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21. High C-Reactive Protein Predicts Delirium Incidence, Duration, and Feature Severity After Major Noncardiac Surgery. Full Text available with Trip Pro

. Delirium was assessed from Confusion Assessment Method (CAM) interviews and chart review. Delirium duration was measured according to number of hospital days with delirium. Delirium feature severity was defined as the sum of CAM-Severity (CAM-S) scores on all postoperative hospital days. Generalized linear models were used to examine independent associations between CRP (preoperatively and POD2 separately) and delirium incidence, duration, and feature severity; prolonged hospital length of stay (LOS (...) , >5 days); and discharge disposition.Postoperative delirium occurred in 24% of participants, 12% had 2 or more delirium days, and the mean ± standard deviation sum CAM-S was 9.3 ± 11.4. After adjusting for age, sex, surgery type, anesthesia route, medical comorbidities, and postoperative infectious complications, participants with preoperative CRP of 3 mg/L or greater had a risk of delirium that was 1.5 times as great (95% confidence interval (CI) = 1.1-2.1) as that of those with CRP less than 3

2017 Journal of the American Geriatrics Society

22. A Novel Stress-Diathesis Model to Predict Risk of Post-operative Delirium: Implications for Intra-operative Management Full Text available with Trip Pro

participants to a rigorously controlled CO2 stimulus. During surgery the patient had hemodynamics and end-tidal gases downloaded at 0.5 hz. Post-operatively, the presence of POD and POD severity was comprehensively assessed using the Confusion Assessment Measure -Severity (CAM-S) scoring instrument on days 0 (surgery) through post-operative day 5, and patients were followed up at least 1 month post-operatively. Results: Six of 12 patients had no evidence of POD (non-POD). Three patients had POD and 3 had (...) clinically significant confusional states (referred as subthreshold POD; ST-POD) (score ≥ 5/19 on the CAM-S). Average severity for delirium was 1.3 in the non-POD group, 3.2 in ST-POD, and 6.1 in POD (F-statistic = 15.4, p < 0.001). Depressive symptoms, and cognitive measures of semantic fluency and executive functioning/processing speed were significantly associated with POD. Second level analysis revealed an increased inverse BOLD responsiveness to CO2 pre-operatively in ST-POD and marked increase

2017 Frontiers in aging neuroscience

23. Delirium Treatment With Acupuncture in Internal Medicine Departments

acupuncture with usual care, sham procedure with usual care or usual care only. Daily treatments and outcomes' follow-up will be conducted up to one week from recruitment or until resolution of delirium or subsyndromal delirium for 48 hours. The primary outcome will be between-groups comparison of the changes in delirium severity over time as defined by continuous variations in CAM-S scores (trajectory). Secondary outcomes will include time to first delirium resolution, percentage of delirium-free days (...) , day 3, day 4, day 5, day 6 and day 7 of the study ] Confusion Assessment Method Severity (CAM-S) scale, tenth item: "sleep-wake cycle". The CAM-S includes 10 delirium-related items, the first one being rated on a 0-1 scale and the nine followings in a 0-2 scale for a total 0-19 score. Here we will use the tenth item (sleep-wake cycle) rated on a 0-2 scale, higher scores indicating worse outcomes. Delirium complications [ Time Frame: At baseline, day 2, day 3, day 4, day 5, day 6 and day 7

2017 Clinical Trials

24. Derivation and Validation of a Severity Scoring Method for the 3-Minute Diagnostic Interview for Confusion Assessment Method--Defined Delirium Full Text available with Trip Pro

