21,853 results match your criteria Delirium


Risk factors for delirium in elderly patients after lumbar spinal fusion.

Clin Neurol Neurosurg 2022 Jun 2;219:107318. Epub 2022 Jun 2.

Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

Objective: To identify perioperative risk factors for postoperative delirium (POD) in patients aged 65 or older undergoing lumbar spinal fusion procedures.

Patients And Methods: A retrospective cohort analysis was performed on patients undergoing lumbar spinal fusion over an approximately three-year period at a single institution. Demographic and perioperative data were obtained from electronic medical records. Read More

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Identifying Patients With Delirium Based on Unstructured Clinical Notes: Observational Study.

JMIR Form Res 2022 Jun 24;6(6):e33834. Epub 2022 Jun 24.

Massachusetts General Hospital, Boston, MA, United States.

Background: Delirium in hospitalized patients is a syndrome of acute brain dysfunction. Diagnostic (International Classification of Diseases [ICD]) codes are often used in studies using electronic health records (EHRs), but they are inaccurate.

Objective: We sought to develop a more accurate method using natural language processing (NLP) to detect delirium episodes on the basis of unstructured clinical notes. Read More

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Ciprofloxacin-Induced Acute Delirium in a Young Female.

Cureus 2022 May 21;14(5):e25182. Epub 2022 May 21.

General Medicine, Rehman Medical Institue, Peshawar, PAK.

Ciprofloxacin is a commonly used drug in our setup. Neurological disturbances are rare side effects of its use and are reported in older adults, patients with comorbidities, or patients with a background of psychiatric illness and antipsychotic drug use. We report the case of a 21-year-old female who developed delirium after taking ciprofloxacin for a urinary tract infection. Read More

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Investigation of Risk Factors for Postoperative Delirium after Transcatheter Aortic Valve Implantation: A Retrospective Study.

J Clin Med 2022 Jun 9;11(12). Epub 2022 Jun 9.

Department of Anesthesiology and Perioperative Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryomachi, Aoba, Sendai 980-8575, Miyagi, Japan.

Transcatheter aortic valve implantation (TAVI) is an effective treatment for severe aortic stenosis (AS); however, postoperative delirium (POD) can worsen patient outcomes. This study aimed to examine the risk factors for POD after TAVI, including possible intervening factors. We included 87 patients (mean age: 83) who underwent TAVI between May 2014 and September 2018. Read More

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Screening for Mild Cognitive Impairment in the Preoperative Setting: A Narrative Review.

Healthcare (Basel) 2022 Jun 15;10(6). Epub 2022 Jun 15.

Department of Anesthesiology, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands.

Cognitive impairment predisposes patients to the development of delirium and postoperative cognitive dysfunction. In particular, in older patients, the adverse sequelae of cognitive decline in the perioperative period may contribute to adverse outcomes after surgical procedures. Subtle signs of cognitive impairment are often not previously diagnosed. Read More

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The Effect of Propofol versus Sevoflurane on Postoperative Delirium in Parkinson's Disease Patients Undergoing Deep Brain Stimulation Surgery: An Observational Study.

Brain Sci 2022 May 25;12(6). Epub 2022 May 25.

Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China.

Background: The selection of the maintenance of general anesthesia may affect the development of postoperative delirium (POD), notably for Parkinson's disease (PD) patients, due to their lower cognitive reserve. The present study was designed to compare the potential impact of propofol vs. sevoflurane based general anesthesia maintenance methods on the development of POD in PD patients following deep brain stimulation (DBS) surgery. Read More

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Psychiatric reaction of an intensive care unit survivor in the context of coronavirus disease 2019: a case report.

J Med Case Rep 2022 Jun 23;16(1):263. Epub 2022 Jun 23.

Department of Neurosciences, Service of Neurology, University Hospital of Geneva, 4, Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland.

Background: The coronavirus disease 2019 pandemic has had a serious impact on global mental health, particularly in intensive care unit survivors. Given the lethal potential and unpredictability of coronavirus disease 2019, a high risk of posttraumatic stress disorder was identified in the beginning of the crisis. There are insufficient details in current literature and no official guidelines available for the treatment and follow-up of acute stress disorder and the prevention of posttraumatic stress disorder for intensive care unit survivors in the context of coronavirus disease 2019. Read More

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Clinical features, electroencephalogram, and biomarkers in pediatric sepsis-associated encephalopathy.

Sci Rep 2022 Jun 23;12(1):10673. Epub 2022 Jun 23.

Department of Pediatrics, D'Or Institute for Research & Education (IDOR), Rio de Janeiro, RJ, 22281-100, Brazil.

