Latest & greatest articles for delirium

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Top results for delirium

61. Parecoxib Supplementation to Morphine Analgesia Decreases Incidence of Delirium in Elderly Patients After Hip or Knee Replacement Surgery: A Randomized Controlled Trial (Abstract)

Parecoxib Supplementation to Morphine Analgesia Decreases Incidence of Delirium in Elderly Patients After Hip or Knee Replacement Surgery: A Randomized Controlled Trial Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery.In a randomized, double-blind, 2-center trial (...) , patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline). All patients received combined spinal-epidural anesthesia during surgery and IV morphine for postoperative analgesia. The primary outcome was the incidence of delirium within 5 days after surgery.Between January 2011 and May 2013, 620 patients were enrolled and were

2017 EvidenceUpdates

62. Effect of a Modified Hospital Elder Life Program on Delirium and Length of Hospital Stay in Patients Undergoing Abdominal Surgery: A Cluster Randomized Clinical Trial Full Text available with Trip Pro

Effect of a Modified Hospital Elder Life Program on Delirium and Length of Hospital Stay in Patients Undergoing Abdominal Surgery: A Cluster Randomized Clinical Trial Older patients undergoing abdominal surgery commonly experience preventable delirium, which extends their hospital length of stay (LOS).To examine whether a modified Hospital Elder Life Program (mHELP) reduces incident delirium and LOS in older patients undergoing abdominal surgery.This cluster randomized clinical trial of 577 (...) nurse) consisted of 3 protocols administered daily: orienting communication, oral and nutritional assistance, and early mobilization. Intervention group participants received all 3 mHELP protocols postoperatively, in addition to usual care, as soon as they arrived in the inpatient ward and until hospital discharge. Adherence to protocols was tracked daily.Presence of delirium was assessed daily by 2 trained nurses who were masked to intervention status by using the Confusion Assessment Method. Data

2017 EvidenceUpdates

63. Intraoperative ketamine for prevention of postoperative delirium or pain after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial. Full Text available with Trip Pro

Intraoperative ketamine for prevention of postoperative delirium or pain after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial. Delirium is a common and serious postoperative complication. Subanaesthetic ketamine is often administered intraoperatively for postoperative analgesia, and some evidence suggests that ketamine prevents delirium. The primary purpose of this trial was to assess the effectiveness of ketamine for prevention (...) of postoperative delirium in older adults.The Prevention of Delirium and Complications Associated with Surgical Treatments [PODCAST] study is a multicentre, international randomised trial that enrolled adults older than 60 years undergoing major cardiac and non-cardiac surgery under general anaesthesia. Using a computer-generated randomisation sequence we randomly assigned patients to one of three groups in blocks of 15 to receive placebo (normal saline), low-dose ketamine (0·5 mg/kg), or high dose ketamine (1

2017 Lancet Controlled trial quality: predicted high

64. Rapidly reversible, sedation-related delirium versus persistent delirium in the intensive care unit

Rapidly reversible, sedation-related delirium versus persistent delirium in the intensive care unit PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2017 PedsCCM Evidence-Based Journal Club

65. Screening for delirium within the Emergency Department

Screening for delirium within the Emergency Department BestBets: Screening for delirium within the Emergency Department Screening for delirium within the Emergency Department Report By: L K Beales - ACCS Emergency Medicine CT2, Search checked by M Mecuri - Assistant Professor McMaster University, Hamilton, Ontario, Canada Institution: Sheffield Teaching Hospitals Date Submitted: 12th May 2016 Date Completed: 11th February 2017 Last Modified: 11th February 2017 Status: Green (complete) Three (...) Part Question In [patients, greater than 75 years, presenting to the emergency department] is [an abbreviated mental test score assessment better than other cognitive screening tools] at [identifying delirium]? Clinical Scenario A confused patient presents to the ED. Is the abbreviated mental test score the best method to screen for delirium/acute confusional state? Search Strategy MEDLINE 1946 to June week 2 2016, EMBASE 1974–June 2016 and the COCHRANE LIBRARY (2016). [exp delirium/or impaired

2017 BestBETS

66. Haloperidol for delirium? Moving on Full Text available with Trip Pro

Haloperidol for delirium? Moving on 28979549 2019 01 16 1751-1437 18 1 2017 Feb Journal of the Intensive Care Society J Intensive Care Soc Haloperidol for delirium? Moving on. 84 10.1177/1751143716670668 Page Valerie V Department of Anaesthesia, Watford General Hospital, Watford, UK. eng Journal Article 2017 02 01 England J Intensive Care Soc 101538668 1751-1437 2017 10 6 6 0 2017 10 6 6 0 2017 10 6 6 1 ppublish 28979549 10.1177/1751143716670668 10.1177_1751143716670668 PMC5606362 Lancet Respir

2017 Journal of the Intensive Care Society

67. Quantitative study - other: DemDel, a nursing-led practice-based delirium intervention, improves certain outcomes for older cognitively impaired inpatients

