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 |
---|---|---|---|---|
Risk factors for postoperative delirium in patients with colorectal cancer | Kim, H. Park, H. Kim, E. K. | J Clin Nurs | 2022 |
*Colorectal Neoplasms/complications/surgery |
Influences of remote ischemic preconditioning on postoperative delirium and cognitive dysfunction in adults after cardiac surgery: a meta-analysis of randomized controlled trials | Jing, Y. Gao, B. Li, X. | Perioper Med (Lond) | 2021 |
Cardiac surgery |
Delirium Reduction by Analgesia Management in Hip Fracture surgery (DRAM-HF): Exploration of perceived facilitators and barriers | Hunter, C. L. Ni Chroinin, D. McEvoy, L. Chuan, A. | Australas J Ageing | 2021 |
*Analgesia |
Management of Delirium in the Intensive Care Unit | Huang, D. D. Fischer, P. E. | Surg Clin North Am | 2022 |
Age Factors |
Postoperative delirium and quality of life after transcatheter and surgical aortic valve replacement: A prospective observational study | Hoogma, D. F. Venmans, E. Al Tmimi, L. Tournoy, J. Verbrugghe, P. Jacobs, S. Fieuws, S. Milisen, K. Adriaenssens, T. Dubois, C. Rex, S. | J Thorac Cardiovasc Surg | 2021 |
Savr |
Construction and Application of a Model for Predicting the Risk of Delirium in Postoperative Patients With Type a Aortic Dissection | He, J. Ling, Q. Chen, Y. | Front Surg | 2021 |
factor |
The Locus Coeruleus Noradrenaline System in Delirium | Hansen, N. Rediske, A. I. | Front Aging Neurosci | 2021 |
attention |
Single bolus dexmedetomidine versus propofol for treatment of pediatric emergence delirium following general anesthesia | Han, X. Sun, X. Liu, X. Wang, Q | Paediatr Anaesth | 2021 |
dexmedetomidine |
Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19 | Fernández-Jiménez, E. Muñoz-Sanjose, A. Mediavilla, R. Martínez-Alés, G. Louzao,, II Andreo, J. Cebolla, S. Bravo-Ortiz, M. F. Bayón, C. | Front Aging Neurosci | 2021 |
Covid-19 |
Relationship Between Cerebral Hemodynamics, Tissue Oxygen Saturation, and Delirium in Patients With Septic Shock: A Pilot Observational Cohort Study | Feng, Q. Ai, M. Huang, L. Peng, Q. Ai, Y. Zhang, L. | Front Med (Lausanne) | 2021 |
cerebral oxygen saturation |
Risk factors for delirium in adult patients receiving specialist palliative care: A systematic review and meta-analysis | Featherstone, I. Sheldon, T. Johnson, M. Woodhouse, R. Boland, J. W. Hosie, A. Lawlor, P. Russell, G. Bush, S. Siddiqi, N. | Palliat Med | 2021 |
Risk factors |
Feasibility trial of weighted blankets as an intervention for emergence delirium in postoperative pediatric patients | Eull, D. Zachrison, B. Nickel, A. | J Pediatr Nurs | 2021 |
Emergence delirium |
The LiberAction Project: Implementation of a Pediatric Liberation Bundle to Screen Delirium, Reduce Benzodiazepine Sedation, and Provide Early Mobilization in a Human Resource-Limited Pediatric Intensive Care Unit | Di Nardo, M. Boldrini, F. Broccati, F. Cancani, F. Satta, T. Stoppa, F. Genuini, L. Zampini, G. Perdichizzi, S. Bottari, G. Fischer, M. Gawronski, O. Bonetti, A. Piermarini, I. Recchiuti, V. Leone, P. Rossi, A. Tabarini, P. Biasucci, D. Villani, A. Raponi | Front Pediatr | 2021 |
benzodiazepine (BDZ) |