Derivation and Validation of a Severity Scoring Method for the 3-Minute Diagnostic Interview for Confusion Assessment Method--Defined Delirium To derive and validate a method for scoring delirium severity using a recently validated, brief, structured diagnostic interview for Confusion Assessment Method (CAM)-defined delirium (3D-CAM) and to demonstrate its agreement with the CAM Severity short form (CAM-S SF) as the reference standard.Derivation and validation analysis in a prospective cohort (...) study.Two academic medical centers.Individuals aged 70 and older enrolled in the Successful Aging after Elective Surgery Study undergoing major elective noncardiac surgery (N = 566).The sample was randomly divided into a derivation dataset (n = 377) and an independent validation dataset (n = 189). These datasets were used to develop a severity scoring method using the 3D-CAM based on the four-item CAM-S SF (3D-CAM-S) and evaluate agreement between the 3D-CAM-S and the traditional CAM-S SF using weighted

2016 EvidenceUpdates

25. Psychosis

. ) Disorder s (new or increasing in intensity/characteristics) IV. Symptoms See V. Exam See See See (CAM, ) s Complete ral exam Evaluate for findings suggestive of organic cause VI. Differential Diagnosis See See Distinguish between , and Rapid onset of confusion Typically older patient (especially hospitalized, underlying cognitive deficits) Substances may also cause or Psychosis (see ) (due to psychiatric disorders such as or ) s Cognitive disorders (prominent) Complicated s (due to medical conditions

2018 FP Notebook

26. Quantifying the Severity of a Delirium Episode Throughout Hospitalization: the Combined Importance of Intensity and Duration. Full Text available with Trip Pro

in two independent cohorts of adult patients aged ≥70.Nine delirium episode severity measures were examined: (1) measures reflecting delirium intensity (peak Confusion Assessment Method-Severity [CAM-S] and mean CAM-S score), (2) a measure reflecting delirium intensity and duration (sum of all CAM-S scores, sum of all CAM-S scores on delirium days only, peak CAM-S score x days with delirium), (3) measures requiring information on delirium duration and delirium at discharge (total number of delirium (...) days, percentage of delirium days, delirium at discharge), and (4) a measure of cognitive change. Associations of the delirium episode severity measures with 30- and 90-day post-hospital outcomes (death, nursing home placement, and readmission) relevant to delirium were examined.The delirium episode severity measure that required information on both delirium intensity and duration (sum of all CAM-S scores) was the most strongly associated with 30- and 90-day post-hospital outcomes. Using

2016 Journal of General Internal Medicine

27. EEG Guidance of Anesthesia (ENGAGES-CANADA)

will be compared between the Control Group and the EEG-Guided Group. As assessed by the CAM-S severity score Association between delirium and falls [ Time Frame: 30 days and 1 year ] The overall incidence of delirium as assessed by CAM vs the incidence of falls by an adjusted regression model. Association between delirium and quality of life by PROMIS Global Health [ Time Frame: 30 days and 1 year ] The overall incidence of delirium as assessed by CAM vs quality of life as assessed by the PROMIS Global Health

2016 Clinical Trials

28. Comparison of Postoperative Delirium in Patients Anaesthetised With Isoflurane and Desflurane During Spinal Surgery

. The features include 1) acute onset and fluctuating course,2) inattention,3) disorganized thinking and 4) altered level of consciousness. Diagnosis of delirium is made if features 1 and 2 and either 3 or 4 are present. Similarly the severity of postoperative delirium will be assessed on day one and day three following surgery. Severity of postoperative delirium will be assessed using the CAM-S(Confusion Assessment Method-severity)long form delirium severity score.It assesses ten features including 1) acute

2016 Clinical Trials

29. Does Apolipoprotein E Genotype Increase Risk of Postoperative Delirium? Full Text available with Trip Pro

-category ApoE measure. Delirium was determined using the Confusion Assessment Method (CAM) and chart review. We used generalized linear models to estimate the association between ApoE and delirium incidence, severity (peak CAM Severity [CAM-S] score), and days.ApoE ε2 and ε4 was present in 15% and 19%, respectively, and postoperative delirium occurred in 24%. Among patients with delirium, the mean peak CAM-S score was 8.0 (standard deviation: 4), with most patients experiencing 1 or 2 delirium days (51

2015 The American Journal of Geriatric Psychiatry

30. Clinical effects of clarithromycin on persistent inflammation following Haemophilus influenzae-positive acute otitis media. (Abstract)

, there were no significant differences between the two treatment groups. However, 1 week after completion of additional treatment, the prevalence of a diminished light reflex was significantly lower in the CAM + S-CMC group than in the S-CMC group (p = 0.017). The prevalence of redness of the tympanic membrane also tended to be lower in the combined treatment group than in those receiving a single drug (p = 0.097).

