What is the Delirium Bibliography? The searchable Delirium Bibliography page is one of our most popular features, allowing you to quickly gain access to the literature on delirium and acute care of older persons. It is primarily intended for clinicians and researchers interested in exploring these topics. The NIDUS team keeps it updated for you on a monthly basis!
How to Search for Articles: Search by author, title, year, and/or keywords. Each article is indexed by keywords taken from MEDLINE and other relevant databases. Click on the title of the article to read the abstract, journal, etc.
Reference Information
- Title
- The 4 'A's test for detecting delirium in acute medical patients: a diagnostic accuracy study
- Authors
- MacLullich, A. M. Shenkin, S. D. Goodacre, S. Godfrey, M. Hanley, J. Stiobhairt, A. Lavender, E. Boyd, J. Stephen, J. Weir, C. MacRaild, A. Steven, J. Black, P. Diernberger, K. Hall, P. Tieges, Z. Fox, C. Anand, A. Young, J. Siddiqi, N. Gray, A.
- Year
- 2019
- Journal
- Health Technol Assess
- Abstract
BACKGROUND: Delirium is a common and serious neuropsychiatric syndrome, usually triggered by illness or drugs. It remains underdetected. One reason for this is a lack of brief, pragmatic assessment tools. The 4 ‘A’s test (Arousal, Attention, Abbreviated Mental Test – 4, Acute change) (4AT) is a screening tool designed for routine use. This project evaluated its usability, diagnostic accuracy and cost. METHODS: Phase 1 – the usability of the 4AT in routine practice was measured with two surveys and two qualitative studies of health-care professionals, and a review of current clinical use of the 4AT as well as its presence in guidelines and reports. Phase 2 – the 4AT’s diagnostic accuracy was assessed in newly admitted acute medical patients aged >/= 70 years. Its performance was compared with that of the Confusion Assessment Method (CAM; a longer screening tool). The performance of individual 4AT test items was related to cognitive status, length of stay, new institutionalisation, mortality at 12 weeks and outcomes. The method used was a prospective, double-blind diagnostic test accuracy study in emergency departments or in acute general medical wards in three UK sites. Each patient underwent a reference standard delirium assessment and was also randomised to receive an assessment with either the 4AT (n = 421) or the CAM (n = 420). A health economics analysis was also conducted. RESULTS: Phase 1 found evidence that delirium awareness is increasing, but also that there is a need for education on delirium in general and on the 4AT in particular. Most users reported that the 4AT was useful, and it was in widespread use both in the UK and beyond. No changes to the 4AT were considered necessary. Phase 2 involved 785 individuals who had data for analysis; their mean age was 81.4 (standard deviation 6.4) years, 45% were male, 99% were white and 9% had a known dementia diagnosis. The 4AT (n = 392) had an area under the receiver operating characteristic curve of 0.90. A positive 4AT score (> 3) had a specificity of 95% [95% confidence interval (CI) 92% to 97%] and a sensitivity of 76% (95% CI 61% to 87%) for reference standard delirium. The CAM (n = 382) had a specificity of 100% (95% CI 98% to 100%) and a sensitivity of 40% (95% CI 26% to 57%) in the subset of participants whom it was possible to assess using this. Patients with positive 4AT scores had longer lengths of stay (median 5 days, interquartile range 2.0-14.0 days) than did those with negative 4AT scores (median 2 days, interquartile range 1.0-6.0 days), and they had a higher 12-week mortality rate (16.1% and 9.2%, respectively). The estimated 12-week costs of an initial inpatient stay for patients with delirium were more than double the costs of an inpatient stay for patients without delirium (e.g. in Scotland, pound7559, 95% CI pound7362 to pound7755, vs. pound4215, 95% CI pound4175 to pound4254). The estimated cost of false-positive cases was pound4653, of false-negative cases was pound8956, and of a missed diagnosis was pound2067. LIMITATIONS: Patients were aged >/= 70 years and were assessed soon after they were admitted, limiting generalisability. The treatment of patients in accordance with reference standard diagnosis limited the ability to assess comparative cost-effectiveness. CONCLUSIONS: These findings support the use of the 4AT as a rapid delirium assessment instrument. The 4AT has acceptable diagnostic accuracy for acute older patients aged > 70 years. FUTURE WORK: Further research should address the real-world implementation of delirium assessment. The 4AT should be tested in other populations. TRIAL REGISTRATION: Current Controlled Trials ISRCTN53388093. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 40. See the NIHR Journals Library website for further project information. The funder specified that any new delirium assessment tool should be compared against the CAM, but had no other role in the study design or conduct of the study.