Quantitative study - other: DemDel, a nursing-led practice-based delirium intervention, improves certain outcomes for older cognitively impaired inpatients DemDel, a nursing-led practice-based delirium intervention, improves certain outcomes for older cognitively impaired inpatients | Evidence-Based Nursing We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use (...) cookies, please see our . 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 using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here DemDel, a nursing-led practice-based delirium intervention, improves certain outcomes for older cognitively

2017 Evidence-Based Nursing

68. Systematic review with meta-analysis: Earplugs could be an effective sleep hygiene strategy to reduce delirium in the ICU

Systematic review with meta-analysis: Earplugs could be an effective sleep hygiene strategy to reduce delirium in the ICU Earplugs could be an effective sleep hygiene strategy to reduce delirium in the ICU | Evidence-Based Nursing We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . 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 using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Earplugs could be an effective sleep hygiene strategy to reduce delirium in the ICU Article Text Nursing issues Systematic review with meta-analysis Earplugs could be an effective sleep

2017 Evidence-Based Nursing

71. Sleep Medications for the Treatment or Prevention of Delirium: Clinical Effectiveness and Guidelines

Sleep Medications for the Treatment or Prevention of Delirium: Clinical Effectiveness and Guidelines Sleep Medications for the Treatment or Prevention of Delirium: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Sleep Medications for the Treatment or Prevention of Delirium: Clinical Effectiveness and Guidelines Sleep Medications for the Treatment or Prevention of Delirium: Clinical Effectiveness and Guidelines Published on: December 9, 2016 Project Number: RB1046 (...) -000 Product Line: Research Type: Drug Report Type: Summary of Abstracts Result type: Report Question What is the clinical effectiveness of sleep medications in older adults for the prevention and treatment of delirium? What are the evidence-based guidelines regarding the use of sleep medications in older adults for the prevention and treatment of delirium? Key Message One systematic review, three randomized controlled trials (RCTs), one non-randomized study, and one evidence-based guideline were

2016 Canadian Agency for Drugs and Technologies in Health - Rapid Review

72. Evaluation of delirium screening tools in geriatric medical inpatients: a diagnostic test accuracy study Full Text available with Trip Pro

Evaluation of delirium screening tools in geriatric medical inpatients: a diagnostic test accuracy study screening all unscheduled older adults for delirium is recommended in national guidelines, but there is no consensus on how to perform initial assessment.to evaluate the test accuracy of five brief cognitive assessment tools for delirium diagnosis in routine clinical practice.a consecutive cohort of non-elective, elderly care (older than 65 years) hospital inpatients admitted to a geriatric (...) medical assessment unit of an urban teaching hospital. Reference assessments were clinical diagnosis of delirium performed by elderly care physicians. Routine screening tests were: Abbreviated Mental Test (AMT-10, AMT-4), 4 A's Test (4AT), brief Confusion Assessment Method (bCAM), months of the year backwards (MOTYB) and informant Single Question in Delirium (SQiD).we assessed 500 patients, mean age 83 years (range = 66-101). Clinical diagnoses were: 93 of 500 (18.6%) definite delirium, 104 of 500

2016 EvidenceUpdates

73. Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial. Full Text available with Trip Pro

Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial. Delirium is a postoperative complication that occurs frequently in patients older than 65 years, and presages adverse outcomes. We investigated whether prophylactic low-dose dexmedetomidine, a highly selective α2 adrenoceptor agonist, could safely decrease the incidence of delirium in elderly patients after non-cardiac surgery.We did this randomised (...) normal saline). Participants, care providers, and investigators were all masked to group assignment. The primary endpoint was the incidence of delirium, assessed twice daily with the Confusion Assessment Method for intensive care units during the first 7 postoperative days. Analyses were done by intention-to-treat and safety populations. This study is registered with Chinese Clinical Trial Registry, www.chictr.org.cn, number ChiCTR-TRC-10000802.Between Aug 17, 2011, and Nov 20, 2013, of 2016 patients

2016 Lancet Controlled trial quality: predicted high

74. The Use of Restraints and Excited Delirium or Positional Asphyxia: A Review of the Safety and Guidelines

The Use of Restraints and Excited Delirium or Positional Asphyxia: A Review of the Safety and Guidelines The Use of Restraints and Excited Delirium or Positional Asphyxia: A Review of the Safety and Guidelines | CADTH.ca Find the information you need The Use of Restraints and Excited Delirium or Positional Asphyxia: A Review of the Safety and Guidelines The Use of Restraints and Excited Delirium or Positional Asphyxia: A Review of the Safety and Guidelines Published on: August 11, 2016 Project (...) Number: RC0801-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the safety of restraints or restraining methods for people in custody or in healthcare facilities? What are the evidence-based guidelines for the prevention or management of excited delirium? What are the evidence-based guidelines for the prevention or management of positional asphyxia? Key Message One low quality systematic review, one fair quality

