Latest & greatest articles for delirium

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Top results for delirium

81. The CAM-S: Development and Validation of a New Scoring System for Delirium Severity in 2 Cohorts.

The CAM-S: Development and Validation of a New Scoring System for Delirium Severity in 2 Cohorts. BACKGROUND: Quantifying the severity of delirium is essential to advancing clinical care by improved understanding of delirium effect, prognosis, pathophysiology, and response to treatment. OBJECTIVE: To develop and validate a new delirium severity measure (CAM-S) based on the Confusion Assessment Method. DESIGN: Validation analysis in 2 independent cohorts. SETTING: Three academic medical centers (...) . PATIENTS: The first cohort included 300 patients aged 70 years or older scheduled for major surgery. The second included 919 medical patients aged 70 years or older. MEASUREMENTS: A 4-item short form and a 10-item long form were developed. Association of the maximum CAM-S score during hospitalization with hospital and posthospital outcomes related to delirium was evaluated. RESULTS: Representative results included adjusted mean length of stay, which increased across levels of short-form severity from

Annals of Internal Medicine2014 Full Text: Link to full Text with Trip Pro

82. Delirium Severity in the Hospitalized Patient: Time to Pay Attention

Delirium Severity in the Hospitalized Patient: Time to Pay Attention 24733202 2014 04 15 2014 06 09 2016 10 19 1539-3704 160 8 2014 Apr 15 Annals of internal medicine Ann. Intern. Med. Delirium severity in the hospitalized patient: time to pay attention. 574-5 10.7326/M14-0553 Eubank Kathryn J KJ Covinsky Kenneth E KE eng K24 AG029812 AG NIA NIH HHS United States P30 AG044281 AG NIA NIH HHS United States K24AG029812 AG NIA NIH HHS United States P30AG044281 AG NIA NIH HHS United States Comment (...) ):526-33 24733193 Delirium diagnosis Female Humans Male Psychological Tests NIHMS602295 PMC4112185 2014 4 16 6 0 2014 4 16 6 0 2014 6 10 6 0 ppublish 24733202 1860540 10.7326/M14-0553 PMC4112185 NIHMS602295

Annals of Internal Medicine2014 Full Text: Link to full Text with Trip Pro

83. Cornell Assessment of Pediatric Delirium: A Valid, Rapid, Observational Tool for Screening Delirium in the PICU

Cornell Assessment of Pediatric Delirium: A Valid, Rapid, Observational Tool for Screening Delirium in the PICU 24145848 2014 02 18 2014 04 22 2014 10 07 1530-0293 42 3 2014 Mar Critical care medicine Crit. Care Med. Cornell Assessment of Pediatric Delirium: a valid, rapid, observational tool for screening delirium in the PICU*. 656-63 10.1097/CCM.0b013e3182a66b76 To determine validity and reliability of the Cornell Assessment of Pediatric Delirium, a rapid observational screening tool. Double (...) -blinded assessments were performed with the Cornell Assessment of Pediatric Delirium completed by nursing staff in the PICU. These ratings were compared with an assessment by consultation liaison child psychiatrist using the Diagnostic and Statistical Manual IV criteria as the "gold standard" for diagnosis of delirium. An initial series of duplicate Cornell Assessment of Pediatric Delirium assessments were performed in blinded fashion to assess interrater reliability. Nurses recorded the time required

EvidenceUpdates2014

84. Development and validation of a delirium predictive score in older people

Development and validation of a delirium predictive score in older people 24064236 2014 04 29 2014 11 21 2014 04 29 1468-2834 43 3 2014 May Age and ageing Age Ageing Development and validation of a delirium predictive score in older people. 346-51 10.1093/ageing/aft141 delirium is frequently under diagnosed in older hospitalised patients. Predictive models have not been widely incorporated in clinical practice. to develop and validate a predictive score for incident delirium. two consecutive (...) observational prospective cohorts (development and validation) in a university affiliated hospital. inpatients 65 years and older. in the development cohort patients were assessed within the first 48 h of admission, and every 48 h thereafter, using the confusion assessment method to diagnose delirium and data were collected on comorbidity, illness severity, functional status and laboratory. Delirium predictive score (DPS) was constructed in the development cohort using variables associated with incident

