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Delirium Epidemiology

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https://www.readbyqxmd.com/read/28990246/excited-delirium-a-systematic-review
#1
Philippe Gonin, Nicolas Beysard, Bertrand Yersin, Pierre-Nicolas Carron
STUDY OBJECTIVE: We aimed to clarify the definition, epidemiology, and pathophysiology of excited delirium syndrome (ExDS) and to summarize evidence-based treatment recommendations. METHODS: We conducted a systematic literature search of MEDLINE, Ovid, Web of Knowledge, and Cochrane Library for articles published to March 18, 2017. We also searched the grey literature (Google Scholar) and official police or medical expert reports to complete specific epidemiological data...
October 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28836711/delirium-tremens-and-alcohol-withdrawal-nationally-in-the-veterans-health-administration
#2
David Thomas Moore, Brian Scott Fuehrlein, Robert Alan Rosenheck
BACKGROUND AND OBJECTIVES: Alcohol withdrawal-especially delirium tremens (DT)-is a potentially life-threatening condition. While short-term treatment regimens and factors that predispose to more severe symptomatology have been extensively studied, little attention has been paid to the clinical epidemiology and long-term care of the chronic medical, addictive, psychiatric, and psychosocial problems faced by these patients. METHODS: National Veterans Health Administration data from fiscal year 2012 were examined to identify veterans diagnosed with DT; with withdrawal but not DT (WNDT); and with Alcohol Use Disorder (AUD) but neither DT nor WNDT...
October 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28783489/improving-delirium-recognition-and-assessment-for-people-receiving-inpatient-palliative-care-a-mixed-methods-meta-synthesis
#3
Annmarie Hosie, Meera Agar, Elizabeth Lobb, Patricia M Davidson, Jane Phillips
BACKGROUND: Delirium is a serious acute neurocognitive condition frequently occurring for hospitalized patients, including those receiving care in specialist palliative care units. There are many delirium evidence-practice gaps in palliative care, including that the condition is under-recognized and challenging to assess. OBJECTIVES: To report the meta-synthesis of a research project investigating delirium epidemiology, systems and nursing practice in palliative care units...
July 12, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28747225/epidemiology-and-outcomes-of-people-with-dementia-delirium-and-unspecified-cognitive-impairment-in-the-general-hospital-prospective-cohort-study-of-10-014-admissions
#4
Emma L Reynish, Simona M Hapca, Nicosha De Souza, Vera Cvoro, Peter T Donnan, Bruce Guthrie
BACKGROUND: Cognitive impairment of various kinds is common in older people admitted to hospital, but previous research has usually focused on single conditions in highly-selected groups and has rarely examined associations with outcomes. This study examined prevalence and outcomes of cognitive impairment in a large unselected cohort of people aged 65+ with an emergency medical admission. METHODS: Between January 1, 2012, and June 30, 2013, admissions to a single general hospital acute medical unit aged 65+ underwent a structured specialist nurse assessment (n = 10,014)...
July 27, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28645616/epidemiological-and-sociodemographic-factors-associated-with-complicated-alcohol-withdrawal-syndrome
#5
R Monte-Secades, M Blanco-Soto, J A Díaz-Peromingo, A Sanvisens-Bergé, M C Martín-González, A Barbosa, B Rosón-Hernández, M A Tejero-Delgado, R Puerta-Louro, R Rabuñal-Rey
OBJECTIVES: To analyse the influence of epidemiological and sociodemographic factors in complicated alcohol withdrawal syndrome (AWS). MATERIAL AND METHODS: A multicentre, observational prospective study was conducted on consecutively added patients with AWS hospitalised in internal medicine departments. We recorded sociodemographic, epidemiological, clinical and progression data. Complicated AWS was defined as that which progressed with seizures or delirium tremens...