Outcomes of a Delirium Prevention Program in Older Persons After Elective Surgery: A Stepped-Wedge Cluster Randomized Clinical Trial | Deeken, F. Sánchez, A. Rapp, M. A. Denkinger, M. Brefka, S. Spank, J. Bruns, C. von Arnim, C. A. F. Küster, O. C. Conzelmann, L. O. Metz, B. R. Maurer, C. Skrobik, Y. Forkavets, O. Eschweiler, G. W. Thomas, C. | JAMA Surg | 2021 |
Delirium, Elective surgery outcomes, Elderly patients, Nonpharmacologic delirium prevention, Delirium Education |
Advanced Age Is Associated With Catatonia in Critical Illness: Results From the Delirium and Catatonia Prospective Cohort Investigation | Connell, J. Kim, A. Brummel, N. E. Patel, M. B. Vandekar, S. N. Pandharipande, P. Dittus, R. S. Heckers, S. Ely, E. W. Wilson, J. E. | Front Psychiatry | 2021 |
age |
Identifying frequent drug combinations associated with delirium in older adults: Application of association rules method to a case-time-control design | Chyou, T. Y. Nishtala, P. S. | Pharmacoepidemiol Drug Saf | 2021 |
Aged |
Risk Factors and a Nomogram Model Establishment for Postoperative Delirium in Elderly Patients Undergoing Arthroplasty Surgery: A Single-Center Retrospective Study | Chen, D. Li, Y. Li, Q. Gao, W. Li, J. Wang, S. Cao, J. | Biomed Res Int | 2021 |
Postoperative Delirium, Geriatrics, Knee and Hip Arthroplasty |
Detecting Incident Delirium within Routinely Collected Inpatient Rehabilitation Data: Validation of a Chart-Based Method | Ceppi, M. G. Rauch, M. S. Sándor, P. S. Gantenbein, A. R. Krishnakumar, S. Albert, M. Meier, C. R. | Neurol Int | 2021 |
delirium |
Spinal Anesthesia with Targeted Sedation based on Bispectral Index Values Compared with General Anesthesia with Masked Bispectral Index Values to Reduce Delirium: The SHARP Randomized Controlled Trial | Brown, C. H. Edwards, C. Lin, C. Jones, E. L. Yanek, L. R. Esmaili, M. Gorashi, Y. Skelton, R. Kaganov, D. Curto, R. Lessing, N. L. Cha, S. Colantuoni, E. Neufeld, K. Sieber, F. Dean, C. L. Hogue, C. W. | Anesthesiology | 2021 |
Aged |
Delirium in Cardiac and Cardiovascular Surgical Intensive Care Units | Breit, H. Bleck, T. P. Koffman, L. | Semin Neurol | 2021 |
Critical Care |
Are treatment effects consistent with hypothesized mechanisms of action proposed for postoperative delirium interventions? Reanalysis of systematic reviews | Boxell, E. G. Malik, Y. Wong, J. Lee, M. H. Berntsson, H. M. Lee, M. J. Bourne, R. S. McCullagh, I. J. Hind, D. Wilson, M. J. | J Comp Eff Res | 2021 |
*Delirium/prevention & control |
DelIrium VULnerability in GEriatrics (DIVULGE) study: a protocol for a prospective observational study of electroencephalogram associations with incident postoperative delirium | Boord, M. S. Davis, D. H. J. Psaltis, P. J. Coussens, S. W. Feuerriegel, D. Garrido, M. I. Bourke, A. Keage, H. A. D | BMJ Neurol Open | 2021 |
Eeg |
Patient Factors That Influence Reliable Delirium Assessments in a Medical Intensive Care Unit During the Routine Clinical Practice | Back, J. S. Jin, T. Jin, H. Lee, S. M. | Clin Nurs Res | 2021 |
Cam-icu |
Monitoring Delirium in the Intensive Care Unit Practices, perceptions and attitudes of critical care nurses and physicians. A French National Survey | Alaterre, C. Fazilleau, C. Constantin, J. M. James, A. | Intensive Crit Care Nurs | 2021 |
Critical Care |
