Latest & greatest articles for delirium

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Top results for delirium

141. Effect of rivastigmine as an adjunct to usual care with haloperidol on duration of delirium and mortality in critically ill patients: a multicentre, double-blind, placebo-controlled randomised trial. Full Text available with Trip Pro

Effect of rivastigmine as an adjunct to usual care with haloperidol on duration of delirium and mortality in critically ill patients: a multicentre, double-blind, placebo-controlled randomised trial. Delirium is frequently diagnosed in critically ill patients and is associated with adverse outcome. Impaired cholinergic neurotransmission seems to have an important role in the development of delirium. We aimed to establish the effect of the cholinesterase inhibitor rivastigmine on the duration (...) of delirium in critically ill patients.Patients (aged ≥18 years) who were diagnosed with delirium were enrolled from six intensive care units in the Netherlands, and treated between November, 2008, and January, 2010. Patients were randomised (1:1 ratio) to receive an increasing dose of rivastigmine or placebo, starting at 0·75 mL (1·5 mg rivastigmine) twice daily and increasing in increments to 3 mL (6 mg rivastigmine) twice daily from day 10 onwards, as an adjunct to usual care based on haloperidol

2010 Lancet Controlled trial quality: predicted high

142. Evidence-based practice guideline. Acute confusion/delirium.

Evidence-based practice guideline. Acute confusion/delirium. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding for the National Guideline

2009 University of Iowa Gerontological Nursing Interventions Research Center, Research Translation and Di

143. Benzodiazepines for delirium. Full Text available with Trip Pro

Benzodiazepines for delirium. Delirium occurs in 30% of hospitalised patients and is associated with prolonged hospital stay and increased morbidity and mortality. The results of uncontrolled studies have been unclear, with some suggesting that benzodiazepines may be useful in controlling non-alcohol related delirium.To determine the effectiveness and incidence of adverse effects of benzodiazapines in the treatment of non-alcohol withdrawal related delirium.The trials were identified from (...) the selection criteria could be identified. In this trial, comparing the effect of the benzodiazepine, lorazepam, with dexmedetomidine, a selective alpha-2-adrenergic receptor agonist, on delirium among mechanically ventilated intensive care unit patients, dexmedetomidine treatment was associated with an increased number of delirium- and coma-free days compared with lorazepam treated patients (dexmedetomidine patients, average seven days; lorazepam patients, average three days; P = 0.01). One partially

2009 Cochrane

144. Comparison of delirium assessment tools in a mixed intensive care unit (Abstract)

Comparison of delirium assessment tools in a mixed intensive care unit Delirium is a frequent problem in the intensive care unit (ICU) associated with poor prognosis. Delirium in the ICU is underdiagnosed by nursing and medical staff. Several detection methods have been developed for use in ICU patients. The aim of this study was to compare the value of three detection methods (the Confusion Assessment Method for the ICU [CAM-ICU], the Intensive Care Delirium Screening Checklist [ICDSC (...) was delirious or not. A psychiatrist, geriatrician, or neurologist serving as reference rater diagnosed delirium using established criteria.The CAM-ICU showed superior sensitivity and negative predictive value (64% and 83%) compared with the ICDSC (43% and 75%). The ICDSC showed higher specificity and positive predictive value (95% and 82% vs. 88% and 72%). The sensitivity of the physicians view was only 29%.ICU physicians underdiagnose delirium in the ICU, which underlines the necessity of standard

2009 EvidenceUpdates

145. Executive function and depression as independent risk factors for postoperative delirium Full Text available with Trip Pro

Executive function and depression as independent risk factors for postoperative delirium Postoperative delirium has been associated with greater complications, medical cost, and increased mortality during hospitalization. Recent evidence suggests that preoperative executive dysfunction and depression may predict postoperative delirium; however, the combined effect of these risk factors remains unknown. This study examined the association among preoperative executive function, depressive (...) symptoms, and established clinical predictors of postoperative delirium among 998 consecutive patients undergoing major noncardiac surgery.A total of 998 patients were screened for postoperative delirium (n = 998) using the Confusion Assessment Method as well as through retrospective chart review. Patients underwent cognitive, psychosocial, and medical assessments preoperatively. Executive function was assessed using the Concept Shifting Task, Letter-Digit Coding, and a modified Stroop Color Word