EvidenceUpdates2013

85. Diagnosing Delirium in Older Emergency Department Patients: Validity and Reliability of the Delirium Triage Screen and the Brief Confusion Assessment Method

Diagnosing Delirium in Older Emergency Department Patients: Validity and Reliability of the Delirium Triage Screen and the Brief Confusion Assessment Method 23916018 2013 10 28 2013 12 11 2017 02 20 1097-6760 62 5 2013 Nov Annals of emergency medicine Ann Emerg Med Diagnosing delirium in older emergency department patients: validity and reliability of the delirium triage screen and the brief confusion assessment method. 457-65 10.1016/j.annemergmed.2013.05.003 S0196-0644(13)00436-8 Delirium (...) is a common form of acute brain dysfunction with prognostic significance. Health care professionals caring for older emergency department (ED) patients miss delirium in approximately 75% of cases. This error results from a lack of available measures that can be performed rapidly enough to be incorporated into clinical practice. Therefore, we developed and evaluated a novel 2-step approach to delirium surveillance for the ED. This prospective observational study was conducted at an academic ED in patients

EvidenceUpdates2013 Full Text: Link to full Text with Trip Pro

86. An early prediction of delirium in the acute phase after stroke

An early prediction of delirium in the acute phase after stroke 23744891 2014 03 06 2014 05 01 2014 03 06 1468-330X 85 4 2014 Apr Journal of neurology, neurosurgery, and psychiatry J. Neurol. Neurosurg. Psychiatr. An early prediction of delirium in the acute phase after stroke. 431-4 10.1136/jnnp-2013-304920 We developed and validated a risk score to predict delirium after stroke which was derived from our prospective cohort study where several risk factors were identified. Using the β (...) to create risk tables to use as a tool in clinical practice. A model including age, stroke severity, stroke subtype and infection can be used to identify patients who have a high risk to develop delirium in the early phase of stroke. Oldenbeuving A W AW Department of Intensive Care Medicine, St Elisabeth Hospital, , Tilburg, The Netherlands. de Kort P L M PL van Eck van der Sluijs J F JF Kappelle L J LJ Roks G G eng Journal Article Validation Studies 2013 06 06 England J Neurol Neurosurg Psychiatry

EvidenceUpdates2013

87. Delirium in elderly people.

Delirium in elderly people. Delirium is an acute disorder of attention and cognition in elderly people (ie, those aged 65 years or older) that is common, serious, costly, under-recognised, and often fatal. A formal cognitive assessment and history of acute onset of symptoms are necessary for diagnosis. In view of the complex multifactorial causes of delirium, multicomponent non-pharmacological risk factor approaches are the most effective strategy for prevention. No convincing evidence shows (...) that pharmacological prevention or treatment is effective. Drug reduction for sedation and analgesia and non-pharmacological approaches are recommended. Delirium offers opportunities to elucidate brain pathophysiology--it serves both as a marker of brain vulnerability with decreased reserve and as a potential mechanism for permanent cognitive damage. As a potent indicator of patients' safety, delirium provides a target for system-wide process improvements. Public health priorities include improvements in coding

Lancet2013 Full Text: Link to full Text with Trip Pro

88. Delirium Outcomes in a Randomized Trial of Blood Transfusion Thresholds in Hospitalized Older Adults with Hip Fracture

Delirium Outcomes in a Randomized Trial of Blood Transfusion Thresholds in Hospitalized Older Adults with Hip Fracture 23898894 2013 08 13 2013 10 28 2016 12 15 1532-5415 61 8 2013 Aug Journal of the American Geriatrics Society J Am Geriatr Soc Delirium outcomes in a randomized trial of blood transfusion thresholds in hospitalized older adults with hip fracture. 1286-95 10.1111/jgs.12396 To determine whether a higher blood transfusion threshold would prevent new or worsening delirium symptoms (...) Fracture Repair. Individuals in the liberal treatment group received one unit of packed red blood cells and as much blood as needed to maintain hemoglobin concentrations at greater than 10 g/dL; those in the restrictive treatment group received transfusions if they developed symptoms of anemia or their hemoglobin fell below 8 g/dL. Delirium assessments were performed before randomization and up to three times after randomization. The primary outcome was severity of delirium according to the Memorial