Predictors of postoperative delirium in elderly patients following total hip and knee arthroplasty: a systematic review and meta-analysis | Zhou, Q. Zhou, X. Zhang, Y. Hou, M. Tian, X. Yang, H. He, F. Chen, X. Liu, T. | BMC Musculoskelet Disord | 2021 |
Aged |
Incidence, characteristics, and outcomes of delirium in patients with noninvasive ventilation: a prospective observational study | Zhang, R. Bai, L. Han, X. Huang, S. Zhou, L. Duan, J. | BMC Pulm Med | 2021 |
Aged |
A systematic review and meta-analysis of the correlation between operation time and postoperative delirium in total hip arthroplasty | Zhang, G. Wang, Z. Wang, D. Jia, Q. Zeng, Y. | Ann Palliat Med | 2021 |
*Arthroplasty, Replacement, Hip/adverse effects |
The PREvention Program for Alzheimer's RElated Delirium (PREPARED) cluster randomized trial: a study protocol | Wilchesky, M. Ballard, S. A. Voyer, P. McCusker, J. Lungu, O. Champoux, N. Vu, T. T. M. Cole, M. G. Monette, J. Ciampi, A. Belzile, E. Carmichael, P. H. McConnell, T. | BMC Geriatr | 2021 |
Aged |
Anaesthetic depth and delirium: a challenging balancing act | Whitlock, E. L. Gross, E. R. King, C. R. Avidan, M. S. | Br J Anaesth | 2021 |
Anesthesia, General |
Identification of risk factors for postoperative delirium in elderly patients with hip fractures by a risk stratification index model: A retrospective study | Wang, Y. Zhao, L. Zhang, C. An, Q. Guo, Q. Geng, J. Guo, Z. Guan, Z. | Brain Behav | 2021 |
health services for the elderly |
Association between perioperative hypotension and postoperative delirium and atrial fibrillation after cardiac surgery: A post-hoc analysis of the DECADE trial | Wang, J. Mao, G. Malackany, N. Marciniak, D. Donaldson, C. Wakefield, B. Hassan, M. Ruetzler, K. Sessler, D. I. Turan, A. | J Clin Anesth | 2021 |
Anesthesia |
The effect of the anticholinergic burden on duration and severity of delirium in older hip-surgery patients with and without haloperidol prophylaxis: A post hoc analysis | Tillemans, M. P. H. Butterhoff-Terlingen, M. H. Stuffken, R. Vreeswijk, R. Egberts, T. C. G. Kalisvaart, K. J. | Brain Behav | 2021 |
anticholinergic burden |
Refractory hyperactive delirium in the dying: pharmacological management | Tham, K. Shiu, A. William, L. Walpole, G. Rashed, S. | BMJ Support Palliat Care | 2021 |
delirium |
Time to Post-Anesthesia Neurological Evaluation and Hemodynamic Stability in Carotid Endarterectomy Comparing Three General Anesthetic Techniques Targeted to a Preset Bispectral Index Value: A Pilot Study | Temmermand, R. Mitrev, L. van Helmond, N. Roberts, D. Lombardi, J. Vuckovic, D. | Aana j | 2021 |
Anesthesia, General |
Delirium During Acute Events in Nursing Home Patients | Skretteberg, W. H. Holmefoss, I. Krogseth, M. | J Am Med Dir Assoc | 2021 |
Delirium |
The impact of emergence delirium on hospital length of stay for children who underwent tonsillectomy/adenotonsillectomy: an observational retrospective study | Simonini, A. Vittori, A. Cascella, M. Calevo, M. G. Marinangeli, F. | Braz J Anesthesiol | 2021 |
Anesthesia |
Effects of Melatonin on Postoperative Delirium After PCI in Elderly Patients: A Randomized, Single-Center, Double-Blind, Placebo-Controlled Trial | Shi, Y. | Heart Surg Forum | 2021 |
