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Delirium Morbidity

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https://www.readbyqxmd.com/read/29771710/cognitive-decline-after-delirium-in-patients-undergoing-cardiac-surgery
#1
Charles H Brown, Julia Probert, Ryan Healy, Michelle Parish, Yohei Nomura, Atsushi Yamaguchi, Jing Tian, Kenton Zehr, Kaushik Mandal, Vidyulata Kamath, Karin J Neufeld, Charles W Hogue
BACKGROUND: Delirium is common after cardiac surgery and has been associated with morbidity, mortality, and cognitive decline. However, there are conflicting reports on the magnitude, trajectory, and domains of cognitive change that might be affected. The authors hypothesized that patients with delirium would experience greater cognitive decline at 1 month and 1 yr after cardiac surgery compared to those without delirium. METHODS: Patients who underwent coronary artery bypass and/or valve surgery with cardiopulmonary bypass were eligible for this cohort study...
May 16, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29746650/age-dependent-morbidity-and-mortality-outcomes-after-surgical-aortic-valve-replacement
#2
Amjad I Hussain, Andreas Auensen, Cathrine Brunborg, Jan Otto Beitnes, Lars Gullestad, Kjell I Pettersen
OBJECTIVES: This study addressed the assumption of increased morbidity and mortality after surgical aortic valve replacement in patients older than 80 years with severe aortic stenosis. METHODS: This prospective study was performed in consecutive patients referred for aortic valve replacement. The age-dependent change in cognitive and physical function, quality of life and rehospitalization and complication rates during the following year and 5-year all-cause mortality were documented...
May 9, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29743884/exploring-postoperative-cognitive-dysfunction-and-delirium-in-noncardiac-surgery-using-mri-a-systematic-review
#3
REVIEW
Chenxi Huang, Johan Mårtensson, Ismail Gögenur, Mohammad Sohail Asghar
Surgical patients are at high risk of developing postoperative cognitive dysfunction (POCD) and postoperative delirium (POD). POCD and POD are associated with increased morbidity and mortality and worsening functional outcomes leading to severe socioeconomic consequences for the patient and the society in general. Magnetic resonance imaging (MRI) offers a unique opportunity to study the anatomy and function of the brain. MRI thus plays an important role in elucidating the neuronal component of POCD and POD...
2018: Neural Plasticity
https://www.readbyqxmd.com/read/29742583/adjunct-ketamine-use-in-the-management-of-severe-ethanol-withdrawal
#4
Anthony F Pizon, Michael J Lynch, Neal J Benedict, Joseph H Yanta, Adam Frisch, Nathan B Menke, Greg S Swartzentruber, Andrew M King, Michael G Abesamis, Sandra L Kane-Gill
OBJECTIVES: Ketamine offers a plausible mechanism with favorable kinetics in treatment of severe ethanol withdrawal. The purpose of this study is to determine if a treatment guideline using an adjunctive ketamine infusion improves outcomes in patients suffering from severe ethanol withdrawal. DESIGN: Retrospective observational cohort study. SETTING: Academic tertiary care hospital. PATIENTS: Patients admitted to the ICU and diagnosed with delirium tremens by Diagnostic and Statistical Manual of Mental Disorders V criteria...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29742533/delirium-screening-and-management-in-inpatient-rehabilitation-facilities
#5
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/29729237/melatonin-and-sleep-in-preventing-hospitalized-delirium-a-randomized-clinical-trial-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2
#6
Stuti J Jaiswal, Thomas J McCarthy, Nathan E Wineinger, Dae Y Kang, Janet Song, Solana Garcia, Christoffel J van Niekerk, Cathy Y Lu, Melissa Loeks, Robert L Owens
PURPOSE: Studies suggest that melatonin may prevent delirium, a condition of acute brain dysfunction occurring in 20-30% of hospitalized older adults that is associated with increased morbidity and mortality. We examined the effect of melatonin on delirium prevention in hospitalized older adults while measuring sleep parameters as a possible underlying mechanism. METHODS: This was a randomized clinical trial measuring the impact of 3 mg of melatonin nightly on incident delirium and both objective and subjective sleep in inpatients age ≥ 65, admitted to Internal Medicine wards (non-ICU)...
May 2, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29726428/effect-of-nursing-assessment-on-predictive-delirium-models-in-hospitalised-patients
#7
Sai P K Veeranki, Dieter Hayn, Diether Kramer, Stefanie Jauk, Günter Schreier
Delirium is an acute neuropsychiatric syndrome which is common in elderly patients during their hospitalisation and is associated with an increased mortality and morbidity. Since delirium is a) often underdiagnosed and b) preventable if early signs are detected,igh expectations are set in delirium risk assessment during hospital admission. In our latest studies, we showed that delirium prediction using machine learning algorithms is possible based on the patients' health history. The aim of this study is to compare the influence of nursing assessment data on prediction models with clinical and demographic data...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29717845/assessment-and-management-of-older-patients-with-delirium-in-acute-settings
#8
Martha Dixon
This article aims to assist nurses and nursing students to consider the presentation of delirium in older patients and the resulting assessment and nursing interventions required. It considers the three types of delirium: hyperactive, hypoactive and mixed. It also discusses potential causes of delirium. Older patients are at increased risk of delirium due to factors such as cognitive impairment, co-morbidities and acute illness. Nurses should be confident in the use of the 4AT score to assess patients with delirium...
