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 |
---|---|---|---|---|
Developing a machine learning model to identify delirium risk in geriatric internal medicine inpatients | Li, Q. Zhao, Y. Chen, Y. Yue, J. Xiong, Y. | Eur Geriatr Med | 2021 |
Delirium |
Development and validation of a risk score for predicting postoperative delirium after major abdominal surgery by incorporating preoperative risk factors and surgical Apgar score | Li, G. H. Zhao, L. Lu, Y. Wang, W. Ma, T. Zhang, Y. X. Zhang, H. | J Clin Anesth | 2021 |
Bootstrapping |
Non-Pharmacological Nursing Interventions for Prevention and Treatment of Delirium in Hospitalized Adult Patients: Systematic Review of Randomized Controlled Trials | Lee, Y. Lee, J. Kim, J. Jung, Y. | Int J Environ Res Public Health | 2021 |
Adult |
Association of natural light exposure and delirium according to the presence or absence of windows in the intensive care unit | Lee, H. J. Bae, E. Lee, H. Y. Lee, S. M. Lee, J. | Acute Crit Care | 2021 |
delirium |
Knowledge, barriers, and training needs of nurses working in delirium care | Lee, G. Roh, Y. S | Nurs Crit Care | 2021 |
barrier |
Causes and Predictors of 30-Day Readmission in Elderly Patients With Delirium | Lau, H. L. Patel, S. D. Garg, N. | Neurol Clin Pract | 2021 |
Readmission rate, Delirium, Hospitalization, Length of stay, Post discharge care |
Comparison of Antipsychotics for the Treatment of Patients With Delirium and QTc Interval Prolongation: A Clinical Decision Analysis | Kurisu, K. Yoshiuchi, K. | Front Psychiatry | 2021 |
QTc prolongation |
The Polish Version of the Nursing Delirium Screening Scale (NuDESC PL)-Experience of Using in Nursing Practice in Cardiac Surgery Intensive Care Unit | Krupa, S. Dorota, O. Friganovic, A. Mędrzycka-Dąbrowska, W. Jurek, K. | Int J Environ Res Public Health | 2021 |
Cardiac Surgical Procedures/adverse effects |
Associations of delirium with urinary tract infections and asymptomatic bacteriuria in adults aged 65 and older: A systematic review and meta-analysis | Krinitski, D. Kasina, R. Klöppel, S. Lenouvel, E. | J Am Geriatr Soc | 2021 |
asymptomatic bacteriuria |
Prevalence and Factors Affecting Postoperative Delirium in a Neurosurgical Intensive Care Unit | Kose, G. Şirin, K. Inel, M. B. Mertoglu, S. Aksakal, R. Kurucu, Ş | J Neurosci Nurs | 2021 |
Cross-Sectional Studies |
Effect of hypertension and medication use regularity on postoperative delirium after maxillofacial tumors radical surgery | Kong, S. Wang, J. Xu, H. Wang, K. | Oncotarget | 2021 |
hypertension |
Perioperative Electroencephalogram Spectral Dynamics Related to Postoperative Delirium in Older Patients | Koch, S. Windmann, V. Chakravarty, S. Kruppa, J. Yürek, F. Brown, E. N. Winterer, G. Spies, C. | Anesth Analg | 2021 |
Electroencephalography, Postoperative delirium, Surgery, Spectral edge frequency |
Is dislocation following total hip arthroplasty caused while suffering from delirium? | Kobayashi, T. Morimoto, T. Sonohata, M. Mawatari, M. | Nagoya J Med Sci | 2021 |
dislocation |
Availability of preoperative neutrophil-lymphocyte ratio to predict postoperative delirium after head and neck free-flap reconstruction: A retrospective study | Kinoshita, H. Saito, J. Takekawa, D. Ohyama, T. Kushikata, T. Hirota, K. | PLoS One | 2021 |
Postoperative delirium, ICU delirium, Neutrophil-lymphocyte ratio, Surgery, Length of Stay |
Delirium risk of histamine-2 receptor antagonists and proton pump inhibitors: A study based on the adverse drug event reporting database in Japan | Kikkawa, N. Sogawa, R. Monji, A. Sumi, S. Murakawa-Hirachi, T. Kubo, T. Eguchi, Y. Miyamoto, Y. Kamo, M. Tobita, S. Yukawa, M. Uchida, R. Egoshi, M. Shimanoe, C. | Gen Hosp Psychiatry | 2021 |