Effects of Melatonin Postoperative Delirium PCI Elderly Patients Randomized Single-Center Double-Blind Placebo-Controlled Trial |
A Quality Improvement Initiative to Reduce Postoperative Delirium among Cardiac Surgery Patients | Sanjanwala, R. M. Hiebert, B. Kent, D. Warren, S. Grocott, H. Arora, R. C. | Geriatrics (Basel) | 2021 |
cardiac surgery |
The prevalence of delirium in belgian nursing homes: a cross-sectional evaluation | Sabbe, K. van der Mast, R. Dilles, T. Van Rompaey, B. | BMC Geriatr | 2021 |
Aged |
Family intervention for delirium for patients in the intensive care unit: A systematic meta-analysis | Qin, M. Gao, Y. Guo, S. Lu, X. Zhu, H. Li, Y. | J Clin Neurosci | 2021 |
Delirium |
Orthogeriatric co-management reduces incidence of delirium in hip fracture patients | Pollmann, C. T. Mellingsæter, M. R. Neerland, B. E. Straume-Næsheim, T. Årøen, A. Watne, L. O. | Osteoporos Int | 2021 |
*Delirium/epidemiology/etiology/prevention & control |
Accuracy of delirium assessments in critically ill children: A prospective, observational study during routine care | Paterson, R. S. Kenardy, J. A. Dow, B. L. De Young, A. C. Pearson, K. Aitken, L. M. Long, D. A. | Aust Crit Care | 2021 |
Australia |
Comparative effectiveness of pharmacological interventions to prevent postoperative delirium: a network meta-analysis | Park, S. K. Lim, T. Cho, H. Yoon, H. K. Lee, H. J. Lee, J. H. Yoo, S. Kim, J. T. Kim, W. H. | Sci Rep | 2021 |
Adult |
Dexmedetomidine, Delirium, and Adverse Outcomes: Analysis of the Society of Thoracic Surgeons Adult Cardiac Surgery Database | Pal, N. Abernathy, J. H., 3rd Taylor, M. A. Bollen, B. A. Shah, A. S. Feng, X. Shotwell, M. S. Kertai, M. D. | Ann Thorac Surg | 2021 |
Analgesics, Non-Narcotic/adverse effects |
ICU delirium burden predicts functional neurologic outcomes | Paixao, L. Sun, H. Hogan, J. Hartnack, K. Westmeijer, M. Neelagiri, A. Zhou, D. W. McClain, L. M. Kimchi, E. Y. Purdon, P. L. Akeju, O. Westover, M. B. | PLoS One | 2021 |
ICU delirium functional neurologic outcomes |
Delirium occurrence and association with outcomes in hospitalized COVID-19 patients | Pagali, S. Fu, S. Lindroth, H. Sohn, S. Burton, M. C. Lapid, M. | Int Psychogeriatr | 2021 |
Adolescent |
Risk Factors for Delirium in Older Adults in the Emergency Department: A Systematic Review and Meta-Analysis | Oliveira, J. E. Silva L. Berning, M. J. Stanich, J. A. Gerberi, D. J. Murad, M. H. Han, J. H. Bellolio, F. | Ann Emerg Med | 2021 |
Aged |
Factors associated with delirium among survivors of acute respiratory distress syndrome: a nationwide cohort study | Oh, T. K. Park, H. Y. Song, I. A. | BMC Pulm Med | 2021 |
Critical Care |
Rapid Handheld Continuous Electroencephalogram (EEG) Has the Potential to Detect Delirium in Older Adults | Mulkey, M. A. Gantt, L. T. Hardin, S. R. Munro, C. L. Everhart, D. E. Kim, S. Schoeman, A. M. Roberson, D. W. McAuliffe, M. Olson, D. M. | Dimens Crit Care Nurs | 2021 |
Aged |
Delirium and Clusters of Older Patients Affected by Multimorbidity in Acute Hospitals | Monacelli, F. Signori, A. Marengoni, A. Di Santo, S. Rossi, E. Valsecchi, M. G. Morandi, A. Bellelli, G. | J Am Med Dir Assoc | 2021 |
Delirium |
Major Surgery and Long Term Cognitive Outcomes: The Effect of Postoperative Delirium on Dementia in the Year Following Discharge | Mohanty, S. Gillio, A. Lindroth, H. Ortiz, D. Holler, E. Azar, J. Boustani, M. Zarzaur, B. | J Surg Res | 2021 |