Delirium is the sudden onset of confusion that can happen when someone is unwell. It is common in older people who go into hospital, and it is upsetting for both the patients and their families. Delirium is important to diagnose, because people with delirium do less well than those without, and it is often treatable. The ideal way to diagnose delirium is with a full assessment by a specialist, but this is expensive and time-consuming. We therefore developed a short test called the 4 ‘A’s Test (4AT). The four ‘A’s stand for Arousal, Attention, Abbreviated Mental Test – 4, and Acute change. First, we interviewed hospital staff about delirium and the 4AT. We found that the 4AT was already widely used and that people found it easy to use. We then tested how the 4AT performed in practice. A total of 785 recently admitted patients aged >/= 70 years participated, of whom around one in eight had delirium. A researcher carried out the full standard delirium assessment on each patient and then a different researcher carried out the 4AT. A normal 4AT score reliably ruled out delirium. An abnormal score was also reasonably effective in detecting delirium, but staff still needed to follow up such patients with a full assessment. People with higher 4AT scores stayed in hospital longer and were more likely to die, and their treatment was more expensive. We conclude that the 4AT is a useful test to rule out delirium or to see if more detailed testing is required. It could help treat patients correctly and quickly. This would save money and improve outcomes.
eng
- PMID
- Keywords
4at
Acute hospitals
Cam
Delirium
Dementia
Diagnostic accuracy
- Page(s)
- 194
- Volume
- 23
- Issue
- 40
| Title | Authors | Journal | Year | Keywords |
|---|---|---|---|---|
| Inhalational Versus Propofol-based Intravenous Maintenance of Anesthesia for Emergence Delirium in Adults: A Meta-analysis and Trial Sequential Analysis | Yang, Y. Feng, L. Ji, C. Lu, K. Chen, Y. Chen, B. | J Neurosurg Anesthesiol | 2022 | |
| Role of interleukin-18 in postoperative delirium: an exploratory analysis | Wu, J. G. Taylor, J. Parker, M. Kunkel, D. Rivera, C. Pearce, R. A. Lennertz, R. Sanders, R. D. | Br J Anaesth | 2022 |
delirium |
| Effect of general anesthesia with thoracic paravertebral block on postoperative delirium in elderly patients undergoing thoracoscopic lobectomy: a randomized-controlled trial | Wei, W. Zheng, X. Gu, Y. Fu, W. Tang, C. Yao, Y. | BMC Anesthesiol | 2022 |
*Postoperative delirium |
| Probable Delirium and Associated Patient Characteristics in Long-Term Care and Complex Continuing Care: A Population-Based Observational Study | Webber, C. Watt, C. L. Bush, S. H. Lawlor, P. G. Knoefel, F. Momoli, F. Thavorn, K. Casey, G. Tanuseputro, P. | J Am Med Dir Assoc | 2022 |
Cross-Sectional Studies |
| Postoperative delirium and its relationship with biomarkers for dementia: a meta-analysis | Wang, S. Greene, R. Song, Y. Chan, C. Lindroth, H. Khan, S. Rios, G. Sanders, R. D. Khan, B. | Int Psychogeriatr | 2022 |
Alzheimer’s disease |
| Melatonin and melatonergic agents for the prevention of postoperative delirium: A meta-analysis of randomized placebo-controlled trials | Wang, C. M. Zhou, L. Y. | Asian J Surg | 2022 |
Adult |
| Dexmedetomidine for prevention of postoperative delirium in older adults undergoing oesophagectomy with total intravenous anaesthesia | Valent, A. Carval, A. Cattan, P. Plaud, B. | Eur J Anaesthesiol | 2022 |
Aged |
| Transfusion-Associated Delirium in Children: No Difference Between Short Storage Versus Standard Issue RBCs | Traube, C. Tucci, M. Nellis, M. E. Avery, K. L. McQuillen, P. S. Fitzgerald, J. C. Muszynski, J. A. Cholette, J. M. Schwarz, A. J. Stalets, E. L. Quaid, M. A. Hanson, S. J. Lacroix, J. Reeder, R. W. Spinella, P. C. | Crit Care Med | 2022 | |