To date, no specific diagnostic criteria for sepsis-associated encephalopathy (SAE) have been established. We studied 33 pediatric patients with sepsis prospectively and evaluated the level of consciousness, the presence of delirium, electroencephalographic (EEG) findings, and plasma levels of neuron-specific enolase and S100-calcium-binding protein-B. A presumptive diagnosis of SAE was primarily considered in the presence of a decreased level of consciousness and/or delirium (clinical criteria), but specific EEG abnormalities were also considered (EEG criteria). Read More

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The Impact of Perioperative and Predisposing Risk Factors on the Development of Postoperative Delirium and a Possible Gender Difference.

Geriatrics (Basel) 2022 Jun 14;7(3). Epub 2022 Jun 14.

Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.

(1) Background: Postoperative delirium (POD) is an undesirable event especially for older patients after surgery. Perioperative risks for POD development are multiple, but gender differences are still poorly considered. In this observational study, predisposing and precipitating risk factors of POD and the possible gender influence are distinguished. Read More

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Coronavirus as the Possible Causative Agent of the 1889-1894 Pandemic.

Infect Dis Rep 2022 Jun 13;14(3):453-469. Epub 2022 Jun 13.

Department of Health Sciences, University of Burgos, 09001 Burgos, Spain.

Using new and original nineteenth-century sources, we analysed the epidemiology, clinical features and virology of the 1889 pandemic, which was referred to at the time as 'Russian flu' or 'Asiatic flu'. However, we rejected this identification of the disease as an 'influenza', which we believe to have been based on insufficient knowledge of the causative agent and instead posit that the pandemic was caused by a coronavirus. We provide a new account of the 1889-1893 pandemic, with a more detailed chronology that included at least four epidemiological waves. Read More

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Demand Ischemia as a Predictor of Mortality in Older Patients With Delirium.

Front Cardiovasc Med 2022 6;9:917252. Epub 2022 Jun 6.

Department of Medicine, Pat and Jim Calhoun Cardiology Center, University of Connecticut, Farmington, CT, United States.

Introduction: The impact of demand ischemia on clinical outcomes in patients with delirium remains largely unexplored. This study aims to evaluate the effects of demand ischemia in older patients with delirium on in-hospital mortality and length of stay (LOS) using the largest US inpatient care database, National Inpatient Sample (NIS).

Methods: We obtained data from the year 2010 to 2014 National Inpatient Sample (NIS). Read More

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Evaluation of Pediatric Delirium Awareness and Management in Pediatric Intensive Care Units in Turkey.

J Pediatr Intensive Care 2022 Jun 15;11(2):130-137. Epub 2020 Dec 15.

Department of Pediatrics, School of Medicine, Inonu University, Malatya, Turkey.

Delirium has been associated with prolonged pediatric intensive care unit (PICU) stay and mechanical ventilation times as well as high hospital costs and mortality rates. This work aimed to examine pediatric delirium awareness and delirium management in Turkey. A total of 19 physicians responsible for their respective PICUs completed the survey. Read More

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Comorbidity patterns in institutionalized older adults affected by dementia.

Alzheimers Dement (Amst) 2022 14;14(1):e12320. Epub 2022 Jun 14.

Department of Cardiovascular Endocrine‑Metabolic Diseases and Aging, Istituto Superiore di Sanità Rome Italy.

Introduction: Dementia is common in nursing homes (NH) residents. Defining dementia comorbidities is instrumental to identify groups of persons with dementia that differ in terms of health trajectories and resources consumption. We performed a cross-sectional study to identify comorbidity patterns and their associated clinical, behavioral, and functional phenotypes in institutionalized older adults with dementia. Read More

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Outcomes of Care by Geriatricians and Non-geriatricians in an Academic Hospital.

Front Med (Lausanne) 2022 6;9:908100. Epub 2022 Jun 6.

Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Introduction: While hospitalist and internist inpatient care models dominate the landscape in many countries, geriatricians and internists are at the frontlines managing hospitalized older adults in countries such as Singapore and the United Kingdom. The primary aim of this study was to determine outcomes for older patients cared for by geriatricians compared with non-geriatrician-led care teams.

Materials And Methods: A retrospective cohort study of 1,486 Internal Medicine patients aged ≥75 years admitted between April and September 2021 was conducted. Read More

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Effect of remifentanil on post-operative analgesic consumption in patients undergoing shoulder arthroplasty after interscalene brachial plexus block: a randomized controlled trial.

J Anesth 2022 Jun 22. Epub 2022 Jun 22.

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.