Dementia |
Elevated neuron-specific enolase level is associated with postoperative delirium and detection of phosphorylated neurofilament heavy subunit: A prospective observational study | Mietani, K. Hasegawa-Moriyama, M. Inoue, R. Ogata, T. Shimojo, N. Kurano, M. Sumitani, M. Uchida, K. | PLoS One | 2021 |
Elevated neuron-specific enolase level postoperative delirium phosphorylated neurofilament heavy subunit prospective observational study |
Variations in analgesic, sedation, and delirium management between trauma and non-trauma critically ill children | Mehl, S. C. Cunningham, M. E. Chance, M. D. Zhu, H. Fallon, S. C. Naik-Mathuria, B. Ettinger, N. A. Vogel, A. M. | Pediatr Surg Int | 2021 |
Analgesia |
Simulation Training Exercise to Improve Outcomes of Emergence Delirium in Patients With Posttraumatic Stress Disorder | Lovestrand, D. Beaumont, C. D. Calder, M. S. Schmidt, M. Calaro, R. | Aana j | 2021 |
Anesthesia |
Effects of Glucocorticoids on Postoperative Delirium in Adult Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis | Liu, W. Wang, Y. Wang, J. Shi, J. Pan, J. Wang, D. | Clin Ther | 2021 |
Glucocorticoids Postoperative Delirium Adult Cardiac Surgery A Systematic Review Meta-analysis |
The Association Between Preoperative Frailty and Postoperative Delirium: A Systematic Review and Meta-analysis | Liu, C. Y. Gong, N. Liu, W. | J Perianesth Nurs | 2021 |
delirium |
A complex intervention to promote prevention of delirium in older adults by targeting caregiver's participation during and after hospital discharge - study protocol of the TRAnsport and DElirium in older people (TRADE) project | Leinert, C. Brefka, S. Braisch, U. Denninger, N. Mueller, M. Benzinger, P. Bauer, J. Bahrmann, A. Frey, N. Katus, H. A. Geisler, T. Eschweiler, G. Klaus, J. Seufferlein, T. Schuetze, K. Gebhard, F. Dreyhaupt, J. Muche, R. Pahmeier, K. Biermann-Stallwitz, | BMC Geriatr | 2021 |
Aged |
Evaluation of Bedside Tests of Attention and Arousal Assessing Delirium in Parkinson's Disease, Dementia, and Older Adults | Lawson, R. A. Richardson, S. J. Kershaw, D. Davis, D. Stephan, B. C. M. Robinson, L. Brayne, C. Barnes, L. Burn, D. J. Yarnall, A. J. Taylor, J. P. Parker, S. Allan, L. M. | J Parkinsons Dis | 2021 |
Delirium |
Dexmedetomidine and paralytic exposure after damage control laparotomy: risk factors for delirium? Results from the EAST SLEEP-TIME multicenter trial | Krause, C. Kwon, E. Luo-Owen, X. McArthur, K. Cochran-Yu, M. Swentek, L. Burruss, S. Turay, D. Grigorian, A. Nahmias, J. Butt, A. Gutierrez, A. LaRiccia, A. Kincaid, M. Fiorentino, M. N. Glass, N. Toscano, S. Ley, E. Lombardo, S. R. Guillamondegui, O. D. | Eur J Trauma Emerg Surg | 2021 |
Damage control laparotomy |
The effects of intraoperative magnesium sulfate administration on emergence agitation and delirium in pediatric patients: a systematic review and meta-analysis of randomized controlled trials | Koo, C. H. Koo, B. W. Han, J. Lee, H. T. Lim, D. Shin, H. J. | Paediatr Anaesth | 2021 |
complications |