| Pediatric Delirium: We Have Come a Long Way, and We Have Only Just Begun | Traube, C. | Crit Care Med | 2022 | |
| Beware the Aftermath: Delirium and Post-Intensive Care Syndrome in Critically Ill Children | Traube, C. | Pediatr Crit Care Med | 2022 | |
| Amyloid deposition on positron emission tomography correlates with severity of perioperative delirium: a case-control pilot study | Torres-Velázquez, M. Parker, M. Bo, A. White, M. Tanabe, S. Pearce, R. A. Lennertz, R. Cho, S. Y. Bendlin, B. Johnson, S. C. Prabhakaran, V. McMillan, A. B. Sanders, R. D. | Br J Anaesth | 2022 |
amyloid |
| VE-CAM-S: Visual EEG-Based Grading of Delirium Severity and Associations With Clinical Outcomes | Tesh, R. A. Sun, H. Jing, J. Westmeijer, M. Neelagiri, A. Rajan, S. Krishnamurthy, P. V. Sikka, P. Quadri, S. A. Leone, M. J. Paixao, L. Panneerselvam, E. Eckhardt, C. Struck, A. F. Kaplan, P. W. Akeju, O. Jones, D. Kimchi, E. Y. Westover, M. B. | Crit Care Explor | 2022 |
Eeg |
| KIBRA, MTNR1B, and FKBP5 genotypes are associated with decreased odds of incident delirium in elderly post-surgical patients | Terrelonge, M. LaHue, S. C. Tang, C. Movsesyan, I. Pullinger, C. R. Dubal, D. B. Leung, J. Douglas, V. C. | Sci Rep | 2022 | |
| Pilot Study of Lemborexant for Insomnia in Cancer Patients with Delirium | Terada, T. Hirayama, T. Sadahiro, R. Wada, S. Nakahara, R. Matsuoka, H. | J Palliat Med | 2022 |
cancer patients |
| Managing agitation secondary to hyperactive delirium in deteriorating patients | Teece, A. | Nurs Stand | 2022 |
*Delirium/etiology |
| Incidence of Delirium With Different Oral Opioids in Previously Opioid-Naive Patients | Sugiyama, Y. Tanaka, R. Sato, T. Sato, T. Saitoh, A. Yamada, D. Shino, M. | Am J Hosp Palliat Care | 2022 |
concomitant drugs |
| Adult behavior toward the child before surgery and pediatric emergence delirium | Sobol, M. Sobol, M. K. Kowal, M. | Paediatr Anaesth | 2022 |
Adult |
| Risk Factors for Delirium and Association of Antipsychotic Use with Delirium Progression in Critically Ill Trauma Patients | Shoulders, B. R. Elsabagh, S. Tam, D. J. Frantz, A. M. Alexander, K. M. Voils, S. A. | Am Surg | 2022 |
antipsychotic |
| Incidence and Risk Factors of Ventilator-Associated Pneumonia among Patients with Delirium in the Intensive Care Unit: A Prospective Observational Study | Shamsizadeh, M. Fathi Jouzdani, A. Rahimi-Bashar, F. | Crit Care Res Pract | 2022 | |
| Delirium in older adults, if you think it's the urine, think again | Schonnop, R. Woods, R. Ellis, B. | Cjem | 2022 | |
| The detection of delirium in admitted oncology patients: a scoping review | Sands, M. B. Wee, I. Agar, M. Vardy, J. L. | Eur Geriatr Med | 2022 |
Cancer |
| Delirium in the Context of Zonisamide-Induced Toxic Epidermal Necrolysis | Reinfeld, S. Tejeda, C. I. Koola, M. M. | Prim Care Companion CNS Disord | 2022 | |
| Prevalence of Delirium in End-of-life Palliative Care Patients: An Observational Study | Recchia, A. Rizzi, B. Favero, A. Nobili, A. Pasina, L. | Med Princ Pract | 2022 | |
| Hospitalizations of older people in an emergency department related to potential medication-induced hyperactive delirium: a cross-sectional study | Raso, J. Santos, L. M. C. Reis, D. A. Frangiotti, M. A. C. Zanetti, A. C. B. Capucho, H. C. Herdeiro, M. T. Roque, F. Pereira, L. R. L. Varallo, F. R. | Int J Clin Pharm | 2022 |
Aged |
| Clinical Significance of Delirium With Catatonic Signs in Patients With Neurological Disorders | Ramirez-Bermudez, J. Medina-Gutierrez, A. Gomez-Cianca, H. Arias, P. Pérez-Gonzalez, A. Lebrija-Reyes, P. A. Espinola-Nadurille, M. Aguilar-Venegas, L. C. Ojeda-López, C. Restrepo-Martínez, M. Bayliss, L. Juárez-Jaramillo, C. A. Peñaloza, G. Rivas-Al | J Neuropsychiatry Clin Neurosci | 2022 |