Delirium |
Delirium in neurosurgery: a systematic review and meta-analysis | Kappen, P. R. Kakar, E. Dirven, C. M. F. van der Jagt, M. Klimek, M. Osse, R. J. Vincent, Apje | Neurosurg Rev | 2021 |
Delirium |
Risk factors for postoperative delirium and subsyndromal delirium in older patients in the surgical ward: A prospective observational study | Kanno, M. Doi, M. Kubota, K. Kanoya, Y. | PLoS One | 2021 |
Postoperative delirium, Subsyndromal delirium, Surgery, CAM |
Diagnostic accuracy and clinical applicability of the Swedish version of the 4AT assessment test for delirium detection, in a mixed patient population and setting | Johansson, Y. A. Tsevis, T. Nasic, S. Gillsjö, C. Johansson, L. Bogdanovic, N. Kenne Sarenmalm, E | BMC Geriatr | 2021 |
Aged |
In-Hospital Delirium as a Prognostic Factor for New Cognitive Disorder in a 1-Year Post-Hip Fracture Follow-Up | Jaatinen, R. Luukkaala, T. Hongisto, M. T. Helminen, H. Nuotio, M. S. | Dement Geriatr Cogn Disord | 2021 |
Cognition |
Italian version of the short 10/66 dementia diagnostic schedule: a validation study | Ibnidris, A. Piumatti, G. Carlevaro, F. Fadda, M. Magno, F. Magistro, D. Albanese, E. | BMJ Open | 2021 |
Aged |
A Machine Learning-Based Algorithm for the Prediction of Intensive Care Unit Delirium (PRIDE): Retrospective Study | Hur, S. Ko, R. E. Yoo, J. Ha, J. Cha, W. C. Chung, C. R. | JMIR Med Inform | 2021 |
clinical prediction |
The effect of evidence-based cluster nursing intervention on the incidences of delirium and the prognoses of ICU patients | Huang, S. Xu, J. Du, Y. Wang, Y. Wei, H. Wei, G. Hu, M. | Am J Transl Res | 2021 |
Evidence-based medicine |
Impact of dexmedetomidine supplemented analgesia on delirium in patients recovering from orthopedic surgery: A randomized controlled tria | Hong, H. Zhang, D. Z. Li, M. Wang, G. Zhu, S. N. Zhang, Y. Wang, D. X. Sessler, D. I. | BMC Anesthesiol | 2021 |
Delirium |
Effects of a simulation-based education programme on delirium care for critical care nurses: A randomized controlled trial | Ho, M. H. Yu, L. F. Lin, P. H. Chang, H. R. Traynor, V. Huang, W. C. Montayre, J. Chen, K. H. | J Adv Nurs | 2021 |
Clinical Competence |
Postoperative Delirium in Older Patients: A Systematic Review of Assessment and Incidence of Postoperative Delirium | Ho, M. H. Nealon, J. Igwe, E. Traynor, V. Chang, H. R. Chen, K. H. Montayre, J. | Worldviews Evid Based Nurs | 2021 |
Aged |
Harmonization of Four Delirium Instruments: Creating Crosswalks and the Delirium Item-Bank (DEL-IB) | Helfand, B. K. I. Detroyer, E. Milisen, K. Adamis, D. Metzger, E. D. Boudreaux, E. D. Inouye, S. K. Jones, R. N. | Am J Geriatr Psychiatry | 2021 | |
Association between genetic variants of the cholinergic system and postoperative delirium and cognitive dysfunction in elderly patients | Heinrich, M. Sieg, M. Kruppa, J. Nürnberg, P. Schreier, P. H. Heilmann-Heimbach, S. Hoffmann, P. Nöthen, M. M. Janke, J. Pischon, T. Slooter, A. J. C. Winterer, G. Spies, C. D. | BMC Med Genomics | 2021 |
Chrm2 |
Risk of delirium and impaired neurological outcome associated with delay in neurorehabilitation after acquired brain injury | Hansen, P. M. Lauridsen, J. T. Frandsen, N. S. | Dan Med J | 2021 |
*Brain Injuries |
Prevalence, Risk Factors, and Impact of Delirium on Hospitalized Older Adults With Dementia: A Systematic Review and Meta-Analysis | Han, Q. Y. C. Rodrigues, N. G. Klainin-Yobas, P. Haugan, G. Wu, X. | J Am Med Dir Assoc | 2021 |
Dementia |
