19,772 results match your criteria delirium


Orthogeriatric co-management reduces incidence of delirium in hip fracture patients.

Osteoporos Int 2021 May 8. Epub 2021 May 8.

Oslo Delirium Research Group, Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.

Hip fracture patients often display an acute confusional state (delirium) which is associated with worse outcomes. In this observational study, we found that co-management of hip fracture patients by a multidisciplinary team including a geriatrician and an orthopaedic surgeon could reduce the incidence of delirium.

Introduction: Delirium after hip fracture is common and is associated with negative outcomes. Read More

View Article and Full-Text PDF

Reply to Anastasiadis et al.

Eur J Cardiothorac Surg 2021 May 8. Epub 2021 May 8.

Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.

View Article and Full-Text PDF

Mixed dementia and hyperactive delirium: a diagnostic challenge.

BMJ Case Rep 2021 May 7;14(5). Epub 2021 May 7.

Department of Acute Medicine, Royal Berkshire NHS Foundation Trust, Reading, UK.

It is well recognised that acute confusion or delirium complicates up to 10% of acute medical admissions. Disorientation in time and place with an impaired short-term memory and conscious level are the hallmarks of an acute confusion. In delirium, disorders of perception may produce restlessness and agitation. Read More

View Article and Full-Text PDF

Sleep in Aneurysmal Subarachnoid Hemorrhage Patients During Critical and Acute Care.

Dimens Crit Care Nurs 2021 Mar-Apr 01;40(2):118-124

Background: Nurses caring for intensive care patients diagnosed with an aneurysmal subarachnoid hemorrhage (aSAH) conduct frequent neurological assessments and vital signs over an extended period during which patients are at risk of vasospasm. The frequency of assessments can negatively impact sleep, resulting in altered thought processes and mood, including delirium. There are 2 types of sleep during the night: non-rapid eye movement (non-REM) sleep and REM sleep (also called stage R). Read More

View Article and Full-Text PDF

Derivation and validation of actionable quality indicators targeting reductions in complications for injury admissions.

Eur J Trauma Emerg Surg 2021 May 7. Epub 2021 May 7.

Axe Santé des Populations et Pratiques Optimales en Santé (Population Health and Optimal Health Practices Research Unit), Traumatologie-Urgence-Soins Intensifs (Trauma-Emergency-Critical Care Medicine), Centre de Recherche du CHU de Québec (Hôpital de l'Enfant-Jésus), Université Laval, Québec, QC, Canada.

Purpose: Approximately, one out of five patients hospitalized following injury will develop at least one hospital complication, more than three times that observed for general admissions. We currently lack actionable Quality Indicators (QI) targeting specific complications in this population. We aimed to derive and validate QI targeting hospital complications for injury admissions and develop algorithms to identify patient charts to review. Read More

View Article and Full-Text PDF

The impact of loco-regional anaesthesia on postoperative opioid use in elderly hip fracture patients: an observational study.

Eur J Trauma Emerg Surg 2021 May 7. Epub 2021 May 7.

Department of Anesthesiology, Luzerner Kantonsspital, Luzern, Switzerland.

Purpose: Hip fractures are a common health problem among the elderly with an increasing incidence. They are associated with high mortality and morbidity. Optimal pain management remains challenging and inadequate pain control is known for negatively affecting outcomes. Read More

View Article and Full-Text PDF

The effect of peri-operative dexmedetomidine on the incidence of postoperative delirium in cardiac and non-cardiac surgical patients: a randomised, double-blind placebo-controlled trial.

Anaesthesia 2021 May 7. Epub 2021 May 7.

Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.

Delirium occurs commonly following major non-cardiac and cardiac surgery and is associated with: postoperative mortality; postoperative neurocognitive dysfunction; increased length of hospital stay; and major postoperative complications and morbidity. The aim of this study was to investigate the effect of peri-operative administration of dexmedetomidine on the incidence of postoperative delirium in non-cardiac and cardiac surgical patients. In this randomised, double-blind placebo-controlled trial we included 63 patients aged ≥ 60 years undergoing major open abdominal surgery or coronary artery bypass graft surgery with cardiopulmonary bypass. Read More

View Article and Full-Text PDF

Predictors of delirium in older patients at the emergency department: a prospective multicentre derivation study.