Catatonia |
| Patient perspectives on delirium and cognitive dysfunction after surgery: a cross-sectional survey | Ragheb, J. Khatibi, N. McKinney, A. Brooks, J. Hill-Carruthers, M. Vlisides, P. E. | Br J Anaesth | 2022 |
cognitive dysfunction |
| Association between delirium and cognitive impairment: there is a link? | Pistacchi, M. Gioulis, M. Marsala, S. Z. | Curr Alzheimer Res | 2022 |
Cognitive Impairment |
| Utility of white matter disease and atrophy on routinely acquired brain imaging for prediction of long-term delirium risk: population-based cohort study | Pendlebury, S. T. Thomson, R. J. Welch, S. J. V. Kuker, W. Rothwell, P. M. | Age Ageing | 2022 |
Atrophy/pathology |
| Massachusetts Intensive Care Unit Nurses From Multiple Hospitals Develop a Collaborative to Improve Delirium Assessment Accuracy | O'Donoghue, S. C. Meyers, K. Manning, C. R. Pellegrino, L. S. Ryan, C. P. Crowell, A. M. Nolan, L. M. Gallagher, G. E. | Dimens Crit Care Nurs | 2022 |
Critical Care |
| Incidence and factors associated with postoperative delirium in patients undergoing transurethral resection of bladder tumor | Nakatani, S. Ida, M. Wang, X. Naito, Y. Kawaguchi, M. | JA Clin Rep | 2022 |
Age |
| Association of Nutritional Status with New-Onset Delirium in Elderly, Acute Care, Orthopaedic Trauma Patients: A Single-Center Observational Study | Maher, S. S. Franco-Garcia, E. Zhou, C. Heng, M. van Pelt, M. Akeju, O. Quraishi, S. A. | J Orthop Trauma | 2022 |
Aged |
| Efficacy of EWINDOW for prevention of delirium at intensive care units: A protocol for systematic review and meta-analysis | Liu, J. Wang, J. | Medicine (Baltimore | 2022 |
delirium, EWINDOW, intensive care units |
| Delirium and subsyndromal delirium are associated with the long-term risk of death after ischaemic stroke | Klimiec-Moskal, E. Slowik, A. Dziedzic, T. | Aging Clin Exp Res | 2022 |
Delirium |
| An innovative post-hospital model of care (DDEFY Delirium): A pilot randomized trial | Khan, A. Uribe-Cano, D. Klumph, M. Simpson, M. Macias Tejada, J. Galambos, C. Hubatch, S. Malone, M. L. | J Am Geriatr Soc | 2022 | |
| Impact of postanesthesia care unit delirium on self-reported cognitive function and perceived health status: a prospective observational cohort study | Kainz, E. Stuff, K. Kahl, U. Wiessner, C. Yu, Y. von Breunig, F. Nitzschke, R. Haese, A. Graefen, M. Fischer, M. | Qual Life Res | 2022 |
Anesthesia recovery period |
| Can multifaceted educational intervention improve clinical practice and patient outcomes regarding delirium in nursing homes? | Jeong, E. Chang, S. O | Jpn J Nurs Sci | 2022 |
Aged |
| Does Preoperative Cognitive Optimization Improve Postoperative Outcomes in the Elderly? | Ishizawa, Y. | J Clin Med | 2022 |
advanced age |
| Postoperative Delirium in Lung Cancer Anatomical Resection-Analysis of Risk Factors and Prognosis | Ishibashi, H. Wakejima, R. Asakawa, A. Sugita, Y. Ishikawa, Y. Hanafusa, M. Baba, S. Nakashima, Y. Seto, K. Okubo, K. | World J Surg | 2022 | |
| Preoperative Risk Factors and Early Outcomes of Delirium in Valvular Open-Heart Surgery | Hulde, N. Zittermann, A. Tigges-Limmer, K. Koster, A. Weinrautner, N. Gummert, J. von Dossow, V. | Thorac Cardiovasc Surg | 2022 | |
| Plasma 5-HIAA activity indicative of serotonergic disturbances in cognitively impaired, elderly patients experiencing postoperative delirium | Heylen, A. Vermeiren, Y. De Rooij, S. E. Scholtens, R. M. Van Munster, B. C. Van Dam, D. De Deyn, P. P. | Int J Geriatr Psychiatry | 2022 |
Aged |
| Depression, Delirium and Post-Intensive Care Syndrome | Garcez-Leme, L. E. Avelino-Silva, T. J. | Int Psychogeriatr | 2022 | |
