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Delirium Morbidity

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https://www.readbyqxmd.com/read/27902744/delirium-detection-and-impact-of-comorbid-health-conditions-in-a-post-acute-rehabilitation-hospital-setting
#1
Julija Stelmokas, Nicolette Gabel, Jennifer M Flaherty, Katherine Rayson, Kathileen Tran, Jason R Anderson, Linas A Bieliauskas
Misdiagnosis and under-detection of delirium may occur in many medical settings. This is important to address as delirium clearly increases risk of morbidity and mortality in such settings. This study assessed whether Veterans who screened positive on a delirium severity measure (Memorial Delirium Assessment Scale; MDAS) differed from those with and without corresponding medical documentation of delirium in terms of cognitive functioning, psychiatric/medical history, and medication use. A medical record review of 266 inpatients at a VA post-acute rehabilitation unit found that 10...
2016: PloS One
https://www.readbyqxmd.com/read/27893697/morbidity-and-mortality-predictivity-of-nutritional-assessment-tools-in-the-postoperative-care-unit
#2
Şule Özbilgin, Volkan Hanc, Dilek Ömür, Mücahit Özbilgin, Mine Tosun, Serhan Yurtlu, Semih Küçükgüçlü, Atalay Arkan
The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27884743/mortality-and-morbidity-after-spinal-surgery-in-patients-with-parkinson-s-disease-a-retrospective-matched-pair-cohort-study
#3
Takeshi Oichi, Hirotaka Chikuda, Junichi Ohya, Ryo Ohtomo, Kojiro Morita, Hiroki Matsui, Kiyohide Fushimi, Sakae Tanaka, Hideo Yasunaga
BACKGROUND CONTEXT: There is a lack of information about postoperative outcomes and related risk factors associated with spinal surgery in patients with Parkinson's disease (PD). PURPOSE: To investigate the postoperative morbidity and mortality associated with spinal surgery for patients with PD, and the risk factors for poor outcomes. STUDY DESIGN: Retrospective matched-pair cohort study. PATIENT SAMPLE: Data of patients who underwent elective spinal surgery between July 2010 and March 2013 were extracted from the Diagnosis Procedure Combination database, a nationwide inpatient database in Japan...
November 21, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27882528/an-empirical-comparison-of-the-eq-5d-5l-demqol-u-and-demqol-proxy-u-in-a-post-hospitalisation-population-of-frail-older-people-living-in-residential-aged-care
#4
Julie Ratcliffe, Thomas Flint, Tiffany Easton, Maggie Killington, Ian Cameron, Owen Davies, Craig Whitehead, Susan Kurrle, Michelle Miller, Enwu Liu, Maria Crotty
OBJECTIVE: To empirically compare the measurement properties of the DEMQOL-U and DEMQOL-Proxy-U instruments to the EQ-5D-5L and its proxy version (CEQ-5D-5L) in a population of frail older people living in residential aged care in the post-hospitalisation period following a hip fracture. METHODS: A battery of instruments to measure health-related quality of life (HRQoL), cognition, and clinical indicators of depression, pain and functioning were administered at baseline and repeated at 4 weeks' follow-up...
November 23, 2016: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/27881092/the-relationship-between-in-hospital-location-and-outcomes-of-care-in-patients-diagnosed-with-dementia-and-or-delirium-diagnoses-analysis-of-patient-journey
#5
Lua Perimal-Lewis, Clare Bradley, Paul H Hakendorf, Craig Whitehead, Louise Heuzenroeder, Maria Crotty
BACKGROUND: The discrepancy between the number of admissions and the allocation of hospital beds means that many patients admitted to hospital can be placed in units or wards other than that which specialise in the patient's primary health issue (home-ward). These patients are called 'outlier' patients. Risk factors and health system outcomes of hospital care for 'outlier' patients diagnosed with dementia and/or delirium are unknown. Therefore, the aim of this research was to examine patient journeys of people with dementia and/or delirium diagnoses, to identify risk factors for 'inlier' or 'outlier' status and patient or health system outcomes (consequences) of this status...
November 24, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27849239/importance-of-the-use-of-protocols-for-the-management-of-analgesia-and-sedation-in-pediatric-intensive-care-unit
#6
Emiliana Motta, Michele Luglio, Artur Figueiredo Delgado, Werther Brunow de Carvalho
Introduction: Analgesia and sedation are essential elements in patient care in the intensive care unit (ICU), in order to promote the control of pain, anxiety and agitation, prevent the loss of devices, accidental extubation, and improve the synchrony of the patient with mechanical ventilation. However, excess of these medications leads to rise in morbidity and mortality. The ideal management will depend on the adoption of clinical and pharmacological measures, guided by scales and protocols...