CJEM 2021 May 4;23(3):330-336. Epub 2021 Jan 4.

Université Laval, Québec, Canada.

Objective: The objective of this study was to identify the predictors of incident delirium in this high-risk population.

Methods: This study was a planned sub-analysis of the INDEED multicentre cohort study. We recruited patients aged ≥ 65, independent/semi-independent, with an emergency department (ED) length of stay ≥ 8 h and admitted to any hospital ward. Read More

View Article and Full-Text PDF

Prospective Randomized Controlled Pilot Study of High-Intensity Lightbox Phototherapy to Prevent ICU-Acquired Delirium Incidence.

Cureus 2021 Apr 1;13(4):e14246. Epub 2021 Apr 1.

Pulmonary, Critical Care and Sleep Medicine Section, Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke, USA.

Background This study aimed to evaluate the role of disturbed circadian rhythm in potentiating intensive care unit (ICU)-acquired delirium.Previous studies have demonstrated bright light therapy (BLT) as an effective modality to improve sleeping patterns and cognitive function in non-critically ill patients. However, its benefit in the ICU has not been clearly established. Read More

View Article and Full-Text PDF

Determining associations between preoperative brain MRI features and occurrence of postoperative delirium.

J Psychosom Res 2021 Apr 30;146:110505. Epub 2021 Apr 30.

Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.

View Article and Full-Text PDF

The Conundrum of Pain, Opiate Use and Delirium: Analgosedation or Analgesia-first Approach?

Am J Respir Crit Care Med 2021 May 6. Epub 2021 May 6.

Vanderbilt University Medical Center, 12328, Department of Anesthesiology, Nashville, Tennessee, United States;

View Article and Full-Text PDF

Platelet aggregometry for hip fracture surgery in patients treated with clopidogrel: a pilot study.

J Clin Monit Comput 2021 May 6. Epub 2021 May 6.

Anesthesia and Intensive Care Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy.

Surgery for hip fractures should be performed within 48 h from patient's admission. However, several factors including chronic antiplatelet therapy could delay operation. Among the totality of patients taking clopidogrel, up to 30% are resistant to the drug and have a normal platelets reactivity. Read More

View Article and Full-Text PDF

Outcomes of hospitalized patients with COVID-19 according to level of frailty.

PeerJ 2021 13;9:e11260. Epub 2021 Apr 13.

Nursing School La Fe., Adscript center of Universidad de Valencia., Valencia, Valencia, Spain.

Background: The complications from coronavirus disease 2019 (COVID-19) have been the subject of study in diverse scientific reports. However, many aspects that influence the prognosis of the disease are still unknown, such as frailty, which inherently reduces resistance to disease and makes people more vulnerable. This study aimed to explore the complications of COVID-19 in patients admitted to a third-level hospital and to evaluate the relationship between these complications and frailty. Read More

View Article and Full-Text PDF

Multi-Component Care Bundle in Geriatric Fracture Hip for Reducing Post-Operative Delirium.

Geriatr Orthop Surg Rehabil 2021 16;12:21514593211004530. Epub 2021 Apr 16.

Department of Anaesthesiology, Queen Mary Hospital, Hong Kong.

Background: Delirium in elderly orthopaedic patients poses an enormous medical, social and financial burden to the healthcare system, and causes significant distress to patients and their caregivers. We examined whether a Multi-component Care Bundle (MCB) could reduce the incidence of post-operative delirium (POD) in fractured hip patients.

Methods: An observational study was conducted, analyzing 154 patients (mean age ± SD, 85 ± 7. Read More

View Article and Full-Text PDF

Laparoscopic Surgery Is Acceptable for Elderly Patients With Colorectal Cancer: A Propensity Score-matched Study.

Anticancer Res 2021 May;41(5):2611-2615

Department of Coloproctological Surgery, Faculty of Medicine, and Medical Technology Innovation Center Clinical Research and Trial Center, Juntendo University, Tokyo, Japan.

Background/aim: The study was performed to examine the suitability of laparoscopic surgery for elderly patients with colorectal cancer.