| Usefulness of Preoperative Controlling Nutritional Status in Predicting Prolonged Hospitalization and Incidence of Postoperative Delirium for Elderly Hepatectomy with Hepatocellular Carcinoma | Fujio, A. Usuda, M. Hara, Y. Kakizaki, Y. Okada, K. Miyata, G. Unno, M. Kamei, T. | Tohoku J Exp Med | 2022 |
Aged |
| Inpatient Diagnosis of Delirium and Encephalopathy: Coding Trends 2011-2018 | Franks, J. A. Anderson, J. L. Bowman, E. Li, C. Y. Kennedy, R. E. Yun, H. | J Acad Consult Liaison Psychiatry | 2022 |
Dsm |
| Barriers and facilitators to nursing delirium screening in older emergency patients: a qualitative study using the theoretical domains framework | Eagles, D. Cheung, W. J. Avlijas, T. Yadav, K. Ohle, R. Taljaard, M. Molnar, F. Stiell, I. G. | Age Ageing | 2022 |
Aged |
| The evidence for introducing case-finding for delirium and dementia in older medical inpatients in a New Zealand hospital | Cullum, S. Kubba, Y. Varghese, C. Coomarasamy, C. Hopkins, J. | Australas Psychiatry | 2022 |
case-finding |
| Pediatric delirium in times of COVID-19 | Castro, R. E. V. Rodríguez-Rubio, M. Magalhães-Barbosa, M. C. Prata-Barbosa, A. | Rev Bras Ter Intensiva | 2022 |
*covid-19 |
| Accuracy of delirium risk factors in adult intensive care unit patients | Carvalho, L. A. C. Correia, M. D. L. Ferreira, R. C. Botelho, M. L. Ribeiro, E. Duran, E. C. M. | Rev Esc Enferm USP | 2022 |
Adult |
| The management of delirium in the older adult in advanced nursing practice | Carey, E. Furlong, E. Smith, R. | Br J Nurs | 2022 |
*Advanced Practice Nursing |
| Postoperative Delirium: The Search for Effective Interventions | Campbell, D. Short, T. G. Chan, M. T. V. | J Neurosurg Anesthesiol | 2022 | |
| Confusion and Representative Restraint: An Exercise in Clinical Reasoning | Bushunow, V. Klein, A. Follansbee, W. Bonifacino, E. | J Gen Intern Med | 2022 |
*Clinical Reasoning |
| Psychoactive medication therapy and delirium screening in skilled nursing facilities | Briesacher, B. A. Olivieri-Mui, B. L. Koethe, B. Saczynski, J. S. Fick, D. M. Devlin, J. W. Marcantonio, E. R. | J Am Geriatr Soc | 2022 |
delirium |
| Comparison of delirium detection tools in acute care : A rapid review | Brefka, S. Eschweiler, G. W. Dallmeier, D. Denkinger, M. Leinert, C. | Z Gerontol Geriatr | 2022 |
4As test |
| Implications of the COVID-19 pandemic: Virtual nursing education for delirium care | Bourgault, A. Mayerson, E. Nai, M. Orsini-Garry, A. Alexander, I. M. | J Prof Nurs | 2022 |
*covid-19 |
| Postoperative delirium prediction using machine learning models and preoperative electronic health record data | Bishara, A. Chiu, C. Whitlock, E. L. Douglas, V. C. Lee, S. Butte, A. J. Leung, J. M. Donovan, A. L. | BMC Anesthesiol | 2022 |
*Delirium prevention |
| Association between nonpharmacological strategies and delirium in intensive care unit | Bersaneti, M. D. R. Whitaker, I. Y. | Nurs Crit Care | 2022 |
caregivers |
| Differential Effects of Gamma-Aminobutyric Acidergic Sedatives on Risk of Post-Extubation Delirium in the ICU: A Retrospective Cohort Study From a New England Health Care Network | Azimaraghi, O. Wongtangman, K. Wachtendorf, L. J. Santer, P. Rumyantsev, S. Ahn, C. Kiyatkin, M. E. Teja, B. Sarge, T. Subramaniam, B. Eikermann, M. | Crit Care Med | 2022 |
Differential Effects Gamma-Aminobutyric Acidergic Sedatives Risk Post-Extubation Delirium ICU Retrospective Cohort Study |
| Risk factors for postoperative delirium after cardiac surgical procedures with cardioplegic arrest | Andrási, T. B. Talipov, I. Dinges, G. Arndt, C. Rastan, A. J. | Eur J Cardiothorac Surg | 2022 |
Cabg |