2015 Acta oto-laryngologica Controlled trial quality: uncertain

31. Dexmedetomidine and IV Acetaminophen for the Prevention of Postoperative Delirium Following Cardiac Surgery

disorganized thinking and altered loss of consciousness, as defined by the Confusion Assessment Method Severity Score (CAM-S). Postoperative opioid consumption [ Time Frame: Participants will be followed for the first 48 hours postoperatively. ] Defined by the amount of additional opioid (IV morphine or hydromorphone) and oral acetaminophen medications required in the first 48 hours postoperatively. Values will be converted to morphine equivalents for analysis. Montreal Cognitive Assessment (MoCA) [ Time

2015 Clinical Trials

32. Preoperative Single Glucocorticoid Hip Fracture Hip Fracture Surgery

to Arm Intervention/treatment Active Comparator: Methylprednisolone sodium succinate 125 mg iv, as single dose, preoperative. Drug: methylprednisolone sodium succinate Single dose Intravenous Other Name: Solu-medrol Product Code 52245 Placebo Comparator: physiological saline 5 mL of Sodium-Chloride 9 mg/ml, Fresenius Kabi Drug: placebo saline Outcome Measures Go to Primary Outcome Measures : Post operative delirium measured with Confusion Assessment Method severity measure CAM-S [ Time Frame: 3 first (...) post operative days ] Post operative delirium measured with Confusion Assessment Method severity measure CAM-S Secondary Outcome Measures : Post operative delirium incidents measured by CAM-S [ Time Frame: 3 days ] Incidents of delirium measured by CAM-S Patient mobility measured by Cumulated Ambulation Score (CAS) [ Time Frame: 3 first operative days ] Physiotherapy The degree of inflammatory response measured by biomarker in the blood (suPAR, Interleukin 6, and others) [ Time Frame: 4 days

2014 Clinical Trials

33. Electroencephalography Guidance of Anesthesia

information will be assessed through the Veteran's RAND 12-item Health Survey at baseline and during follow-up (30-day and 1-year). Other Outcome Measures: Duration and Severity of Delirium [ Time Frame: 5 days ] The severity of delirium will be scored using the CAM-Severity (CAM-S) metric, which has specifically been shown to be strongly associated with clinically relevant outcomes. Agreements among the FAM-CAM, researchers' delirium assessments and patient perceptions [ Time Frame: 5 days ] The Family

2014 Clinical Trials

34. Delirium (Overview)

for detection of delirium. Ann Intern Med . 1990 Dec 15. 113(12):941-8. . Alagiakrishnan K, Marrie T, Rolfson D et al. Gaps in patient care practices to prevent hospital-acquired delirium. Can Fam Physician . 2009. 55:e41-6. . Neto AS, Nassar AP Jr, Cardoso SO, Manetta JA, Pereira VG, Espósito DC, et al. Delirium screening in critically ill patients: A systematic review and meta-analysis. Crit Care Med . 2012 Jun. 40(6):1946-51. . Inouye SK, Kosar CM, Tommet D, et al. The CAM-S: development and validation