October 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28625252/-cerebral-injury-induced-by-heat-stroke-and-the-therapeutic-effect-of-hyperbaric-oxygen-therapy
#6
Xiaoxiao Ni, Zhifeng Liu, Qiuyou Xie, Huasheng Tong, Lei Su, Ronghao Yu
With the global warming, the incidence of heat stroke was significantly higher than before. Severe heat stroke has a high mortality, high morbidity and consolidated central nervous system injury characteristics. The main features of severe heat stroke cerebral injury include cognitive impairment, delirium, convulsions and coma. Its mechanism is related with heat shock induced cerebral tissue ischemia and hypoxia, vascular dysfunction, secondary cascade inflammation and so on. Currently, the main treatment of heat stroke cerebral injury is the hypothermia therapy, dehydration for the reduction of intracranial pressure, naloxone and other cerebral protection and nutrition treatments...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#7
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28601132/acute-brain-failure-pathophysiology-diagnosis-management-and-sequelae-of-delirium
#8
REVIEW
José R Maldonado
Delirium is the most common psychiatric syndrome found in the general hospital setting, with an incidence as high as 87% in the acute care setting. Delirium is a neurobehavioral syndrome caused by the transient disruption of normal neuronal activity secondary to systemic disturbances. The development of delirium is associated with increased morbidity, mortality, cost of care, hospital-acquired complications, placement in specialized intermediate and long-term care facilities, slower rate of recovery, poor functional and cognitive recovery, decreased quality of life, and prolonged hospital stays...
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28498176/effectiveness-of-haloperidol-prophylaxis-in-critically-ill-patients-with-a-high-risk-of-delirium-a-systematic-review
#9
Eduardo Santos, Daniela Cardoso, Hugo Neves, Madalena Cunha, Manuel Rodrigues, João Apóstolo
BACKGROUND: Delirium is associated with increased intensive care unit and hospital length of stay, prolonged duration of mechanical ventilation, unplanned removal of tubes and catheters, and increased morbidity and mortality. Prophylactic treatment with low-dose haloperidol may have beneficial effects for critically ill patients with a high risk of delirium. OBJECTIVES: To identify the effectiveness of haloperidol prophylaxis in critically ill patients with a high risk for delirium...
May 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28381144/varicella-zoster-virus-gastritis
#10
Erik W Nohr, Doha M Itani, Christopher N Andrews, Margaret M Kelly
We report varicella-zoster virus (VZV) gastritis in a 70-year-old woman postchemotherapy for lymphoma, presenting with abdominal pain, vomiting, and delirium without rash. A gastric biopsy demonstrated viral inclusions but posed a diagnostic challenge as immunohistochemistry for cytomegalovirus and herpes simplex virus were negative, and VZV immunohistochemistry was not available. The patient developed a vesicular rash 7 days after her symptoms began. Molecular testing of the gastric biopsy and a skin swab both confirmed VZV infection...
March 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28288026/delirium-and-mortality-in-critically-ill-children-epidemiology-and-outcomes-of-pediatric-delirium
#11
Chani Traube, Gabrielle Silver, Linda M Gerber, Savneet Kaur, Elizabeth A Mauer, Abigail Kerson, Christine Joyce, Bruce M Greenwald
OBJECTIVES: Delirium occurs frequently in adults and is an independent predictor of mortality. However, the epidemiology and outcomes of pediatric delirium are not well-characterized. The primary objectives of this study were to describe the frequency of delirium in critically ill children, its duration, associated risk factors, and effect on in-hospital outcomes, including mortality. Secondary objectives included determination of delirium subtype, and effect of delirium on duration of mechanical ventilation, and length of hospital stay...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28271556/where-next-for-delirium-research
#12
Rowan H Harwood, Elizabeth Teale
Clinicians who manage delirium must do so without key information required for evidence-based practice, not least lack of any clearly effective treatment for established delirium. Both the nature of delirium and the methods used to research it contribute to difficulties. Delirium is heterogeneous, with respect to motor subtype, aetiology, setting and the co-existence of dementia, and may be almost inevitable towards the end of life. Elements of assessment are subjective, so diagnosis can be uncertain or unreliable...
March 8, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28215925/-elderly-patients-and-intensive-care-systematic-review-and-geriatrician-s-point-of-view
#13
H Vallet, B Riou, J Boddaert
The global population is aging and intensive care unit admission rate of elderly patients is dramatically increasing. The objective of this review is to provide an overview of the literature about the management of elderly patients in intensive care unit and more specifically about epidemiology, admission criteria, mortality, functional prognosis and ethical aspects. We also discuss the data on cardiorespiratory arrest, shock, acute respiratory failure and delirium. The mortality rate of patients over 80 years old in intensive care unit can reach up to 70% at 1year, but is dependent on many factors, such as comorbidities or frailty...