| Delirium screening tools in the post-anaesthetic care unit: a systematic review and meta-analysis | Aldwikat, R. K. Manias, E. Tomlinson, E. Amin, M. Nicholson, P. | Aging Clin Exp Res | 2022 |
Delirium |
| Effect of earplug/eye mask on sleep and delirium in intensive care patients | Akpinar, R. B. Aksoy, M. Kant, E. | Nurs Crit Care | 2022 |
delirium |
| Inclusion of interleukin-6 improved performance of postoperative delirium prediction for patients undergoing coronary artery bypass graft (POD-CABG): A derivation and validation study | Zhang, S. Ji, M. H. Ding, S. Wu, Y. Feng, X. W. Tao, X. J. Liu, W. W. Ma, R. Y. Wu, F. Q. Chen, Y. L. | J Cardiol | 2021 |
Coronary artery bypass graft surgery |
| DNA methylation in the TNF-alpha gene decreases along with aging among delirium inpatients | Yamanashi, T. Saito, T. Yu, T. Alario, A. Comp, K. Crutchley, K. J. Sullivan, E. J. Anderson, Z. M. Marra, P. S. Chang, G. Wahba, N. E. Jellison, S. S. Meyer, A. A. Mathur, S. Pandharipande, P. Yoshino, A. Kaneko, K. Lee, S. Toda, H. Iwata, M. Shinozaki, | Neurobiol Aging | 2021 |
Aged |
| DNA methylation in the inflammatory genes after neurosurgery and diagnostic ability of post-operative delirium | Yamanashi, T. Nagao, T. Wahba, N. E. Marra, P. S. Crutchley, K. J. Meyer, A. A. Andreasen, A. J. Hellman, M. M. Jellison, S. S. Hughes, C. G. Pandharipande, P. P. Howard Iii, M. A. Kawasaki, H. Iwata, M. Hefti, M. M. Shinozaki, G. | Transl Psychiatry | 2021 |
Epigenetics and behaviour, Molecular neuroscience |
| Intraoperative hypotension and delirium among older adults undergoing transcatheter aortic valve replacement | Wesselink, E. M. Abawi, M. Kooistra, N. H. M. Kappen, T. H. Agostoni, P. Emmelot-Vonk, M. Pasma, W. van Klei, W. A. van Jaarsveld, R. C. van Dongen, C. S. Doevendans, Pafm Slooter, A. J. C. Stella, P. R. | J Am Geriatr Soc | 2021 |
Aged, 80 and over |
| Patterns of Delirium in a Pediatric Intensive Care Unit and Associations With Noise Pollution | Weatherhead, J. R. Niedner, M. Dahmer, M. K. Malas, N. Owens, T. Kawai, Y. | J Intensive Care Med | 2021 |
delirium |
| Gender Differences and Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery | Wang, H. Guo, X. Zhu, X. Li, Y. Jia, Y. Zhang, Z. Yuan, S. Yan, F. | Front Cardiovasc Med | 2021 |
adult |
| Comparison of restrictive fluid therapy with goal-directed fluid therapy for postoperative delirium in patients undergoing spine surgery: a randomized controlled trial | Wang, D. D. Li, Y. Hu, X. W. Zhang, M. C. Xu, X. M. Tang, J. | Perioper Med (Lond) | 2021 |
Goal-directed fluid therapy |
| Effect of dexmedetomidine on postoperative delirium in patients undergoing brain tumour resections: study protocol of a randomised controlled trial | Wang, D. Li, R. Li, S. Wang, J. Zeng, M. Dong, J. Liu, X. Lin, N. Peng, Y. | BMJ Open | 2021 |
*Brain Neoplasms |
| Association of preoperative frailty with postoperative delirium after elective brain tumor resection: Retrospective analysis of a prospective cohort | Wang, C. M. Ma, Y. L. Yang, X. Y. Ji, R. Q. Gu, W. J. Zhou, J. X. | Surgery | 2021 |
Adult |
| Delirium and other neuropsychiatric manifestations of COVID-19 infection in people with preexisting psychiatric disorders: a systematic review | van Reekum, E. A. Rosic, T. Sergeant, A. Sanger, N. Rodrigues, M. Rebinsky, R. Panesar, B. Deck, E. Kim, N. Woo, J. D'Elia, A. Hillmer, A. Dufort, A. Sanger, S. Thabane, L. Mbuagbaw, L. Samaan, Z. | J Med Case Rep | 2021 |
Bias |
| Suvorexant with or without ramelteon to prevent delirium: a systematic review and meta-analysis | Tian, Y. Qin, Z. Han, Y. | Psychogeriatrics | 2021 |
delirium |
| Nurses' Experience of Caring for Patients with Delirium: Systematic Review and Qualitative Evidence Synthesis | Thomas, N. Coleman, M. Terry, D. | Nurs Rep | 2021 |
anxiety |