The Modified Hospital Elder Life Program (HELP) in geriatric hospitalized patients in internal wards: A double-blind randomized control trial | Kojaie-Bidgoli, A. Sharifi, F. Maghsoud, F. Alizadeh-Khoei, M. Jafari, F. Sadeghi, F. | BMC Geriatr | 2021 |
Aged |
The economic cost of delirium: A systematic review and quality assessment | Kinchin, I. Mitchell, E. Agar, M. Trépel, D. | Alzheimers Dement | 2021 |
Cost-Benefit Analysis/*economics |
The Risk of Preoperative Central Nervous System-Acting Medications on Delirium Following Hip or Knee Surgery: A Matched Case-Control Study | Kassie, G. M. Roughead, E. E. Nguyen, T. A. Pratt, N. L. Kalisch Ellett, L. M. | Drug Saf | 2021 |
Preoperative Central Nervous System Delirium Hip or Knee Surgery Matched Case-Control Study |
Association between ankle brachial index and development of postoperative intensive care unit delirium in patients with peripheral arterial disease | Kang, J. An, J. H. Jeon, H. J. Park, Y. J. | Sci Rep | 2021 |
Aged |
Incidence and predictors of delirium on the intensive care unit in patients with acute kidney injury, insight from a retrospective registry | Jäckel, M. Aicher, N. Rilinger, J. Bemtgen, X. Widmeier, E. Wengenmayer, T. Duerschmied, D. Biever, P. M. Stachon, P. Bode, C. Staudacher, D. L. | Sci Rep | 2021 |
Acute Kidney Injury/*diagnosis/epidemiology |
Advantages of score-based delirium detection compared to a clinical delirium assessment-a retrospective, monocentric cohort study | Jäckel, M. Aicher, N. Bemtgen, X. Rilinger, J. Zotzmann, V. Biever, P. M. Supady, A. Stachon, P. Duerschmied, D. Wengenmayer, T. Bode, C. Staudacher, D. L. | PLoS One | 2021 |
score-based delirium detection clinical delirium monocentric cohort study |
A Comparison of Dexmedetomidine and Propofol on Emergence Delirium in Children Undergoing Cleft Palate Surgery With Sevoflurane-Based Anesthesia | Huang, L. Wang, L. Peng, W. Qin, C. | J Craniofac Surg | 2021 |
Emergence Delirium Children Cleft Palate Surgery Sevoflurane |
Automated machine learning-based model predicts postoperative delirium using readily extractable perioperative collected electronic data | Hu, X. Y. Liu, H. Zhao, X. Sun, X. Zhou, J. Gao, X. Guan, H. L. Zhou, Y. Zhao, Q. Han, Y. Cao, J. L. | CNS Neurosci Ther | 2021 |
delirium |
Feasibility of low-dose dexmedetomidine for prevention of postoperative delirium after intracranial operations: a pilot randomized controlled trial | He, X. Cheng, K. M. Duan, Y. Q. Xu, S. S. Gao, H. R. Miao, M. Y. Li, H. L. Chen, K. Yang, Y. L. Zhang, L. Gu, H. Q. Zhou, J. X. | BMC Neurol | 2021 |
Delirium |
Reliability and validity of the Japanese version of the 4A's Test for delirium screening in the elderly patient | Hasegawa, T. Seo, T. Kubota, Y. Sudo, T. Yokota, K. Miyazaki, N. Muranaka, A. Hirano, S. Yamauchi, A. Nagashima, K. Iyo, M. Sakai, I. | Asian J Psychiatr | 2021 |
Attention |
Neural autoantibodies in delirium | Hansen, N. Krasiuk, I. Titsch, T. | J Autoimmun | 2021 |
Cognitive dysfunction |
Risk Factors for Delirium in the Palliative Care Population: A Systematic Review and Meta-Analysis | Guo, D. Lin, T. Deng, C. Zheng, Y. Gao, L. Yue, J. | Front Psychiatry | 2021 |
delirium |
Incidence, risk factors, and consequences of emergence delirium after elective brain tumor resection | Gu, W. J. Zhou, J. X. Ji, R. Q. Zhou, L. Y. Wang, C. M. | Surgeon | 2021 |
Emergence delirium |