EvidenceUpdates2013 Full Text: Link to full Text with Trip Pro

89. On the utility of diagnostic instruments for pediatric delirium in critical illness: an evaluation of the Pediatric Anesthesia Emergence Delirium Scale, the Delirium Rating Scale 88, and the Delirium Rating Scale-Revised R-98

On the utility of diagnostic instruments for pediatric delirium in critical illness: an evaluation of the Pediatric Anesthesia Emergence Delirium Scale, the Delirium Rating Scale 88, and the Delirium Rating Scale-Revised R-98 PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

PedsCCM Evidence-Based Journal Club2013

90. Detecting pediatric delirium: development of a rapid observational assessment tool

Detecting pediatric delirium: development of a rapid observational assessment tool PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

PedsCCM Evidence-Based Journal Club2013

91. In-facility delirium prevention programs as a patient safety strategy: a systematic review

In-facility delirium prevention programs as a patient safety strategy: a systematic review In-facility delirium prevention programs as a patient safety strategy: a systematic review In-facility delirium prevention programs as a patient safety strategy: a systematic review Reston JT, Schoelles KM CRD summary This review concluded that most multicomponent interventions were effective in preventing onset of delirium in at-risk patients in a hospital setting but there was insufficient evidence (...) to determine the benefit of such programmes in other care settings. This conclusion reflects the consistent benefit seen across studies; the risk of bias is acknowledged. This conclusion is probably reliable. Authors' objectives To assess the benefits and harms of multicomponent interventions, including system-level changes, designed to prevent delirium in hospitals, palliative care centres and long-term care facilities. Searching Six databases including MEDLINE, CINAHL and EMBASE were searched from 1999

DARE.2013

92. Delirium in older patients: a diagnostic study of NEECHAM Confusion Scale in surgical intensive care unit

Delirium in older patients: a diagnostic study of NEECHAM Confusion Scale in surgical intensive care unit 23121489 2013 09 16 2014 04 02 2013 09 16 1365-2702 22 19-20 2013 Oct Journal of clinical nursing J Clin Nurs Delirium in older patients: a diagnostic study of NEECHAM Confusion Scale in surgical intensive care unit. 2849-57 10.1111/j.1365-2702.2012.04300.x To estimate the diagnostic value and determine the feasibility of the NEECHAM Confusion Scale on critically ill older patients (...) . Delirium is a common syndrome in hospitalised older patients, especially in surgical intensive care units, and the consequences of under-detection can be very serious for older people. Therefore, assessment of the cognitive status of older patients using a valid instrument is important in intensive care units. A descriptive prospective design was used. Consecutive nonintubated patients aged 65 and older, admitted to a surgical intensive care unit of an Italian hospital during a seven months period

EvidenceUpdates2013

93. Cost-effectiveness of multi-component interventions to prevent delirium in older people admitted to medical wards

Cost-effectiveness of multi-component interventions to prevent delirium in older people admitted to medical wards Cost-effectiveness of multi-component interventions to prevent delirium in older people admitted to medical wards Cost-effectiveness of multi-component interventions to prevent delirium in older people admitted to medical wards Akunne A, Murthy L, Young J Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each (...) abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The study assessed the cost-effectiveness of a multi-component intervention to prevent delirium in older people admitted to a general medicine service for urgent care. The authors concluded that the multi-component intervention was a cost-effective strategy. The methods of the study appear valid and the authors

NHS Economic Evaluation Database.2013

94. Observational study: Among patients admitted to ICU, delirium is most common in those with neurological diagnoses, and is associated with adverse health outcomes

Observational study: Among patients admitted to ICU, delirium is most common in those with neurological diagnoses, and is associated with adverse health outcomes Among patients admitted to ICU, delirium is most common in those with neurological diagnoses, and is associated with adverse health outcomes | Evidence-Based Nursing This site uses cookies. By continuing to browse the site you are agreeing to our use of cookies. Log in via your Society Log in using your username and password (...) For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in via your Society Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Among patients admitted to ICU, delirium is most common in those with neurological diagnoses, and is associated with adverse health outcomes Article Text