May 2, 2018: Nursing Older People
https://www.readbyqxmd.com/read/29710871/characteristics-and-management-of-community-acquired-pneumonia-in-the-era-of-global-aging
#9
REVIEW
Catia Cillóniz, Diana Rodríguez-Hurtado, Antoni Torres
Community-acquired pneumonia (CAP) can occur at any time of life, but its incidence and risk of death are linked to increasing age. CAP in the elderly is a major health problem associated with high rates of readmission, morbidity, and mortality. Since the clinical presentation of pneumonia in the elderly may be atypical, clinicians should suspect pneumonia in older patients presenting symptoms such as falls and altered mental status, fatigue, lethargy, delirium, anorexia, in order to avoid the complications associated with delayed diagnosis and therapy...
April 30, 2018: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29699467/nonpharmacologic-and-medication-minimization-strategies-for-the-prevention-and-treatment-of-icu-delirium-a-narrative-review
#10
Gregory J Blair, Talha Mehmood, Mona Rudnick, Ware G Kuschner, Juliana Barr
Delirium is a multifactorial entity, and its understanding continues to evolve. Delirium has been associated with increased morbidity, mortality, length of stay, and cost for hospitalized patients, especially for patients in the intensive care unit (ICU). Recent literature on delirium focuses on specific pharmacologic risk factors and pharmacologic interventions to minimize course and severity of delirium. While medication management clearly plays a role in delirium management, there are a variety of nonpharmacologic interventions, pharmacologic minimization strategies, and protocols that have been recently described...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29623158/undiagnosed-partial-ornithine-transcarbamylase-deficiency-presenting-postoperatively-as-agitated-delirium
#11
E D Goldstein, R Cannistraro, P S Atwal, J F Meschia
Partial ornithine transcarbamylase deficiency (pOTCD), an enzymatic defect within the urea cycle, is an increasingly recognized etiology for hyperammonemia of unclear source following a stressor within female adults. Here we present a case of newly diagnosed pOTCD following a systemic stressor and prolonged hospitalization course. From a neurological perspective, prompt recognition provided the patient with a swift and near complete recovery. We briefly review the pertinent literature pertaining to this genetically based condition including historical context and current therapeutic approaches...
April 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29614992/a-research-study-review-of-effectiveness-of-treatments-for-psychiatric-conditions-common-to-end-stage-cancer-patients-needs-assessment-for-future-research-and-an-impassioned-plea
#12
Ralph J Johnson
BACKGROUND: Rates of psychiatric conditions common to end-stage cancer patients (delirium, depression, anxiety disorders) remain unchanged. However, patient numbers have increased as the population has aged; indeed, cancer is a chief cause of mortality and morbidity in older populations. Effectiveness of psychiatric interventions and research to evaluate, inform, and improve interventions is critical to these patients' care. This article's intent is to report results from a recent review study on the effectiveness of interventions for psychiatric conditions common to end-stage cancer patients; the review study assessed the state of research regarding treatment effectiveness...
April 3, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29573769/-delirium-the-7th-vital-sign
#13
REVIEW
Rita Prayce, Filipa Quaresma, Isabel Galriça Neto
INTRODUCTION: Delirium is an acute, transient and fluctuating neuropsychiatric syndrome that is common in medical wards, particularly in the geriatric and palliative care population. MATERIAL AND METHODS: We present a brief literature review of the definition, pathophysiology, aetiology, diagnosis, prevention and treatment of delirium and its social and economic impact. RESULTS AND DISCUSSION: Delirium is under-recognized, especially by health professionals, and is associated with higher morbidity, mortality and economic burden...
January 31, 2018: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/29567515/in-hospital-complication-rate-following-microendoscopic-versus-open-lumbar-laminectomy-a-propensity-score-matched-analysis
#14
Takeshi Oichi, Yasushi Oshima, Hirotaka Chikuda, Junichi Ohya, Hiroki Matsui, Kiyohide Fushimi, Sakae Tanaka, Hideo Yasunaga
BACKGROUND CONTEXT: The incidence of postoperative complications after microendoscopic laminectomy (MEL) has not been compared with that of open laminectomy in a large study, so it is not clear whether MEL is a safer procedure. PURPOSE: To compare postoperative morbidity and mortality following lumbar laminectomy between patients treated with MEL and open laminectomy. STUDY DESIGN: Retrospective cohort study with propensity score-matched analysis...