A scientometric study of publications on delirium from 2001 to 2020 | Grover, S. Gupta, B. M | Asian J Psychiatr | 2021 |
Aged |
The neuropsychological profile of delirium vulnerability: A systematic review and meta-analysis | Ghezzi, E. S. Ross, T. J. Sharman, R. Davis, D. Boord, M. S. Thanabalan, T. Thomas, J. Keage, H. A. D. | Neurosci Biobehav Rev | 2021 |
ageing |
Cognitive Functionality of Patients with Delirium after Stroke | Dostović, Z. Ibrahimagić, OĆ Smajlović, D. Kunić, S. Čustović, A. | Psychiatr Danub | 2021 |
Cognition |
Sleep quality and emergence delirium in children undergoing strabismus surgery: a comparison between preschool- and school-age patients | Do, W. Kim, H. S. Kim, S. H. Kang, H. Lee, D. Baik, J. Lee, H. J. Hong, J. M. | BMC Anesthesiol | 2021 |
*Emergence delirium |
Multicomponent nursing program to prevent delirium in critically ill patients: a randomized clinical trial | Contreras, C. C. T. Esteban, A. N. P. Parra, M. D. Romero, M. K. R. Silva, C. G. D. Buitrago, N. P. D. | Rev Gaucha Enferm | 2021 |
*Critical Illness |
Longitudinal validation of an electronic health record delirium prediction model applied at admission in COVID-19 patients | Castro, V. M. Hart, K. L. Sacks, C. A. Murphy, S. N. Perlis, R. H. McCoy, T. H., Jr. | Gen Hosp Psychiatry | 2021 |
Covid-19 |
Independent, Differential Effects of Delirium on Disability and Mortality Risk After Hip Fracture | Cartei, A. Mossello, E. Ceccofiglio, A. Rubbieri, G. Polidori, G. Ranalli, C. Cammilli, A. Curcio, M. Cavallini, M. C. Mannarino, G. M. Ungar, A. Toccafondi, G. Peris, A. Marchionni, N. Rostagno, C. | J Am Med Dir Assoc | 2021 |
Delirium |
Melatonin and melatonin-receptor agonists to prevent delirium in hospitalized older adults: An umbrella review | Blodgett, T. J. Blodgett, N. P. | Geriatr Nurs | 2021 |
Circadian Rhythm |
Barriers to completing the 4AT for delirium and its clinical implementation in two hospitals: a mixed-methods study | Alhaidari, A. A. O. Matsis, K. P. | Eur Geriatr Med | 2021 |
Delirium |
The relationship between sensory stimuli and the physical environment in complex healthcare settings: A systematic literature review | Bayramzadeh, S. Ahmadpour, S. Aghaei, P. | Intensive Crit Care Nurs | 2021 |
*Communication |
Simultaneous bilateral total knee arthroplasty is safe and effective for patients in different ages | Ariga, A. Kohno, Y. Nakagawa, Y. Watanabe, T. Katagiri, H. Ohara, T. Shioda, M. Ozeki, N. Amemiya, M. Okawa, A. Sekiya, I. Koga, H. | J Orthop Sci | 2021 |
Age groups |
Machine Learning Algorithm Using Electronic Chart-Derived Data to Predict Delirium After Elderly Hip Fracture Surgeries: A Retrospective Case-Control Study | Zhao, H. You, J. Peng, Y. Feng, Y. | Front Surg | 2021 |
delirium |
The Effect of Data Length on the Assessment of Dynamic Cerebral Autoregulation with Transfer Function Analysis in Neurological ICU Patients | Zhang, W. Lu, H. Zhang, P. Mo, X. Ou, A. Liu, J. Zhong, J. | Neurocrit Care | 2021 |
Data length |
Clinical Features and Outcomes of Neuropsychiatric Systemic Lupus Erythematosus in China | Zhang, S. Li, M. Zhang, L. Wang, Z. Wang, Q. You, H. Wang, Y. Li, M. Zeng, X. | J Immunol Res | 2021 |
Adult |
