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Delirium Morbidity

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https://www.readbyqxmd.com/read/28905076/-life-after-ards
#1
REVIEW
B Sensen, S Braune, G de Heer, T Bein, S Kluge
Patients who survive acute respiratory distress syndrome (ARDS) often suffer from long-term physical and psychological sequelae. Lung function is commonly only mildly reduced, whereas general physical activity and walking distance are often compromised. Most markedly, these patients have a high incidence of depression, anxiety, and posttraumatic stress disorder. The rate of cognitive dysfunction is as high as 70-100% at the time of hospital discharge, and remains 46-80% and 20% one year and five years post discharge, respectively...
September 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28904548/effect-of-family-patient-communication-on-the-incidence-of-delirium-in-hospitalized-patients-in-cardiovascular-surgery-icu
#2
Maryam Eghbali-Babadi, Nasrin Shokrollahi, Tayebe Mehrabi
BACKGROUND: Cardiovascular diseases are the most important causes of morbidity and mortality in the world, and cardiac surgery is one of the treatments that have complication for patients. One of the most important current psychological complications after cardiac surgery is delirium. For its prevention and treatment, considerable attention should be paid to the role of family. This study has been conducted for assessing the effect of the relationship between the family and patient on the incidence of delirium in hospitalized patients in cardiovascular surgery intensive care unit (ICU) of Isfahan Shahid Chamran hospital...
July 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28894686/risk-factors-for-delirium-after-spine-surgery-in-extremely-elderly-patients-aged-80-years-or-older-and-review-of-the-literature-japan-association-of-spine-surgeons-with-ambition-multicenter-study
#3
Kazuyoshi Kobayashi, Shiro Imagama, Kei Ando, Naoki Ishiguro, Masaomi Yamashita, Yawara Eguchi, Morio Matsumoto, Ken Ishii, Tomohiro Hikata, Shoji Seki, Hidetomi Terai, Akinobu Suzuki, Koji Tamai, Masaaki Aramomi, Tetsuhiro Ishikawa, Atsushi Kimura, Hirokazu Inoue, Gen Inoue, Masayuki Miyagi, Wataru Saito, Kei Yamada, Michio Hongo, Yuji Matsuoka, Hidekazu Suzuki, Atsushi Nakano, Kazuyuki Watanabe, Hirotaka Chikuda, Junichi Ohya, Yasuchika Aoki, Masayuki Shimizu, Toshimasa Futatsugi, Keijiro Mukaiyama, Masaichi Hasegawa, Katsuhito Kiyasu, Haku Iizuka, Yoichi Iizuka, Ryoichi Kobayashi, Kotaro Nishida, Kenichiro Kakutani, Hideaki Nakajima, Hideki Murakami, Satoru Demura, Satoshi Kato, Katsuhito Yoshioka, Takashi Namikawa, Kei Watanabe, Kazuyoshi Nakanishi, Yukihiro Nakagawa, Mitsunori Yoshimoto, Hiroyasu Fujiwara, Norihiro Nishida, Yasuaki Imajo, Masashi Yamazaki, Masataka Sakane, Tetsuya Abe, Kengo Fujii, Takashi Kaito, Takeo Furuya, Sumihisa Orita, Seiji Ohtori
STUDY DESIGN: Retrospective database analysis. OBJECTIVE: Spine surgeries in elderly patients have increased in recent years due to aging of society and recent advances in surgical techniques, and postoperative complications have become more of a concern. Postoperative delirium is a common complication in elderly patients that impairs recovery and increases morbidity and mortality. The objective of the study was to analyze postoperative delirium associated with spine surgery in patients aged 80 years or older with cervical, thoracic, and lumbar lesions...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28885286/predicting-perioperative-complications-in-adult-spinal-deformity-surgery-using-a-simple-sliding-scale
#4
Go Yoshida, Tomohiko Hasegawa, Yu Yamato, Sho Kobayashi, Shin Oe, Tomohiro Banno, Yuuki Mihara, Hideyuki Arima, Hiroki Ushirozako, Tatsuya Yasuda, Daisuke Togawa, Yukihiro Matsuyama
STUDY DESIGN: Retrospective database study OBJECTIVE.: To develop and validate a sliding scale for predicting perioperative complications associated with ASD surgery. SUMMARY OF BACKGROUND DATA: ASD surgery can have high perioperative complication rates, which is associated with increased morbidity and mortality. METHODS: Data on consecutive ASD patients undergoing posterior corrective surgery over a six-year interval were collected from a prospective database...
September 6, 2017: Spine
https://www.readbyqxmd.com/read/28864877/clinical-assessment-and-management-of-delirium-in-the-palliative-care-setting
#5
Shirley Harvey Bush, Sallyanne Tierney, Peter Gerard Lawlor
Delirium is a neurocognitive syndrome arising from acute global brain dysfunction, and is prevalent in up to 42% of patients admitted to palliative care inpatient units. The symptoms of delirium and its associated communicative impediment invariably generate high levels of patient and family distress. Furthermore, delirium is associated with significant patient morbidity and increased mortality in many patient populations, especially palliative care where refractory delirium is common in the dying phase. As the clinical diagnosis of delirium is frequently missed by the healthcare team, the case for regular screening is arguably very compelling...