2016 Canadian Agency for Drugs and Technologies in Health - Rapid Review

75. 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 (...) delirium severity using the 3D-CAM (the 3D-CAM-S) has excellent agreement with the CAM-S SF. This new methodology enables clinicians and researchers using the 3D-CAM for surveillance to measure delirium severity and monitor its course simultaneously by tracking changes over time. The 3D-CAM-S expands the utility of the 3D-CAM as an important tool for delirium recognition and management.© 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

2016 EvidenceUpdates

76. Effect of Dexmedetomidine Added to Standard Care on Ventilator-Free Time in Patients With Agitated Delirium: A Randomized Clinical Trial

Effect of Dexmedetomidine Added to Standard Care on Ventilator-Free Time in Patients With Agitated Delirium: A Randomized Clinical Trial PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2016 PedsCCM Evidence-Based Journal Club

77. Cognitive Reserve and Postoperative Delirium in Older Adults Full Text available with Trip Pro

Cognitive Reserve and Postoperative Delirium in Older Adults To examine the role of cognitive reserve in reducing delirium incidence and severity in older adults undergoing surgery.Prospective cohort study.Hospital.Older adults (mean age 71.2, 65% women) undergoing elective orthopedic surgery (N = 142).Incidence (Confusion Assessment Method) and severity (Memorial Delirium Assessment Scale) of postoperative delirium were the primary outcomes. Predictors included early- (literacy) and late-life (...) (cognitive activities) proxies for cognitive reserve.Forty-five participants (32%) developed delirium. Greater participation in cognitive activity was associated with lower incidence (odds ratio = 0.92 corresponding to increase of 1 activity per week, 95% confidence interval (CI) = 0.86-0.98, P = .006) and severity (B = -0.06, 95% CI = -0.11 to -0.01, P = .02) of delirium after adjustment for age, sex, medical illnesses, and baseline cognition. Greater literacy was not associated with lower delirium

2016 EvidenceUpdates

78. Abnormal Mini-Cog Is Associated with Higher Risk of Complications and Delirium in Geriatric Patients with Fracture (Abstract)

Abnormal Mini-Cog Is Associated with Higher Risk of Complications and Delirium in Geriatric Patients with Fracture The Mini-Cog test is a validated and simple tool to screen for dementia. The purpose of this study was to investigate the relationship of cognitive impairment as measured by Mini-Cog testing as a predictor for in-hospital complications and mortality in geriatric patients with fracture.From 2011 to 2014, patients who were seventy years of age or older, had a fracture, and were (...) age, eighty-three years) attempted Mini-Cog testing. Of those, 513 were able to complete the test, demonstrating a 35.1% prevalence of cognitive impairment. The cohort's rate of in-hospital medical complications was 28.6%. Patients with an abnormal Mini-Cog test or those unable to complete the test had significantly higher odds of in-hospital complications (2.16 and 2.27, respectively) compared with patients with a normal Mini-Cog test (p < 0.001). Delirium was significantly increased in patients

2016 EvidenceUpdates

79. Predicting delirium after hip fracture with a 2-min cognitive screen: prospective cohort study Full Text available with Trip Pro

Predicting delirium after hip fracture with a 2-min cognitive screen: prospective cohort study although the importance of identifying hip fracture patients with high risk for delirium has been well established, considerable controversy exists over the choice of the screening tool. The most commonly used cognitive screeners take an excessive amount of time and include drawing tasks that can be troublesome for individuals with hip fracture who are invariably lying in bed.to evaluate (...) the properties of the 10-point Cognitive Screener (10-CS), a 2-min bedside tool, for predicting delirium in older adults with hip fracture.prospective cohort study.a tertiary referral hospital in São Paulo, Brazil.non-delirious older adults with hip fracture (n = 147).the 10-CS was administered as a baseline predictor. The test is composed of three-item temporal orientation (date, month, year), category fluency (animals in 1 min) and three-word recall. Incident delirium has been diagnosed according

2016 EvidenceUpdates

80. Utility of the PRE-DELIRIC delirium prediction model in a Scottish ICU cohort Full Text available with Trip Pro

Utility of the PRE-DELIRIC delirium prediction model in a Scottish ICU cohort The PREdiction of DELIRium for Intensive Care (PRE-DELIRIC) model reliably predicts at 24 h the development of delirium during intensive care admission. However, the model does not take account of alcohol misuse, which has a high prevalence in Scottish intensive care patients. We used the PRE-DELIRIC model to calculate the risk of delirium for patients in our ICU from May to July 2013. These patients were screened (...) for delirium on each day of their ICU stay using the Confusion Assessment Method for ICU (CAM-ICU). Outcomes were ascertained from the national ICU database. In the 39 patients screened daily, the risk of delirium given by the PRE-DELIRIC model was positively associated with prevalence of delirium, length of ICU stay and mortality. The PRE-DELIRIC model can therefore be usefully applied to a Scottish cohort with a high prevalence of substance misuse, allowing preventive measures to be targeted.

2016 Journal of the Intensive Care Society