2009 EvidenceUpdates

146. Measures of executive function and depression identify patients at risk for postoperative delirium Full Text available with Trip Pro

Measures of executive function and depression identify patients at risk for postoperative delirium Postoperative delirium is associated with increased morbidity and mortality. Preexisting cognitive impairment and depression have been frequently cited as important risk factors for this complication. This prospective cohort study was designed to determine whether individuals who perform poorly on preoperative cognitive tests and/or exhibited depressive symptoms would be at high risk (...) for the development of postoperative delirium.One hundred nondemented patients, aged 50 yr and older, scheduled to undergo major, elective noncardiac surgery completed a preoperative test battery that included measures of global cognition, executive function, and symptoms of depression. Known preoperative risk factors for delirium were collected and examined with the results of the preoperative test battery to determine the independent predictors of delirium.The overall incidence of delirium was 16

2009 EvidenceUpdates

147. Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery Full Text available with Trip Pro

Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery Delirium is a common outcome after cardiac surgery. Delirium prediction rules identify patients at risk for delirium who may benefit from targeted prevention strategies, early identification, and treatment of underlying causes. The purpose of the present prospective study was to develop a prediction rule for delirium in a cardiac surgery cohort and to validate it in an independent cohort.Prospectively (...) , cardiac surgery patients > or =60 years of age were enrolled in a derivation sample (n=122) and then a validation sample (n=109). Beginning on the second postoperative day, patients underwent a standardized daily delirium assessment, and delirium was diagnosed according to the confusion assessment method. Delirium occurred in 63 (52%) of the derivation cohort patients. Multivariable analysis identified 4 variables independently associated with delirium: prior stroke or transient ischemic attack, Mini

2009 EvidenceUpdates

148. Benzodiazepines for delirium. (Abstract)

Benzodiazepines for delirium. Delirium occurs in 30% of hospitalised patients and is associated with prolonged hospital stay and increased morbidity and mortality. The results of uncontrolled studies have been unclear, with some suggesting that benzodiazepines may be useful in controlling non-alcohol related delirium.To determine the effectiveness and incidence of adverse effects of benzodiazapines in the treatment of non-alcohol withdrawal related delirium.The trials were identified from (...) the selection criteria could be identified. In this trial, comparing the effect of the benzodiazepine, lorazepam, with dexmedetomidine, a selective alpha-2-adrenergic receptor agonist, on delirium among mechanically ventilated intensive care unit patients, dexmedetomidine treatment was associated with an increased number of delirium- and coma-free days compared with lorazepam treated patients (dexmedetomidine patients, average seven days; lorazepam patients, average three days; P = 0.01). One partially

2009 Cochrane

149. Pharmacological management of delirium in hospitalized adults: a systematic evidence review Full Text available with Trip Pro

Pharmacological management of delirium in hospitalized adults: a systematic evidence review Pharmacological management of delirium in hospitalized adults: a systematic evidence review Pharmacological management of delirium in hospitalized adults: a systematic evidence review Campbell N, Boustani MA, Ayub A, Fox GC, Munger SL, Ott C, Guzman O, Farber M, Ademuyiwa A, Singh R CRD summary This review assessed use of pharmacological agents for managing and preventing delirium. The conclusions (...) that second-generation antipsychotics appeared to offer no advantage over haloperidol in managing delirium and further research was required in both management and prevention of delirium was reasonable given methodological limitations of many of the included studies. Authors' objectives To evaluate the efficacy and safety of pharmacologic interventions targeting either prevention or management of delirium. Searching MEDLINE via PubMed, Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL

2009 DARE.

150. Agitation and Delirium at the End of Life: "We Couldn't Manage Him" Full Text available with Trip Pro

Agitation and Delirium at the End of Life: "We Couldn't Manage Him" Delirium is the most common neuropsychiatric complication experienced by patients with advanced illness, occurring in up to 85% of patients in the last weeks of life. Using the case of Mr L, a 59-year-old man with metastatic lung cancer who developed an agitated delirium in the last week of life, we review the evaluation and management of delirium near the end of life. Although some studies have identified agitation (...) as a central feature of delirium in 13% to 46% of patients, other studies have found up to 80% of patients near the end of life develop a hypoactive, nonagitated delirium. Both the agitated (hyperactive) and nonagitated (hypoactive) forms of delirium are harbingers of impending death and are associated with increased morbidity in patients who are terminally ill, causing distress for patients, family members, and staff. Delirium is a sign of significant physiological disturbance, usually involving multiple

2008 JAMA

151. Pediatric illness severity measures predict delirium in a pediatric intensive care unit (Abstract)

Pediatric illness severity measures predict delirium in a pediatric intensive care unit Delirium in children is a serious but understudied neuropsychiatric disorder. So there is little to guide the clinician in terms of identifying those at risk.To study, in a pediatric intensive care unit (PICU), the predictive power of widely used generic pediatric mortality scoring systems in relation to the occurrence of pediatric delirium (PD).Four-year prospective observational study, 2002-2005 (...) % in mechanically ventilated patients) and values for negative predictive value were higher (PRISM II: 98.3%; PIM: 98.7%).Given the relatively low incidence of delirium, a low detection rate biased toward the most severe cases cannot be excluded.Given the fact that PIM and PRISM II are widely used mortality scoring instruments, prospective associations with PD suggest additional value for ruling in, or out, patients at risk of PD.

2008 EvidenceUpdates

152. Cognitive disorders and HIV/AIDS: HIV-associated dementia and delirium.

Cognitive disorders and HIV/AIDS: HIV-associated dementia and delirium. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding for the National

2008 New York State Department of Health

153. Delirium and acute problematic behavior in the long-term care setting.

Delirium and acute problematic behavior in the long-term care setting. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding for the National

2008 American Medical Directors Association

154. Cholinesterase inhibitors for delirium. Full Text available with Trip Pro

Cholinesterase inhibitors for delirium. Delirium is now the preferred term to describe acute confusional states. It is experienced by 10 to 30% of all hospital inpatients. Delirium is potentially reversible and is related to several adverse outcomes, including increased hospital length of stay, poor functional status, persistent cognitive impairment, need for institutional care and probably mortality. Disruption of the cholinergic system has been proposed as a key mechanism of delirium (...) , galantamine or reminyl, rivastigmine OR exelon and tacrine OR cognex on 19 April 2005. As this Specialised Register only contains trials relating to dementia and cognitive impairment, in addition all years of MEDLINE, EMBASE, PsycINFO and CINAHL were searched for trials of cholinesterase inhibitors for delirium in non-demented people.Unconfounded, blinded randomised controlled trials, published or unpublished in which treatment with cholinesterase inhibitors was administered and compared with alternative

2008 Cochrane

155. Drug treatment of delirium: past, present and future

Drug treatment of delirium: past, present and future Drug treatment of delirium: past, present and future Drug treatment of delirium: past, present and future Bourne RS, Tahir TA, Borthwick M, Sampson EL CRD summary This review concluded that the efficacy rates between typical and atypical antipsychotics for the treatment of delirium were similar, but the latter was associated with fewer extrapyramidal adverse effects. In view of a lack of details on study quality and other methodological (...) concerns in the review methods, the authors' conclusions may not be reliable. Authors' objectives To assess the efficacy and safety of drug therapy for the treatment or prevention of delirium. Searching The following databases were searched for English language studies from 1967 to March 2008: MEDLINE, EMBASE, PsycINFO and the Cochrane Library. Search terms were reported. Conference proceedings from Academy of Psychosomatic Medicine, European Delirium Association and critical care (European Society

2008 DARE.

156. Adjunctive haloperidol prophylaxis reduces postoperative delirium severity and duration in at-risk elderly patients Full Text available with Trip Pro