September 1, 2017: Drugs
https://www.readbyqxmd.com/read/28854401/post-icu-psychological-morbidity-in-very-long-icu-stay-patients-with-ards-and-delirium
#6
Farshid R Bashar, Amir Vahedian-Azimi, Mohammadreza Hajiesmaeili, Mahmood Salesi, Behrooz Farzanegan, Seyedpouzhia Shojaei, Reza Goharani, Seyed J Madani, Kivan G Moghaddam, Sevak Hatamian, Hosseinali J Moghaddam, Seyed M M Mosavinasab, Elamin M Elamin, Andrew C Miller
PURPOSE: We investigated the impact of delirium on illness severity, psychological state, and memory in acute respiratory distress syndrome patients with very long ICU stay. MATERIALS AND METHODS: Prospective cohort study in the medical-surgical ICUs of 2 teaching hospitals. Very long ICU stay (>75days) and prolonged delirium (≥40days) thresholds were determined by ROC analysis. Subjects were ≥18years, full-code, and provided informed consent. Illness severity was assessed using Acute Physiology and Chronic Health Evaluation IV, Simplified Acute Physiology Score-3, and Sequential Organ Failure Assessment scores...
August 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28836711/delirium-tremens-and-alcohol-withdrawal-nationally-in-the-veterans-health-administration
#7
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...
August 24, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28827863/reasons-for-referral-and-diagnostic-concordance-between-physicians-surgeons-and-the-consultation-liaison-psychiatry-team-an-exploratory-study-from-a-tertiary-care-hospital-in-india
#8
Sandeep Grover, Swapnajeet Sahoo, Shivali Aggarwal, Shallu Dhiman, Subho Chakrabarti, Ajit Avasthi
BACKGROUND: Very few studies have evaluated the reasons for referral to consultation-liaison (CL) psychiatry teams. AIM: This study aimed to evaluate the psychiatric morbidity pattern, reasons for referral and diagnostic concordance between physicians/surgeons and the CL psychiatry team. MATERIALS AND METHODS: Two hundred and nineteen psychiatric referrals made to the CL psychiatry team were assessed for reason for referral and diagnostic concordance in terms of reason of referral and psychiatric diagnosis made by the CL psychiatry team...
April 2017: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/28801871/pediatric-delirium-evaluation-management-and-special-considerations
#9
REVIEW
Nasuh Malas, Khyati Brahmbhatt, Cristin McDermott, Allanceson Smith, Roberto Ortiz-Aguayo, Susan Turkel
Delirium describes a syndrome of acute brain dysfunction with severe consequences on patient outcomes, medical cost, morbidity, and mortality. It represents a final common pathway of numerous pathophysiologic disturbances disrupting cerebral homeostasis. The diagnosis is predicated on recognition of the clinical features of the syndrome through ongoing clinical assessment. Early identification can be aided by routine screening, particularly in high-risk populations. Evaluation and management are continuous and simultaneous processes involving a multidisciplinary care team including child psychiatry consultation...
August 12, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28797379/delirium
#10
REVIEW
Belinda Setters, Laurence M Solberg
Delirium is a common, often underdiagnosed, geriatric syndrome characterized by an acute change in attention and consciousness. As a neuropsychiatric disorder with an underlying organic cause, delirium has been considered a diagnosis reserved for the hospital setting. However, delirium is known to occur as both an acute and subacute condition that carries significant morbidity and mortality. Combined with its association with dementia and aging, this makes delirium an important topic for primary care providers to become more familiar with as they are tasked with caring for an aging population...
September 2017: Primary Care
https://www.readbyqxmd.com/read/28776209/potentially-inappropriate-medications-and-the-time-to-full-functional-recovery-after-hip-fracture
#11
Andrea Iaboni, Kerri Rawson, Craig Burkett, Eric J Lenze, Alastair J Flint
BACKGROUND: Older adults after hip fracture are at increased risk of being prescribed potentially inappropriate medications, and may be particularly vulnerable to their adverse effects. OBJECTIVE: The objective of this study was to examine the association of potentially inappropriate medication use with the time to full functional recovery within 1 year of hip fracture repair. METHODS: We conducted a secondary analysis of a prospective longitudinal study of eight hospitals in St...
August 3, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28759544/minimally-invasive-access-aortic-arch-surgery
#12
Nora Goebel, Daniel Bonte, Schahriar Salehi-Gilani, Ragi Nagib, Adrian Ursulescu, Ulrich F W Franke
OBJECTIVE: Median sternotomy is still the standard approach for aortic arch surgery. Minimally invasive techniques promise faster recovery with shorter hospital stay due to thoracic stability, reduced pain, and superior cosmetic results. However, safety is a concern in complex aortic surgery. The aim of our study was to demonstrate that aortic arch surgery via partial upper sternotomy is viable, safe, and equivalent to standard procedure both in terms of its safety and the risk of major adverse cardiac and cerebrovascular events...