Purpose: Remifentanil is useful in balanced anesthesia; however, there is concern regarding opioid-induced hyperalgesia. The effect of remifentanil on rebound pain, characterized by hyperalgesia after peripheral nerve block has rarely been studied. This study evaluated whether intraoperative remifentanil infusion may increase postoperative analgesic requirement in patients receiving preoperative interscalene brachial plexus block (IBP). Read More

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Prevalence and Correlates of Caregiver Anxiety in Family Caregivers of Patients With Advanced Cancer: a Cross-Sectional Study in a Palliative Care Unit in Hong Kong.

Authors:
L M Chan S C J Ng

East Asian Arch Psychiatry 2022 Jun;32(2):27-33

Department of Medicine, Haven of Hope Hospital, Hong Kong.

Objectives: To assess the prevalence of caregiver anxiety and to identify correlates of caregiver anxiety in family caregivers of patients with advanced cancer in a palliative care unit in Hong Kong.

Methods: Family caregivers of patients admitted to the palliative care ward for the first time between July 2019 and September 2019 were screened for recruitment. Caregiver demographics (age, sex, marital status, occupation, education level, housing condition, relationship with the patient, known diagnosis of anxiety or depression, and Charlson comorbidity index) were collected, as were caregiver understanding of patient's diagnosis and prognosis, perceived patient's distress, frequency of witnessing confusion or delirium of patients in past month, perceived adequacy of psychological support (other than general social support), and perceived anxiety towards patient's approaching death. Read More

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A Survey of Implementation of ABCDE Protocols.

J Intensive Care Med 2022 Jun 22:8850666221109157. Epub 2022 Jun 22.

Pulmonary, Allergy, and Critical Care Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Background: Spontaneous awakening trials (SATs), spontaneous breathing trials (SBTs), delirium assessment/management, early mobility have been termed the ABCDE bundle. The ABCDE bundle has been proven to improve patient outcomes. However, there is often a long gap in dissemination and implementation of evidence-based medicine. Read More

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Association Between Anesthetics and Postoperative Delirium in Elderly Patients Undergoing Spine Surgery: Propofol Versus Sevoflurane.

Global Spine J 2022 Jun 22:21925682221110828. Epub 2022 Jun 22.

Department of Anesthesiology and Pain Medicine, 65633SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.

Study Designs: Retrospective Observational Study To compare the incidence of POD after propofol- and sevoflurane-based anesthesia in elderly patients undergoing spine surgery.

Methods: In this study, the medical records of elderly patients ≥ 65 years of age who underwent spine surgery under total intravenous anesthesia with propofol or inhalational anesthesia with sevoflurane were reviewed. The primary outcome was the incidence of POD after propofol- and sevoflurane-based anesthesia. Read More

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Ultrasound-guided peripheral nerve blocks for preoperative pain management in hip fractures: a systematic review.

BMC Anesthesiol 2022 Jun 21;22(1):192. Epub 2022 Jun 21.

Department of Anaesthesiology and Intensive Care, Copenhagen University Hospital, Nordsjællands Hospital, Hillerød, Denmark.

Systematic reviews associate peripheral nerve blocks based on anatomic landmarks or nerve stimulation with reduced pain and need for systemic analgesia in hip fracture patients. We aimed to investigate the effect of ultrasound-guided nerve blocks compared to conventional analgesia for preoperative pain management in hip fractures. Five databases were searched until June 2021 to identify randomised controlled trials. Read More

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A Multi-country Comparative Study on Palliative Care Knowledge and Attitudes Toward End-of-Life Care Among Undergraduate Nursing Students.

J Cancer Educ 2022 Jun 21. Epub 2022 Jun 21.

Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Al-Khod, 123, P.O. Box 66, Muscat, Oman.

The global burden of human death after experiencing serious health-related suffering (SHRS) requiring palliative care (PC) and end-of-life care (EOLC) is increasing. The largest increase in SHRS, death situations, PC, and EOLC needs continues to be in developing countries with limited access to PC. It is critical that nursing human resources in countries with limited access to PC are well trained and have adequate knowledge, attitudes, and skills to provide PC and EOLC. Read More

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Validation of a delirium predictive model in patients admitted to surgical intensive care units: a multicentre prospective observational cohort study.

BMJ Open 2022 Jun 21;12(6):e057890. Epub 2022 Jun 21.

Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Objective: To internally and externally validate a delirium predictive model for adult patients admitted to intensive care units (ICUs) following surgery.

Design: A prospective, observational, multicentre study.

Setting: Three university-affiliated teaching hospitals in Thailand. Read More

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Development of a non-pharmacologic delirium management bundle in paediatric intensive care units.

Nurs Crit Care 2022 Jun 21. Epub 2022 Jun 21.

Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Background: Non-pharmacologic interventions might be effective to reduce the incidence of delirium in pediatric intensive care units (PICU).