2014 eMedicine.com

35. Confusional States and Acute Memory Disorders (Treatment)

method. A new method for detection of delirium. Ann Intern Med . 1990 Dec 15. 113(12):941-8. . Alagiakrishnan K, Marrie T, Rolfson D et al. Gaps in patient care practices to prevent hospital-acquired delirium. Can Fam Physician . 2009. 55:e41-6. . Neto AS, Nassar AP Jr, Cardoso SO, Manetta JA, Pereira VG, Espósito DC, et al. Delirium screening in critically ill patients: A systematic review and meta-analysis. Crit Care Med . 2012 Jun. 40(6):1946-51. . Inouye SK, Kosar CM, Tommet D, et al. The CAM-S

2014 eMedicine.com

36. Delirium (Treatment)

in patient care practices to prevent hospital-acquired delirium. Can Fam Physician . 2009. 55:e41-6. . Neto AS, Nassar AP Jr, Cardoso SO, Manetta JA, Pereira VG, Espósito DC, et al. Delirium screening in critically ill patients: A systematic review and meta-analysis. Crit Care Med . 2012 Jun. 40(6):1946-51. . Inouye SK, Kosar CM, Tommet D, et al. The CAM-S: development and validation of a new scoring system for delirium severity in 2 cohorts. Ann Intern Med . 2014 Apr 15. 160(8):526-33. . Brooks M. New

2014 eMedicine.com

37. Confusional States and Acute Memory Disorders (Overview)

method. A new method for detection of delirium. Ann Intern Med . 1990 Dec 15. 113(12):941-8. . Alagiakrishnan K, Marrie T, Rolfson D et al. Gaps in patient care practices to prevent hospital-acquired delirium. Can Fam Physician . 2009. 55:e41-6. . Neto AS, Nassar AP Jr, Cardoso SO, Manetta JA, Pereira VG, Espósito DC, et al. Delirium screening in critically ill patients: A systematic review and meta-analysis. Crit Care Med . 2012 Jun. 40(6):1946-51. . Inouye SK, Kosar CM, Tommet D, et al. The CAM-S

2014 eMedicine.com

38. Delirium (Follow-up)

hospital-acquired delirium. Can Fam Physician . 2009. 55:e41-6. . Neto AS, Nassar AP Jr, Cardoso SO, Manetta JA, Pereira VG, Espósito DC, et al. Delirium screening in critically ill patients: A systematic review and meta-analysis. Crit Care Med . 2012 Jun. 40(6):1946-51. . Inouye SK, Kosar CM, Tommet D, et al. The CAM-S: development and validation of a new scoring system for delirium severity in 2 cohorts. Ann Intern Med . 2014 Apr 15. 160(8):526-33. . Brooks M. New scoring tool gauges severity

2014 eMedicine.com

39. Confusional States and Acute Memory Disorders (Follow-up)

method. A new method for detection of delirium. Ann Intern Med . 1990 Dec 15. 113(12):941-8. . Alagiakrishnan K, Marrie T, Rolfson D et al. Gaps in patient care practices to prevent hospital-acquired delirium. Can Fam Physician . 2009. 55:e41-6. . Neto AS, Nassar AP Jr, Cardoso SO, Manetta JA, Pereira VG, Espósito DC, et al. Delirium screening in critically ill patients: A systematic review and meta-analysis. Crit Care Med . 2012 Jun. 40(6):1946-51. . Inouye SK, Kosar CM, Tommet D, et al. The CAM-S

2014 eMedicine.com

40. Delirium (Diagnosis)

for detection of delirium. Ann Intern Med . 1990 Dec 15. 113(12):941-8. . Alagiakrishnan K, Marrie T, Rolfson D et al. Gaps in patient care practices to prevent hospital-acquired delirium. Can Fam Physician . 2009. 55:e41-6. . Neto AS, Nassar AP Jr, Cardoso SO, Manetta JA, Pereira VG, Espósito DC, et al. Delirium screening in critically ill patients: A systematic review and meta-analysis. Crit Care Med . 2012 Jun. 40(6):1946-51. . Inouye SK, Kosar CM, Tommet D, et al. The CAM-S: development and validation

2014 eMedicine.com

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