Patients And Methods: The subjects were 242 patients aged ≥80 years who underwent primary tumor resection of colorectal cancer using laparoscopic assisted colectomy (LAC, n=145) or open colectomy (OC, n=97). Propensity score matching used to balance the characteristics of the groups resulted in 76 patients being assigned to each group. Read More

View Article and Full-Text PDF

Dealing with missing delirium assessments in prospective clinical studies of the critically ill: a simulation study and reanalysis of two delirium studies.

BMC Med Res Methodol 2021 May 6;21(1):97. Epub 2021 May 6.

Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA.

Background: In longitudinal critical care studies, researchers may be interested in summarizing an exposure over time and evaluating its association with a long-term outcome. For example, the number of days a patient has delirium (i.e. Read More

View Article and Full-Text PDF

Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study.

Authors:
Carly Welch

Age Ageing 2021 05;50(3):617-630

Introduction: Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear.

Methods: This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. Read More

View Article and Full-Text PDF

Follow-up services for delirium after COVID-19-where now?

Age Ageing 2021 05;50(3):601-604

NHS Practitioner Health, Riverside Medical Centre, St George Wharf, Wandsworth Road, London SW8 2JB, UK.

Delirium is a common presentation in older inpatients with coronavirus disease 2019 (COVID-19), and a risk factor for cognitive decline at discharge. The glaring gaps in the service provision in delirium care, regardless of aetiology, after a hospital admission pre-existed the pandemic, but the pandemic arguably offers an opportunity now to address them. Whilst a delirium episode in itself is not a long-term condition, the context of it may well be, and therefore patients might benefit from personalised care and support planning. Read More

View Article and Full-Text PDF

Dysphagia due to necrotizing otitis externa.

Age Ageing 2021 May;50(3):1004-1005

University of Nottingham School of Health Sciences, Nottingham, UK.

An 88-year-old man presented with delirium, and subsequently developed hoarseness and oropharyngeal dysphagia. This was due to skull-based osteomyelitis from necrotizing otitis externa (NOE), causing lower cranial nerve (X, XII) palsies and venous sinus thrombosis. Diagnosis was delayed as the patient reported no otalgia, had an almost normal looking external auditory canal and was not diabetic. Read More

View Article and Full-Text PDF

Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis.

Age Ageing 2021 May;50(3):733-743

School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.

Objective: Detection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 'A's Test (4AT) is a short (<2 minutes) instrument for delirium detection that is used internationally as a standard tool in clinical practice. We performed a systematic review and meta-analysis of diagnostic test accuracy of the 4AT for delirium detection. Read More

View Article and Full-Text PDF

Perioperative dexmedetomidine reduces emergence agitation without increasing the oculocardiac reflex in children: A systematic review and meta-analysis.

Medicine (Baltimore) 2021 May;100(18):e25717

Department of Anesthesiology, The Second Hospital of Jilin University, Changchun, China.

Background: Intravenous dexmedetomidine (DEX) has been used to prevent emergence agitation (EA) in children. The aim of this meta-analysis was to evaluate whether DEX decreases EA incidence without augmenting oculocardiac reflex (OCR) in pediatric patients undergoing strabismus surgery.

Methods: We searched PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Wan Fang, and the Cochrane Library to collect the randomized controlled trials (RCTs) investigating the effects of intraoperative DEX in children undergoing strabismus surgery from inception to October 2019. Read More

View Article and Full-Text PDF

Electroencephalography of mechanically ventilated patients at high risk of delirium.

Acta Neurol Scand 2021 May 5. Epub 2021 May 5.

Department of Intensive Care Medicine, University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.

Objective: Neurophysiological exploration of ICU delirium is limited. Here, we examined EEG characteristics of medical-surgical critically ill patients with new-onset altered consciousness state at high risk for ICU delirium.

Materials And Methods: Pre-planned analysis of non-neurological mechanically ventilated medical-surgical ICU subjects, who underwent a prospective multicenter randomized, controlled EEG study (NCT03129438, April 2017-November 2018). Read More

View Article and Full-Text PDF

The Trigger Tool Method for Routine Pharmacovigilance: A Retrospective Cohort Study of the Medical Records of Hospitalized Geriatric Patients.