September 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27809575/a-systematic-review-of-postoperative-cognitive-decline-following-open-and-endovascular-aortic-aneurysm-surgery
#7
R A Benson, B A Ozdemir, D Matthews, I M Loftus
OBJECTIVES Postoperative cognitive decline (POCD) is a well-recognised neurological phenomenon following major surgery. Most commonly seen in elderly patients, it has direct links to increased long-term morbidity and reduced quality of life. Its incidence following open and endovascular abdominal and thoracic aneurysm surgery is unclear. The purpose of this systematic review is to collate available evidence for POCD following abdominal and thoracic aortic surgery, and to identify continuing controversies directing future research...
November 4, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27808035/delirium-is-seen-in-one-third-of-patients-in-an-acute-hospital-setting-identification-pharmacologic-and-non-pharmacologic-treatment-is-inadequate
#8
Jens Nørbæk, Elsebeth Glipstrup
INTRODUCTION: Delirium is an organically caused acute dysfunction of the brain associated with increased morbidity, mortality, cost of care and poor cognitive recovery. METHOD: This point prevalence study of delirium was conducted at Hvidovre Hospital, Copenhagen, Denmark at two separate occasions. Patients were examined with the Brief Confusion Assessment Method (bCAM) in both, but in the second survey bCAM was supplemented with a psychiatric assessment using the Diagnostic and Statistical Manual of Mental Disorders, fourth ed...
November 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27787611/delirium-is-a-strong-predictor-of-mortality-in-patients-receiving-non-invasive-positive-pressure-ventilation
#9
Ka-Yee Chan, Linda S L Cheng, Ivan W C Mak, Shu-Wah Ng, Michael G C Yiu, Chung-Ming Chu
PURPOSE: Non-invasive positive pressure ventilation (NIPPV) has gained popularity over the years in the treatment of acute respiratory failure (ARF). Preliminary evidence suggests that delirium is an important factor contributing to NIPPV failure and death. This study was conducted to evaluate delirium and other associated factors of deaths in patients with ARF requiring the use of NIPPV. METHODS: A prospective observational study was conducted in a specialised NIPPV unit...
October 27, 2016: Lung
https://www.readbyqxmd.com/read/27785357/perioperative-regional-anaesthesia-and-postoperative-longer-term-outcomes
#10
REVIEW
Jan Jakobsson, Mark Z Johnson
Regional anaesthesia provides effective anaesthesia and analgesia in the perioperative setting. Central neuraxial blocks-that is, spinal and epidural blocks-are well established as an alternative or adjunct to general anaesthesia. Peripheral blocks may be used as part of multimodal anaesthesia/analgesia in perioperative practice, reducing the need for opioid analgesics and enhancing early recovery. Furthermore, regional anaesthesia has increased in popularity and may be done with improved ease and safety with the introduction of ultrasound-guided techniques...
2016: F1000Research
https://www.readbyqxmd.com/read/27761759/caring-for-critically-ill-oldest-old-patients-a-clinical-review
#11
Nicola Vargas, Loredana Tibullo, Emanuela Landi, Giovanni Carifi, Alfonso Pirone, Antonio Pippo, Immacolata Alviggi, Renato Tizzano, Elisa Salsano, Francesco Di Grezia, Maria Vargas
Despite technological advances, the mortality rate for critically ill oldest old patients remains high. The intensive caring should be able to combine technology and a deep humanity considering that the patients are living the last part of their lives. In addition to the traditional goals of ICU of reducing morbidity and mortality, of maintaining organ functions and restoring health, caring for seriously oldest old patients should take into account their end-of-life preferences, the advance or proxy directives if available, the prognosis, the communication, their life expectancy and the impact of multimorbidity...
October 19, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27749567/morbidity-and-mortality-predictivity-of-nutritional-assessment-tools-in-the-postoperative-care-unit
#12
Şule Özbilgin, Volkan Hancı, Dilek Ömür, Mücahit Özbilgin, Mine Tosun, Serhan Yurtlu, Semih Küçükgüçlü, Atalay Arkan
The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27729950/prevention-of-post-operative-delirium-in-the-elderly-using-pharmacological-agents
#13
Patrice Tremblay, Susan Gold
INTRODUCTION: Post-operative delirium (POD) is a serious surgical complication that can cause significant morbidity and mortality. It is associated with prolonged hospital stay, delayed admission to rehabilitation programs, persistent cognitive deficits, marked health-care costs, and more. The pathophysiology is multi-factorial and not completely understood, which complicates the optimal management. Non-pharmacological measures have been the mainstay of treatment, but there has been an ongoing interest in the medical literature on the prevention of post-operative delirium using medications...
September 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27707832/readmissions-and-mortality-in-delirious-versus-non-delirious-octogenarian-patients-after-aortic-valve-therapy-a-prospective-cohort-study
#14
Leslie S P Eide, Anette H Ranhoff, Bengt Fridlund, Rune Haaverstad, Karl Ove Hufthammer, Karel K J Kuiper, Jan Erik Nordrehaug, Tone M Norekvål
OBJECTIVES: To determine whether postoperative delirium predicts first-time readmissions and mortality in octogenarian patients within 180 days after aortic valve therapy with surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI), and to determine the most common diagnoses at readmission. DESIGN: Prospective cohort study of patients undergoing elective SAVR or TAVI. SETTING: Tertiary university hospital that performs all SAVRs and TAVIs in Western Norway...