July 28, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28754544/consensus-report-by-pediatric-acute-lung-injury-and-sepsis-investigators-and-pediatric-blood-and-marrow-transplantation-consortium-joint-working-committees-supportive-care-guidelines-for-management-of-veno-occlusive-disease-in-children-and-adolescents-part
#13
REVIEW
Rajinder P S Bajwa, Kris M Mahadeo, Benjamin H Taragin, Christopher C Dvorak, Jennifer McArthur, Asumthia Jeyapalan, Christine N Duncan, Robert Tamburro, Alison Gehred, Leslie Lehman, Paul Richardson, Jeffery J Auletta, Ann E Woolfrey
Veno-occlusive disease (VOD) is a common and potentially fatal complication in children undergoing hematopoietic cell transplantation (HCT). It occurs in about one-third of all patients undergoing transplantation and is fatal in 50% of patients with severe disease. Early intervention and specific treatment with defibrotide are associated with improved outcomes. However, there is a lack of supportive care guidelines for management of the multiorgan dysfunction seen in most cases. There is high variability in the management of VOD, which may contribute to the increased morbidity and mortality...
July 25, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28753076/the-burden-of-psychosocial-morbidity-related-to-cancer-patient-and-family-issues
#14
Rosangela Caruso, Mara Giulia Nanni, Michelle B Riba, Silvana Sabato, Luigi Grassi
With cancer incidence increasing over time, attention to the burden of related psychiatric and psychosocial consequences of the disease and treatment is a major topic for both cancer patients and their caregivers. Among cancer patients, psychiatric (e.g. adjustment, anxiety, depressive disorders) and neuropsychiatric disorders (e.g. cognitive disorders secondary to treatment, delirium) have been shown to affect an average of 30-35% patients, with differences according to stage and type of cancer. Also other psychosocial syndromes (e...
July 28, 2017: International Review of Psychiatry
https://www.readbyqxmd.com/read/28743315/tight-intra-operative-blood-pressure-control-versus-standard-care-for-patients-undergoing-hip-fracture-repair-hip-fracture-intervention-study-for-prevention-of-hypotension-hip-hop-trial-study-protocol-for-a-randomised-controlled-trial
#15
Iain Keith Moppett, Stuart White, Richard Griffiths, Donal Buggy
BACKGROUND: Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control...
July 25, 2017: Trials
https://www.readbyqxmd.com/read/28742701/postoperative-delirium-as-a-target-for-surgical-quality-improvement
#16
Julia R Berian, Lynn Zhou, Marcia M Russell, Melissa A Hornor, Mark E Cohen, Emily Finlayson, Clifford Y Ko, Ronnie A Rosenthal, Thomas N Robinson
OBJECTIVE: To explore hospital-level variation in postoperative delirium using a multi-institutional data source. BACKGROUND: Postoperative delirium is closely related to serious morbidity, disability, and death in older adults. Yet, surgeons and hospitals rarely measure delirium rates, which limits quality improvement efforts. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Geriatric Surgery Pilot (2014 to 2015) collects geriatric-specific variables, including postoperative delirium using a standardized definition...
July 24, 2017: Annals of Surgery
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
#17
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/28681427/delirium-after-fast-track-hip-and-knee-arthroplasty-a-cohort-study-of-6331-elderly-patients
#18
P B Petersen, C C Jørgensen, H Kehlet
BACKGROUND: Postoperative delirium (PD) is a well-known complication among elderly surgical patients and associated with increased morbidity, mortality and length of stay (LOS). In elective orthopedic surgery, including hip and knee arthroplasty (THA/TKA), most studies report incidences between 5% and 10%. The multimodal optimization of perioperative care (fast-track) aims to enhance recovery and reduce morbidity and LOS, but limited data are available on the effect on PD. Consequently, the study investigated signs of PD associated with LOS > 4 days...
August 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28666930/delirium-following-transcatheter-aortic-valve-replacement-national-inpatient-sample-analysis
#19
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/28638240/perioperative-management-of-neurological-conditions
#20
REVIEW
Manjeet Singh Dhallu, Ahmed Baiomi, Madhavi Biyyam, Sridhar Chilimuri
Perioperative care of the patients with neurological diseases can be challenging. Most important consideration is the management and understanding of pathophysiology of these disorders and evaluation of new neurological changes that occur perioperatively. Perioperative generally refers to 3 phases of surgery: preoperative, intraoperative, and postoperative. We have tried to address few commonly encountered neurological conditions in clinical practice, such as delirium, stroke, epilepsy, myasthenia gravis, and Parkinson disease...
2017: Health Services Insights
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