Noncontact Monitoring of Heart Rate and Heart Rate Variability in Geriatric Patients Using Photoplethysmography Imaging | Yu, X. Laurentius, T. Bollheimer, C. Leonhardt, S. Antink, C. H. | IEEE J Biomed Health Inform | 2021 |
Aged |
Non-Contact Measurement of Heart Rate Variability in Frail Geriatric Patients: Response to Early Geriatric Rehabilitation and Comparison with Healthy Old Community-Dwelling Individuals - A Pilot Study | Yu, X. Hoog Antink, C. Leonhardt, S. Bollheimer, L. C. Laurentius, T. | Gerontology | 2021 |
Frailty |
Aggressive patient behaviours and unplanned nursing staff leave - is there an association? | Yu, J. J. Holbeach, E. | Int J Ment Health Nurs | 2021 |
Aggression |
The Significant Prognostic Factors in Prolonged Intensive/High Care Unit Stay After Living Donor Liver Transplantation | Yoshiya, S. Harada, N. Tomiyama, T. Takeishi, K. Toshima, T. Iguchi, T. Itoh, S. Ninomiya, M. Yoshizumi, T. Mori, M. | Transplant Proc | 2021 |
Adult |
Mode displaying mouse cursors for reducing input language mode confusion: Utility and user attitude evaluation | Yoo, T. Lee, H. Hyun, S. Park, W. | Appl Ergon | 2021 |
Confusion |
Incidence and influencing factors of post-intensive care cognitive impairment | Yao, L. Li, Y. Yin, R. Yang, L. Ding, N. Li, B. Shen, X. Zhang, Z. | Intensive Crit Care Nurs | 2021 |
Apache |
Validation of the Simplified Palliative Prognostic Index to Predict Survival for Advanced Cancer Patients in Home Hospice Setting | Yang, H. J. Yoon, S. J. Kim, J. S. Kim, S. S. Jung, J. G. Suh, W. Y. Lee, S. Kim, H. G. Lee, Y. W. | Korean J Fam Med | 2021 |
Hospice Care |
Oral corticosteroid dosage and clinical presentation of psychiatric conditions after steroid use: A consultation-liaison psychiatry service's experience | Yagi, Y. Takahashi, Y. Ogata, Y. Yamana, H. Kumakura, Y. Ichihashi, K. Kasai, K. Kondo, S. | Neuropsychopharmacol Rep | 2021 |
consultation-liaison psychiatry |
Machine learning-assisted screening for cognitive impairment in the emergency department | Yadgir, S. R. Engstrom, C. Jacobsohn, G. C. Green, R. K. Jones, C. M. C. Cushman, J. T. Caprio, T. V. Kind, A. J. H. Lohmeier, M. Shah, M. N. Patterson, B. W. | J Am Geriatr Soc | 2021 |
cognitive impairment |
Effects of perioperative rosuvastatin on postoperative delirium in elderly patients: A randomized, double-blind, and placebo-controlled trial | Xu, X. Q. Luo, J. Z. Li, X. Y. Tang, H. Q. Lu, W. H. | World J Clin Cases | 2021 |
Elderly |
Is Perioperative Dexmedetomidine Associated With a Reduced Risk of Perioperative Neurocognitive Disorders Following Cardiac Surgery? A Systematic Review and Meta-Analysis With Trial Sequential Analysis of Randomized Controlled Trials | Xiong, X. Chen, D. Shi, J. | Front Med (Lausanne) | 2021 |
cardiac surgery |
The effect of pre-operative methylprednisolone on postoperative delirium in elderly patients undergoing gastrointestinal surgery: a randomized, double-blind, placebo-controlled trial | Xiang, X. B. Chen, H. Wu, Y. L. Wang, K. Yue, X. Cheng, X. Q. | J Gerontol A Biol Sci Med Sci | 2021 |
Delirium |
Social Determinants of Health and Delirium Occurrence and Duration in Critically Ill Adults | Wu, T. T. Zegers, M. Kooken, R. Griffith, J. L. Molnar, B. E. Devlin, J. W. van den Boogaard, M. | Crit Care Explor | 2021 |
delirium |