J Patient Saf 2021 Feb 11. Epub 2021 Feb 11.

From the *Pharmacovigilance, Pharmacoepidemiology, and Drug Information Centre, Department of Clinical Pharmacology, Rennes University Hospital, Rennes, France †Geriatrics Department, Rennes University Hospital, Rennes, France ‡Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France §Univ Rennes, CHU Rennes, REPERES (Pharmacoepidemiology and Health Services Research), Rennes, France ∥Medical Faculty, Rennes 1 University, Rennes, France ¶National Scientific Research Centre ARENES, UMR 6051 Rennes, France.

Objective: The main objective was to assess the feasibility of the trigger tool method for the retrospective detection of adverse drug reactions (ADRs) in the Rennes University Hospital. The secondary objective was to describe the performance of the method in terms of positive predictive values (PPVs) and severity or preventability of ADRs.

Methods: Using the Rennes University Hospital clinical data warehouse, pharmacovigilance experts performed a retrospective review of a random sample of 30 inpatient hospital medical records per month using the triggers "fall" and "delirium" to identify related ADRs among patients 65 years and older in 2018 in the geriatrics department. Read More

View Article and Full-Text PDF
February 2021

Depression and anxiety symptoms are related to pain and frailty but not cognition or delirium in older surgical patients.

Brain Behav 2021 May 5:e02164. Epub 2021 May 5.

Department of Anesthesiology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.

Objective: In community dwelling older adults, depression and anxiety symptoms can be associated with early cognitive decline. Symptoms of depression and anxiety are common in older adults prior to surgery. However, their significance is unknown. Read More

View Article and Full-Text PDF

A rare case of emphysematous gastritis caused by Lactobacillus fermentum in a patient with diabetes.

Rev Esp Enferm Dig 2021 May 5. Epub 2021 May 5.

Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México.

A 42-year-old man with a history of type 2 diabetes mellitus (complicated by end stage renal disease on peritoneal dialysis) and chronic diarrhea was admitted to the emergency department for having an exacerbation in the number of evacuations. The patient was hypotensive and lethargic. Arterial blood gases were obtained and reported pH 7. Read More

View Article and Full-Text PDF

Mobilization in the evening to prevent delirium: A pilot randomized trial.

Nurs Crit Care 2021 May 4. Epub 2021 May 4.

Department of Anaesthesiology, University Hospital Mannheim, Heidelberg, Germany.

Background: Delirium is a common complication in patients in Intensive Care Units (ICU). Interventions such as mobilization are effective in the prevention and treatment of delirium, although this is usually completed during the daytime.

Aim: The aim of this study was to assess the feasibility of mobilization in the evening to prevent and treat ICU patients from delirium by an additional mobility team over 2 weeks. Read More

View Article and Full-Text PDF

A randomized double-blind placebo-controlled trial of intravenous thiamine for prevention of delirium following allogeneic hematopoietic stem cell transplantation.

J Psychosom Res 2021 Apr 27;146:110503. Epub 2021 Apr 27.

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Objective: To determine if high dose intravenous (IV) thiamine can prevent delirium during hospitalization following allogeneic HSCT. Secondarily, we evaluated the effects of high dose IV thiamine on thiamine levels and explored risk factors for delirium.

Methods: Randomized, double-blind, placebo-controlled trial in patients undergoing allogeneic HSCT at a U. Read More

View Article and Full-Text PDF

Hospitalisation without delirium is not associated with cognitive decline in a population-based sample of older people-results from a nested, longitudinal cohort study.

Age Ageing 2021 May 3. Epub 2021 May 3.

Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter EX1 2LU, UK.

Background: Acute hospitalisation and delirium have individually been shown to adversely affect trajectories of cognitive decline but have not previously been considered together. This work aimed to explore the impact on cognition of hospital admission with and without delirium, compared to a control group with no hospital admissions.

Methods: The Delirium and Cognitive Impact in Dementia (DECIDE) study was nested within the Cognitive Function and Ageing Study II (CFAS II)-Newcastle cohort. Read More

View Article and Full-Text PDF