February 16, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28196947/cohort-profile-the-welsh-geriatric-registrar-led-research-network-wegen-rationale-design-and-description
#14
Benjamin Jelley, Sara Long, John Butler, Jonathan Hewitt
PURPOSE: Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28124100/-treatment-with-psychotropic-agents-in-patients-with-dementia-and-delirium-gap-between-guideline-recommendations-and-treatment-practice
#15
REVIEW
Walter Hewer, Christine Thomas
BACKGROUND AND OBJECTIVES: Psychiatric symptoms in dementia and delirium are associated with a substantially reduced quality of life of patients and their families and often challenging for professionals. Pharmacoepidemiological surveys have shown that, in particular, patients living in nursing homes receive prescriptions of psychotropic agents in significant higher frequency than recommended by current guidelines. This article focuses on a critical appraisal of this gap from the point of view of German healthcare services...
February 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28114436/association-of-delirium-with-cognitive-decline-in-late-life-a-neuropathologic-study-of-3-population-based-cohort-studies
#16
Daniel H J Davis, Graciela Muniz-Terrera, Hannah A D Keage, Blossom C M Stephan, Jane Fleming, Paul G Ince, Fiona E Matthews, Colm Cunningham, E Wesley Ely, Alasdair M J MacLullich, Carol Brayne
Importance: Delirium is associated with accelerated cognitive decline. The pathologic substrates of this association are not yet known, that is, whether they are the same as those associated with dementia, are independent, or are interrelated. Objective: To examine whether the accelerated cognitive decline observed after delirium is independent of the pathologic processes of classic dementia. Design, Setting, and Participants: Harmonized data from 987 individual brain donors from 3 observational cohort studies with population-based sampling (Vantaa 85+, Cambridge City Over-75s Cohort, Cognitive Function and Ageing Study) performed from January 1, 1985, through December 31, 2011, with a median follow-up of 5...
March 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/27126837/restraint-related-deaths-and-excited-delirium-syndrome-in-ontario-2004-2011
#17
Alain Michaud
Restraint related death in individuals in excited delirium syndrome (ExDS) is a rare event that has been the subject of controversies for more than 3 decades. The purpose of this retrospective study was to retrieve data on all restraint related deaths (RRD) that occurred in Ontario during an 8-year period and compare them with an earlier study on RRD in ExDS covering the period 1988-1995 in Ontario. The Office of the Chief Coroner of Ontario website was consulted under verdicts and recommendations. The Canadian Legal Information Institute website was used to consult verdict explanations and coroner's summary of evidence...
July 2016: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/27107564/distinguishing-features-of-excited-delirium-syndrome-in-non-fatal-use-of-force-encounters
#18
Simon Baldwin, Christine Hall, Craig Bennell, Brittany Blaskovits, Chris Lawrence
STUDY OBJECTIVE: The frequency with which the police encounter non-fatal cases of Excited Delirium Syndrome (ExDS) has not been well studied. To date only a single prospective, epidemiologic study has been completed to determine the prevalence of the features of ExDS in police use of force (UoF) encounters. We examined a cluster of previously published features associated with ExDS to establish if these features were consistently recognizable across policing populations, thus demonstrating reproducibility...
July 2016: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/26743858/increased-risk-of-psychosis-in-patients-with-hearing-impairment-review-and-meta-analyses
#19
REVIEW
Mascha M J Linszen, Rachel M Brouwer, Sophie M Heringa, Iris E Sommer
Several studies suggest hearing impairment as a risk factor for psychosis. Hearing impairment is highly prevalent and potentially reversible, as it can be easily diagnosed and sometimes improved. Insight in the association between hearing impairment and psychosis can therefore contribute to prevention of psychosis. This paper provides meta-analyses of all epidemiologic evidence on the association between hearing impairment and psychosis and summarizes mechanisms that potentially underlie this relationship. Meta-analyses showed an increased risk of hearing impairment on all psychosis outcomes, such as hallucinations (OR 1...
March 2016: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/26678967/palliative-pharmacotherapy-state-of-the-art-management-of-symptoms-in-patients-with-cancer
#20
REVIEW
Eric E Prommer
BACKGROUND: Advanced cancer produces multiple symptoms as patients progress through their disease trajectory. Identifying, measuring, and providing therapy for uncontrolled symptoms becomes important because disease-altering therapies may be no longer possible. Symptoms other than pain that cause distress in patients with cancer include delirium, dyspnea, anorexia, nausea, and fatigue. Precise management of these symptoms can lead to the best possible quality of life and lessen distress...
October 2015: Cancer Control: Journal of the Moffitt Cancer Center
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