Evidence-Based Nursing (Requires free registration)2013

95. Clinical Practice Guideline for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

Clinical Practice Guideline for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit Clinical Practice Guidelines for the Management of Pain, Agi... : Critical Care Medicine You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. You currently have no recent searches Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed (...) force with expertise in guideline development, pain , agitation and sedation , delirium management, and associated outcomes in adult critically ill patients. The task force, divided into four subcommittees, collaborated over 6 yr in person, via teleconferences, and via electronic communication. Subcommittees were responsible for developing relevant clinical questions, using the Grading of Recommendations Assessment, Development and Evaluation method ( ) to review, evaluate, and summarize

Society of Critical Care Medicine2013

96. The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies

The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies The confusion assessment method for the intensive care unit (CAM-ICU (...) ) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies Gusmao-Flores D, Figueira Salluh JI, Chalhub RT, Quarantini LC CRD summary This review concluded that the Confusion Assessment Method for Intensive Care Unit was an excellent diagnostic tool in intensive care patients. The Intensive Care Delirium Screening Checklist had moderate sensitivity and good specificity. Inclusion was restricted to peer-reviewed

DARE.2012

98. Drug therapy for delirium in terminally ill adult patients.

Drug therapy for delirium in terminally ill adult patients. BACKGROUND: Delirium is a syndrome characterised by a disturbance of consciousness (often fluctuating), cognition and perception. In terminally ill patients it is one of the most common causes of admission to clinical care. Delirium may arise from any number of causes and treatment should be directed at addressing these causes rather than the symptom cluster. In cases where this is not possible, or treatment does not prove successful (...) , the use of drug therapy to manage the symptoms may become necessary. This is an update of the review published on 'Drug therapy for delirium in terminally ill adult patients' in The Cochrane Library 2004, Issue 2 ( Jackson 2004). OBJECTIVES: To evaluate the effectiveness of drug therapies to treat delirium in adult patients in the terminal phase of a disease. SEARCH METHODS: We searched the following sources: CENTRAL (The Cochrane Library 2012, Issue 7), MEDLINE (1966 to 2012), EMBASE (1980 to 2012

Cochrane2012

99. Cognitive trajectories after postoperative delirium.

Cognitive trajectories after postoperative delirium. BACKGROUND: Delirium is common after cardiac surgery and may be associated with long-term changes in cognitive function. We examined postoperative delirium and the cognitive trajectory during the first year after cardiac surgery. METHODS: We enrolled 225 patients 60 years of age or older who were planning to undergo coronary-artery bypass grafting or valve replacement. Patients were assessed preoperatively, daily during hospitalization (...) beginning on postoperative day 2, and at 1, 6, and 12 months after surgery. Cognitive function was assessed with the use of the Mini-Mental State Examination (MMSE; score range, 0 to 30, with lower scores indicating poorer performance). Delirium was diagnosed with the use of the Confusion Assessment Method. We examined performance on the MMSE in the first year after surgery, controlling for demographic characteristics, coexisting conditions, hospital, and surgery type. RESULTS: The 103 participants (46

NEJM2012 Full Text: Link to full Text with Trip Pro

100. Adverse outcomes after hospitalization and delirium in persons with Alzheimer disease.

Adverse outcomes after hospitalization and delirium in persons with Alzheimer disease. BACKGROUND: Hospitalization, frequently complicated by delirium, can be a life-changing event for patients with Alzheimer disease (AD). OBJECTIVE: To determine risks for institutionalization, cognitive decline, or death associated with hospitalization and delirium in patients with AD. DESIGN: Prospective cohort enrolled between 1991 and 2006 into the Massachusetts Alzheimer's Disease Research Center (MADRC (...) ) patient registry. SETTING: Community-based. PARTICIPANTS: 771 persons aged 65 years or older with a clinical diagnosis of AD. MEASUREMENTS: Hospitalization, delirium, death, and institutionalization were identified through administrative databases. Cognitive decline was defined as a decrease of 4 or more points on the Blessed Information-Memory-Concentration test score. Multivariate analysis was used to calculate adjusted relative risks (RRs). RESULTS: Of 771 participants with AD, 367 (48%) were

Annals of Internal Medicine2012 Full Text: Link to full Text with Trip Pro