Aim: To explore expert opinions and generate informed consensus decisions regarding the content of a non-pharmacologic delirium bundle to manage delirium in PICU patients.

Study Design: A two-round online Delphi study was conducted from February to April 2021. Read More

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Improving quantification of anticholinergic burden using the Anticholinergic Effect on Cognition Scale - a healthcare improvement study in a geriatric ward setting.

Australas Psychiatry 2022 Jun 21:10398562221103117. Epub 2022 Jun 21.

Department of Gastroenterology, 26674Changi General Hospital, Singapore.

Objective: Anticholinergic burden refers to the cumulative effects of taking multiple medications with anticholinergic effects. This study was carried out in a public hospital in Singapore, aimed to improve and achieve a 100% comprehensive identification and review of measured, anticholinergic burden in a geriatric psychiatry liaison service to geriatric wards. We evaluated changes in pre-to post-assessment anticholinergic burden scores and trainee feedback. Read More

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Alpha-2-adrenergic receptor agonists for the prevention of delirium and cognitive decline after open heart surgery (ALPHA2PREVENT): protocol for a multicentre randomised controlled trial.

BMJ Open 2022 Jun 20;12(6):e057460. Epub 2022 Jun 20.

Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.

Introduction: Postoperative delirium is common in older cardiac surgery patients and associated with negative short-term and long-term outcomes. The alpha-2-adrenergic receptor agonist dexmedetomidine shows promise as prophylaxis and treatment for delirium in intensive care units (ICU) and postoperative settings. Clonidine has similar pharmacological properties and can be administered both parenterally and orally. Read More

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Study design and protocol of a low to high intensity computer-based cognitive training at home in supplement to standard care in patients with AD.

BMJ Open 2022 Jun 20;12(6):e050993. Epub 2022 Jun 20.

EMC Laboratory - (Etudes des Mécanismes Cognitifs), Universite Lumiere Lyon 2, Lyon, France.

Introduction: Recent studies on cognitive training in patients with Alzheimer's disease (AD) showed positive long-term effects on cognition and daily living, suggesting remote computer-based programmes to increase training sessions while reducing patient's travelling. The aim of this study is to examine short-term and long-term benefits of computer-based cognitive training at home in patients with mild to moderate AD, as a complement to the training in speech and language therapists' (SLT) offices. The secondary purpose is to study training frequency required to obtain noticeable effects. Read More

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Predictors of post-stroke delirium incidence and duration: results of a prospective observational study using high frequency delirium screening.

Int J Stroke 2022 Jun 19:17474930221109353. Epub 2022 Jun 19.

Department of Neurology, University Medicine Greifswald, Greifswald, Germany 60634.

BackgroundPost-stroke delirium (PSD) is a modifiable predictor for inferior outcome in stroke. Knowledge of its risk factors would facilitate clinical management of affected patients, but recently updated national guidelines consider available evidence insufficient.AimsThe study aims to establish risk factors for PSD incidence and duration using high-frequency screening. Read More

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Low Dose Antipsychotics for the Treatment of Delirium in Hospitalized Elderly Patients and Their Effects on QTc Interval.

J Pharm Pract 2022 Jun 19:8971900221108966. Epub 2022 Jun 19.

Research Center for Rational Use of Drugs, 48439Tehran University of Medical Sciences, Tehran, Iran.

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Potential Markers of Neurocognitive Disorders After Cardiac Surgery: A Bibliometric and Visual Analysis.

Authors:
Linna Ji Fang Li

Front Aging Neurosci 2022 1;14:868158. Epub 2022 Jun 1.

Department of Neurology, Fu Xing Hospital, Capital Medical University, Beijing, China.

Background: Identifying useful markers is essential for diagnosis and prevention of perioperative neurocognitive disorders (PNDs). Here, we attempt to understand the research basis and status, potential hotspots and trends of predictive markers associated with PNDs after cardiac surgery via bibliometric analysis.

Methods: A total of 4,609 original research articles and reviews that cited 290 articles between 2001 and 2021 were obtained from the Web of Science Core Collection (WoSCC) as the data source. Read More

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Do We Have Measures to Reduce Post-operative Cognitive Dysfunction?

Front Neurosci 2022 2;16:850012. Epub 2022 Jun 2.

Department of Anesthesiology, University of Virginia, Charlottesville, VA, United States.

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EEG Abnormalities During Delirium as a Prodromal Feature of Dementia with Lewy Bodies: A Case Report.

J Alzheimers Dis Rep 2022 10;6(1):223-228. Epub 2022 May 10.

Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.

Background: A 79-year-old woman was admitted to the Neurology Clinic of the University of Chieti-Pescara for a syncope. At admission, the occurrence of an acute stroke was ruled out. Her cognitive status was unimpaired. Read More

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