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28587754/delirium-screening-in-intensive-care-a-life-saving-opportunity
#16
REVIEW
E Lamond, S Murray, C E Gibson
BACKGROUND: Delirium is described as 'acute brain failure' and constitutes a medical emergency which presents a hazard for people cared for in intensive care units. The Scottish intensive care society audit group recommend that all people cared for in intensive care units be screened for signs of delirium so that treatment and management of complications can be implemented at an early stage. CLINICAL IMPLICATION: There is inconsistent evidence about when and how the assessment of delirium is carried out by nursing staff in the intensive care setting...
June 3, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28585290/csf-biomarkers-in-delirium-a-systematic-review
#17
Roanna J Hall, Leiv Otto Watne, Emma Cunningham, Henrik Zetterberg, Susan D Shenkin, Torgeir Bruun Wyller, Alasdair M J MacLullich
OBJECTIVE: In recent years, there has been a blossoming of studies examining cerebrospinal fluid (CSF) as a method of studying the pathophysiology of delirium. We systematically reviewed the literature for CSF studies in delirium and provide here a summary of the implications for our understanding of delirium pathophysiology. We also summarise the methods used for CSF analysis and discuss challenges and implications for future studies. METHODS: In this systematic review, we screened MEDLINE, EMBASE, PsycINFO, Web of Science, PubMed and the Cochrane Library for articles on CSF biomarkers in delirium, published on 3 September 2016...
June 6, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28574907/-the-times-they-are-a-changin-universal-delirium-screening-in-pediatric-critical-care
#18
Chani Traube, Bruce M Greenwald
No abstract text is available yet for this article.
June 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28571901/how-can-we-identify-patients-with-delirium-in-the-emergency-department-a-review-of-available-screening-and-diagnostic-tools
#19
Hidetaka Tamune, Daisuke Yasugi
Delirium is a widespread and serious but under-recognized problem. Increasing evidence argues that emergency health care providers need to assess the mental status of the patient as the "sixth vital sign". A simple, sensitive, time-efficient, and cost-effective tool is needed to identify delirium in patients in the emergency department (ED); however, a stand-alone measurement has not yet been established despite previous studies partly because the differential diagnosis of dementia and delirium superimposed on dementia (DSD) is too difficult to achieve using a single indicator...
May 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28561887/reconciling-patient-and-provider-priorities-for-improving-the-care-of-critically-ill-patients-a-consensus-method-and-qualitative-analysis-of-decision-making
#20
Emily McKenzie, Melissa L Potestio, Jamie M Boyd, Daniel J Niven, Rebecca Brundin-Mather, Sean M Bagshaw, Henry T Stelfox
BACKGROUND: Providers have traditionally established priorities for quality improvement; however, patients and their family members have recently become involved in priority setting. Little is known about how to reconcile priorities of different stakeholder groups into a single prioritized list that is actionable for organizations. OBJECTIVE: To describe the decision-making process for establishing consensus used by a diverse panel of stakeholders to reconcile two sets of quality improvement priorities (provider/decision maker priorities n=9; patient/family priorities n=19) into a single prioritized list...
May 31, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
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