March 19, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29529166/development-of-a-dynamic-multi-protein-signature-of-postoperative-delirium
#15
Sarinnapha M Vasunilashorn, Long H Ngo, Noel Y Chan, Wenxiao Zhou, Simon T Dillon, Hasan H Otu, Sharon K Inouye, Iris Wyrobnik, George A Kuchel, Janet E McElhaney, Zhongcong Xie, David C Alsop, Richard N Jones, Towia A Libermann, Edward R Marcantonio
Background: Delirium is common, morbid, and costly, yet its biology is poorly understood. We aimed to develop a multi-protein signature of delirium by identifying proteins associated with delirium from unbiased proteomics and combining them with delirium biomarkers identified in our prior work (interleukin [IL]-6 and IL-2). Methods: We used the Successful Aging after Elective Surgery (SAGES) Study of adults age ≥70 undergoing major non-cardiac surgery (N=560; 24% delirium)...
February 24, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29528738/tackling-delirium-a-crucial-target-for-improving-clinical-outcomes
#16
Hanieh Asadi, Daniel Martin, Helen McKenna
Delirium is a common and debilitating syndrome in hospitalized patients, and its impact on mortality, morbidity and duration of hospital admission is increasingly apparent. Delirium is a complex phenomenon, for which there is no specific treatment, but research over the last decade has revealed contributing factors, many of which are modifiable, and preventative strategies have demonstrated benefit. This review highlights the importance of reducing the impact of delirium on hospitalized patients, and summarizes the current evidence for strategies to achieve this...
March 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29511014/protocol-for-a-single-centre-prospective-observational-study-of-postoperative-delirium-following-total-joint-arthroplasties-among-south-east-asians
#17
Hairil Rizal Abdullah, Sapphire RouXi Tan, Si Jia Lee, Hamid Rahmatullah Bin Abd Razak, Rachel Huiqi Seet, Hao Ying, Ervin Sethi, Eileen Yilin Sim
INTRODUCTION: Postoperative delirium is a serious and common complication in older adults following total joint arthroplasties (TJA). It is associated with increased risk of postoperative complications, mortality, length of hospital stay and postdischarge institutionalisation. Thus, it has a negative impact on the health-related quality of life of the patient and poses a large economic burden. This study aims to characterise the incidence of postoperative delirium following TJA in the South East Asian population and investigate any risk factors or associated outcomes...
March 6, 2018: BMJ Open
https://www.readbyqxmd.com/read/29488398/cervical-spine-immobilisation-in-the-elderly-a-literature-review
#18
George Edward Peck, David James Heming Shipway, Kevin Tsang, Michael Fertleman
Developed populations are ageing rapidly and by 2040, approximately 1 in 4 adults will be over 65 years of age. This is resulting in higher incidence of traumatic injury in older patients. Cognitive and physical comorbidities in this group can pose significant challenges. Due to mechanisms of injury and pre-existing degenerative spinal disease, cervical spine fractures are particularly prevalent in elderly patients. These are associated with significant morbidity and mortality. In this literature review we examine current evidence surrounding the use of cervical spine immobilisation in elderly patients in the pre-hospital and emergency department setting and also as a treatment option for cervical spine fractures...
February 28, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29485961/cerebral-function-and-perfusion-during-cardiopulmonary-bypass-a-plea-for-a-multimodal-monitoring-approach
#19
Marcus Thudium, Ingo Heinze, Richard K Ellerkmann, Tobias Hilbert
BACKGROUND: Postoperative neurological injury still represents a major cause of morbidity after cardiac surgery. Our objective was to compare the limits as well as advantages of routine monitoring tools for the detection of cerebral function and perfusion deficits during cardiopulmonary bypass in a daily clinical setting. METHODS: Adult patients undergoing elective cardiac surgery with use of cardiopulmonary bypass were included. Patients received monitoring comprising Bispectral Index (BIS), Near Infrared Spectroscopy (NIRS) and assessment of middle cerebral artery flow velocity (MCAV) using transcranial Doppler (TCD) sonography...
January 31, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29462362/postoperative-delirium-in-glioblastoma-patients-risk-factors-and-prognostic-implications
#20
Patrick M Flanigan, Arman Jahangiri, Drew Weinstein, Fara Dayani, Ankush Chandra, Ishan Kanungo, Sarah Choi, Sujatha Sankaran, Annette M Molinaro, Michael W McDermott, Mitchel S Berger, Manish K Aghi
BACKGROUND: Delirium is a postoperative neurological morbidity in glioblastoma whose risk factors, incidence, and prognostic implications remain undefined. OBJECTIVE: To develop an algorithm using preoperative factors to predict postoperative delirium. METHODS: Retrospective analysis of 554 consecutive patients (mean age = 61.5 yr; 42% female) undergoing first glioblastoma procedure at our institution 2005 to 2011. RESULTS: Postoperative delirium occurred in 7% of patients (n = 38)...
February 16, 2018: Neurosurgery
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