Adjunctive haloperidol prophylaxis reduces postoperative delirium severity and duration in at-risk elderly patients Adjunctive haloperidol prophylaxis reduces postoperative delirium severity and duration in at-risk elderly patients Adjunctive haloperidol prophylaxis reduces postoperative delirium severity and duration in at-risk elderly patients Schrader S L, Wellik K E, Demaerschalk B M, Caselli R J, Woodruff B K, Wingerchuk D M CRD summary The review concluded that adjunctive low-dose (...) haloperidol prophylaxis reduced severity and duration of delirium and length of hospital stay in elderly at-risk patients. Further research needed to determine: an optimal pharmacological approach; combination with non-pharmacological strategies; and generalisability. The paucity of evidence and methodological uncertainties made the authors' conclusion seem overstated and it may not be reliable. Authors' objectives To determine whether antipsychotic drug prophylaxis reduces the incidence and severity

2008 DARE.

157. WITHDRAWN: Multidisciplinary team interventions for delirium in patients with chronic cognitive impairment. (Abstract)

WITHDRAWN: Multidisciplinary team interventions for delirium in patients with chronic cognitive impairment. Delirium is common in hospitalized elderly people. Delirium may affect 60% of frail elderly people in hospital. Among the cognitively impaired, 45% have been found to develop delirium and these patients have longer lengths of hospital stay and a higher rate of complications which, with other factors, increase costs of care. The management of delirium has commonly been multifaceted (...) , the primary emphasis has to be on the diagnosis and therapy of precipitating factors, but as these may not be immediately resolved, symptomatic and supportive care are also of major importance.The objective of this review is to assess the available evidence for the effectiveness, if any, of multidisciplinary team interventions in the coordinated care of elderly patients with delirium superimposed on an underlying chronic cognitive impairment in comparison with usual care.The trials were identified from

2007 Cochrane

158. Interventions for preventing delirium in hospitalised patients. (Abstract)

Interventions for preventing delirium in hospitalised patients. Delirium is a common mental disorder with serious adverse outcomes in hospitalised patients. It is associated with increases in mortality, physical morbidity, length of hospital stay, institutionalisation and costs to healthcare providers. A range of risk factors has been implicated in its aetiology, including aspects of the routine care and environment in hospitals. Prevention of delirium is clearly desirable from patients (...) ' and carers' perspectives, and to reduce hospital costs. Yet it is currently unclear whether interventions for prevention of delirium are effective, whether they can be successfully delivered in all environments, and whether different interventions are necessary for different groups of patients.Our primary objective was to determine the effectiveness of interventions designed to prevent delirium in hospitalised patients. We also aimed to highlight the quality and quantity of research evidence to prevent

2007 Cochrane

159. Antipsychotics in the treatment of delirium: a systematic review

Antipsychotics in the treatment of delirium: a systematic review Antipsychotics in the treatment of delirium: a systematic review Antipsychotics in the treatment of delirium: a systematic review Seitz D P, Gill S S, van Zyl L T CRD summary The authors assessed the efficacy and safety of antipsychotic drugs for treating delirium. They concluded that the use of some low-dose, short-term antipsychotic drugs is supported only by limited evidence, and that further research is required. The authors (...) ’ conclusions follow from the evidence presented and appear reliable. Authors' objectives To evaluate the efficacy and safety of antipsychotic drugs for treating the symptoms of delirium. Searching MEDLINE (January 1980 to July 2005) and the Cochrane Library were searched for articles published in English; the search terms were reported. The reference lists of retrieved articles were checked. Study selection Study designs of evaluations included in the review Prospective studies that used standardised

2007 DARE.

160. Watching a video of themselves experiencing delirium tremens reduces relapse rates for up to three months in people with severe alcohol dependence

Watching a video of themselves experiencing delirium tremens reduces relapse rates for up to three months in people with severe alcohol dependence Watching a video of themselves experiencing delirium tremens reduces relapse rates for up to three months in people with severe alcohol dependence | Evidence-Based Mental Health 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 Watching a video of themselves experiencing delirium tremens reduces relapse rates for up

2007 Evidence-Based Mental Health