| Understanding the decision-making of critical care nurses when restraining a patient with psychomotor agitation secondary to hyperactive delirium: A 'Think Aloud' study | Teece, A. Baker, J. Smith, H | J Clin Nurs | 2022 |
Critical Care |
| Reduced Electroencephalogram Complexity in Postoperative Delirium | Tanabe, S. Parker, M. Lennertz, R. Pearce, R. A. Banks, M. I. Sanders, R. D. | J Gerontol A Biol Sci Med Sci | 2021 |
*Age-related pathology |
| Using Telehealth to Improve the Accuracy of Delirium Screening by Bedside Critical Care Nurses | Sinvani, L. Hertz, C. Chandra, S. Ilyas, A. Ardito, S. Hajizadeh, N. | Am J Crit Care | 2022 | |
| Melatonin for prevention of postoperative delirium after lower limb fracture surgery in elderly patients (DELIRLESS): study protocol for a multicentre randomised controlled trial | Sigaut, S. Couffignal, C. Esposito-Farèse, M. Degos, V. Molliex, S. Boddaert, J. Raynaud-Simon, A. Durand-Zaleski, I. Marcault, E. Jacota, M. Dahmani, S. Paugam-Burtz, C. Weiss, E. | BMJ Open | 2021 |
anaesthesia in orthopaedics |
| Management of delirium in a medical and surgical intensive care unit | Shivji, S. Stabler, S. N. Boyce, K. Haljan, G. J. McGloin, R. | J Clin Pharm Ther | 2021 |
Aged |
| 5-HT(3) receptor antagonists decrease the prevalence of postoperative delirium in older patients undergoing orthopedic lower limb surgery | Shin, H. J. Yoon, J. Na, H. S. | Perioper Med (Lond) | 2021 |
5-HT3 receptor antagonist |
| Neutrophil-Lymphocyte Ratio as a Potential Biomarker for Delirium in the Intensive Care Unit | Seo, C. L. Park, J. Y. Park, J. Kim, H. E. Cho, J. Seok, J. H. Kim, J. J. Shin, C. S. Oh, J. | Front Psychiatry | 2021 |
C-reactive protein |
| Diagnosis and management of delirium in hospital oncology service | Ramírez Zuluaga, L. P. Ruano Restrepo, M. I. Osorio Bermúdez, J. D. Díaz Vallejo, J. A. | J Geriatr Oncol | 2021 |
Cancer |
| Preschool Confusion Assessment Method for the Intensive Care Unit-Spanish (psCAM-ICU-S): Cross-Cultural Adaptation and Validation in Colombia | Pinzón-Casas, E. Soto-Trujillo, M. Camargo-Agón, L. Henao-Castaño, Á Gualdrón, N. Bonilla-González, C. | Front Pediatr | 2021 |
delirium |
| Baseline Vulnerabilities May Play a Larger Role than Depth of Anesthesia or Sedation in Postoperative Delirium | Pandharipande, P. P. Whitlock, E. L. Hughes, C. G. | Anesthesiology | 2021 |
*Anesthesia |
| Prediction of Postoperative Delirium in Geriatric Hip Fracture Patients: A Clinical Prediction Model Using Machine Learning Algorithms | Oosterhoff, J. H. F. Karhade, A. V. Oberai, T. Franco-Garcia, E. Doornberg, J. N. Schwab, J. H. | Geriatr Orthop Surg Rehabil | 2021 |
clinical prediction model |
| REcognizing DElirium in geriatric Emergency Medicine: The REDEEM risk stratification score | Oliveira, J. E. Silva L. Stanich, J. A. Jeffery, M. M. Mullan, A. F. Bower, S. M. Campbell, R. L. Rabinstein, A. A. Pignolo, R. J. Bellolio, F. | Acad Emerg Med | 2021 |
Geriatrics, Emergency department, delirium screening, REDEEM |
| Evaluation of the 3-Minute Diagnostic Confusion Assessment Method for Identification of Postoperative Delirium in Older Patients | Oberhaus, J. Wang, W. Mickle, A. M. Becker, J. Tedeschi, C. Maybrier, H. R. Upadhyayula, R. T. Muench, M. R. Lin, N. Schmitt, E. M. Inouye, S. K. Avidan, M. S. | JAMA Netw Open | 2021 |
3D-CAM, Postoperative Delirium, Major Elective Surgery, Geriatrics, long-form CAM |
| Is delirium associated with negative outcomes in older patients with hip fracture: analysis of the 4904 patients 2017-2018 from the Australian and New Zealand hip fracture registry | Oberai, T. Woodman, R. Laver, K. Crotty, M. Kerkhoffs, G. Jaarsma, R | ANZ J Surg | 2021 |
delirium |