October 5, 2016: BMJ Open
https://www.readbyqxmd.com/read/27695303/geriatric-falls-in-the-context-of-a-hospital-fall-prevention-program-delirium-low-body-mass-index-and-other-risk-factors
#15
Katarzyna Mazur, Krzysztof Wilczyński, Jan Szewieczek
BACKGROUND: Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. OBJECTIVE: Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. METHODS: Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27692030/frailty-and-adverse-outcomes-impact-of-multiple-bed-moves-for-older-inpatients
#16
Champa Ranasinghe, Aisling Fleury, Nancye M Peel, Ruth E Hubbard
BACKGROUND: A consequence of pressure on hospitals to accommodate care needs of older patients is "boarding" or out-lying from their home ward. This may have greater adverse effects on older inpatients who are frail. METHODS: A retrospective matched cohort study was conducted in an outer metropolitan general hospital. Randomly selected patients hospitalized between July 2012 and June 2013 under the care of an Older Person Evaluation Review and Assessment (OPERA) team (n = 300) were age and sex matched with patients under the care of general physicians (n = 300)...
October 3, 2016: International Psychogeriatrics
https://www.readbyqxmd.com/read/27687177/safety-of-simultaneous-bilateral-total-knee-arthroplasty-using-an-extramedullary-referencing-system-results-from-2098-consecutive-patients
#17
Jai Gon Seo, Sang Min Kim, Jung Min Shin, Youngjun Kim, Byung Hoon Lee
INTRODUCTION: Simultaneous bilateral total knee arthroplasty (TKA) has been associated with a high risk of morbidity and mortality. The orthopedic surgeon must, therefore, decide whether bilateral simultaneous TKA is a safe operation to perform and endeavor to decrease the risk of serious complications or even death. METHODS: This retrospective review included 2098 consecutive patients who underwent bilateral simultaneous TKAs by the protocol used in our institution, including the use of extramedullary instruments to minimize medullary canal invasion and overlapping procedures for both knees to decrease operation time...
November 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27676278/the-confused-oncologic-patient-a-rational-clinical-approach
#18
Craig Nolan, Lisa M DeAngelis
PURPOSE OF REVIEW: The purpose of this review is to provide a practical clinical approach to confusion in the patient with cancer. Confusion in the cancer population has a broader differential diagnosis than in the general medical population. The clinician must consider the usual differential diagnoses as well as causes unique to the cancer patient including direct complications from the cancer and indirect complications related to cancer treatment. RECENT FINDINGS: In the recent age of precision medicine, the oncologist now utilizes the genomic profile of both the patient and the tumor to provide advanced biologic therapies including targeted anticancer drugs, antiangiogenic agents, and immunotherapy...
December 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27665997/agitation-delirium-and-cognitive-outcomes-in-intracerebral-hemorrhage
#19
Lisa J Rosenthal, Brandon A Francis, Jennifer L Beaumont, David Cella, Michael D Berman, Matthew B Maas, Eric M Liotta, Robert Askew, Andrew M Naidech
BACKGROUND: Delirium predicts higher long-term cognitive morbidity. We previously identified a cohort of patients with spontaneous intracerebral hemorrhage and delirium and found worse outcomes in health-related quality of life (HRQoL) in the domain of cognitive function. OBJECTIVE: We tested the hypothesis that agitation would have additional prognostic significance on later cognitive function HRQoL. METHODS: Prospective identification of 174 patients with acute intracerebral hemorrhage, measuring stroke severity, agitation, and delirium, with a standardized protocol and measures...
August 5, 2016: Psychosomatics
https://www.readbyqxmd.com/read/27633985/systemic-tnf-%C3%AE-produces-acute-cognitive-dysfunction-and-exaggerated-sickness-behavior-when-superimposed-upon-progressive-neurodegeneration
#20
Edel Hennessy, Shane Gormley, Ana Belen Lopez-Rodriguez, Caoimhe Murray, Carol Murray, Colm Cunningham
Inflammation influences chronic neurodegeneration but its precise roles are not yet clear. Systemic inflammation caused by infection, trauma or co-morbidity can alter the brain's inflammatory status, produce acute cognitive impairments, such as delirium, and drive new pathology and accelerated decline. Consistent with this, elevated systemic TNF-α is associated with more rapid cognitive decline over 6 months in Alzheimer's disease patients. In the current study we challenged normal animals and those with existing progressive neurodegeneration (ME7 prion disease) with TNF-α (i...
September 12, 2016: Brain, Behavior, and Immunity
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