| Postoperative delirium in older patients with cancer: the role of psychological distress and social support | O'Hanlon, S. Baxter, M. Hosie, A. | Curr Opin Support Palliat Care | 2021 | |
| Postoperative delirium and neurocognitive disorders | Migirov, A. Chahar, P. Maheshwari, K. | Curr Opin Crit Care | 2021 |
Aging |
| Development of a delirium predictive model for adult trauma patients in an emergency and critical care center: a retrospective study | Matsuoka, A. Miike, T. Miyazaki, M. Goto, T. Sasaki, A. Yamazaki, H. Komaki, M. Higuchi, M. Mori, K. Shinada, K. Nakayama, K. Sakurai, R. Asahi, M. Futami, A. Yoshitake, K. Narumi, S. Koba, M. Koami, H. Kawaguchi, A. Murakawa, T. H. Monji, A. Sakamoto, Y. | Trauma Surg Acute Care Open | 2021 |
adult |
| Early-onset delirium after spontaneous intracerebral hemorrhage | Marrama, F. Kyheng, M. Pasi, M. Pierre Rutgers, M. Moulin, S. Diomedi, M. Leys, D. Cordonnier, C. Hénon, H. Casolla, B. | Int J Stroke | 2021 |
Intracerebral hemorrhage |
| An Emergency Department Delirium Screening and Management Initiative: The Development and Refinement of the SCREENED-ED Intervention | Mailhot, T. Saczynski, J. S. Malyuta, Y. Inouye, S. K. Darling, C. | J Gerontol Nurs | 2021 |
*Delirium/diagnosis/therapy |
| Impact of a multifaceted and multidisciplinary intervention on pain, agitation and delirium management in an intensive care unit: an experience of a Canadian community hospital in conducting a quality improvement project | Ma, Z. Camargo Penuela, M. Law, M. Joshi, D. Chung, H. O. Lam, J. N. H. Tsang, J. L. | BMJ Open Qual | 2021 |
Canada |
| Prevalence, classification, risk factors and outcome impact of delirium in patients with COVID-19: a meta-analysis protocol for systematic review | Lou, B. Guo, J. Liu, Y. Xiong, C. Shi, J. Zhou, C. | BMJ Open | 2021 |
*COVID-19/complications |
| Effect of Regional vs General Anesthesia on Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery: The RAGA Randomized Trial | Li, T. Li, J. Yuan, L. Wu, J. Jiang, C. Daniels, J. Mehta, R. L. Wang, M. Yeung, J. Jackson, T. Melody, T. Jin, S. Yao, Y. Wu, J. Chen, J. Smith, F. G. Lian, Q. | Jama | 2021 | |
| Opioid and benzodiazepine use in the emergency department and the recognition of delirium within the first 24 hours of hospitalization | Lee, S. Okoro, U. E. Swanson, M. B. Mohr, N. Faine, B. Carnahan, R. | J Psychosom Res | 2021 |
Delirium |
| Awareness and Perspectives among Asian Anesthesiologists on Postoperative Delirium: A Multinational Survey | Lee, H. Kim, J. Lee, K. Y. Gan, T. J. Lekprasert, V. Laosuwan, P. Chew, S. T. H. Seet, E. Lim, V. Ti, L. K. | J Clin Med | 2021 |
NIR spectroscopy |
| Utilization of Kotter's Stages and Statistical Process Control to Implement and Sustain Delirium Screening in PICU | Kupferschmid, M. Tripathi, S. | Pediatr Qual Saf | 2021 |
Delirium, ICU Delirium, ICU morbidity and mortality, Screening compliance, Kotter’s stages |
| Impact of postoperative delirium on days alive and at home after surgery: a prospective cohort study | Kunkel, D. Parker, M. Casey, C. Krause, B. Pearce, R. A. Lennertz, R. Sanders, R. D. | Br J Anaesth | 2021 |
Cohort Studies |
| Delirium in a Tertiary Pediatric Cardiac Intensive Care Unit: Risk Factors and Outcomes | Koth, A. M. Chan, T. Tjoeng, Y. L. Watson, R. S. Dervan, L. A. | J Intensive Care Med | 2021 |
analgesics |
| Postoperative delirium screening tools for post-anaesthetic adult patients in non-intensive care units: A systematic review and meta-analysis | Kim, S. Choi, E. Jung, Y. Jang, I. | J Clin Nurs | 2021 |
adult nursing |
| Factors Related to Delirium of Intensive Care Unit Patients in Korea: A Systematic Review | Kim, N. Y. Ryu, S. A. Kim, Y. H. | Iran J Public Health | 2021 |
Delirium |