Urinary albumin creatinine ratio associated with postoperative delirium in elderly patients undergoing elective non-cardiac surgery: A prospective observational study | Guan, H. L. Liu, H. Hu, X. Y. Abdul, M. Dai, M. S. Gao, X. Chen, X. F. Zhou, Y. Sun, X. Zhou, J. Li, X. Zhao, Q. Zhang, Q. Q. Wang, J. Han, Y. Cao, J. L. | CNS Neurosci Ther | 2021 |
delirium |
Cognitive Impairment and Delirium in Older Patients Undergoing Major Head and Neck Surgery | Goldstein, D. P. Blasco, M. de Almeida, J. Su, J. Xu, W. Cohen, M. Sklar, M. Alibhai, S | Otolaryngol Head Neck Surg | 2021 |
clock draw test |
What prompts patients to present with delirium? | Gibb, K. Krywonos, A. Shah, R. Jha, A. Davis, D. | Eur Geriatr Med | 2021 |
Adult |
Admission Systolic Blood Pressure Predicts Post-Operative Delirium of Acute Aortic Dissection Patients in the Intensive Care Unit | Fu, Z. Xu, Q. Zhang, C. Bai, H. Chen, X. Zhang, Y. Luo, W. Lin, G. | Int J Gen Med | 2021 |
acute Stanford type A aortic dissection |
Postoperative Delirium in Patients After Brain Tumor Surgery | French, J. Weber, T. Ge, B. Litofsky, N. S. | World Neurosurg | 2021 |
Confusion assessment method |
Physical Restraints and Post-Traumatic Stress Disorder in Survivors of Critical Illness. A Systematic Review and Meta-analysis | Franks, Z. M. Alcock, J. A. Lam, T. Haines, K. J. Arora, N. Ramanan, M. | Ann Am Thorac Soc | 2021 |
Adult |
Long-Term Outcomes in ICU Patients with Delirium: A Population-based Cohort Study | Fiest, K. M. Soo, A. Hee Lee, C. Niven, D. J. Ely, E. W. Doig, C. J. Stelfox, H. T. | Am J Respir Crit Care Med | 2021 |
Adolescent |
The effect of foot reflexology massage on delirium and sleep quality following cardiac surgery: A randomized clinical trial | Fazlollah, A. Babatabar Darzi, H. Heidaranlu, E. Moradian, S. T. | Complement Ther Med | 2021 |
*Cardiac Surgical Procedures/adverse effects |
A delirium prevalence audit and a pre and post evaluation of an interprofessional education intervention to increase staff knowledge about delirium in older adults | Ewens, B. Seaman, K. Whitehead, L. Towell-Barnard, A. Young, M. | BMC Nurs | 2021 |
Delirium |
Anaesthetic depth and delirium after major surgery: a randomised clinical trial | Evered, L. A. Chan, M. T. V. Han, R. Chu, M. H. M. Cheng, B. P. Scott, D. A. Pryor, K. O. Sessler, D. I. Veselis, R. Frampton, C. Sumner, M. Ayeni, A. Myles, P. S. Campbell, D. Leslie, K. Short, T. G. | Br J Anaesth | 2021 |
anaesthesia |
Association of preoperative frailty with postoperative delirium in elderly orthopedic trauma patients | Esmaeeli, S. Franco-Garcia, E. Akeju, O. Heng, M. Zhou, C. Azocar, R. J. Quraishi, S. A. | Aging Clin Exp Res | 2021 |
Cognition |
Prevention of postoperative delirium after cardiovascular surgery: A team-based approach | Enomoto, K. Kosaka, S. Kimura, T. Matsubara, M. Kitada, Y. Mieno, M. Okamura, H. | J Thorac Cardiovasc Surg | 2021 |
Delirium Team Approach program |
Serum Levels of S100β, Neuron-Specific Enolase, Glial Fibrillary Acidic Protein in Kidney Transplant Recipients and Donors: A Prospective Cohort Study | Dinc, B. Yılmaz, V. T. Aslan, M. Aycan, I. O. Kiraz, N. Kisaoglu, A. Dandin, O. Hadimioglu, N. Ertug, Z. | Transplant Proc | 2021 |
Nephrectomy, Kidney transplant, Neuromarkers, Postoperative delirium |
Delirium and Its Pharmacological Causes in Older People, Part 1 | DeMaagd, G. A. DeMaagd, D. R. Philip, A. Coalter, C. F. | Sr Care Pharm | 2021 |
Aged |
Potentially inappropriate prescribing in dementia, multi-morbidity and incidence of adverse health outcomes | Delgado, J. Jones, L. Bradley, M. C. Allan, L. M. Ballard, C. Clare, L. Fortinsky, R. H. Hughes, C. M. Melzer, D. | Age Ageing | 2021 |
Aged |
The Nexus Between Sleep Disturbance and Delirium Among Intensive Care Patients | Delaney, L. J. Litton, E. Van Haren, F. | Crit Care Nurs Clin North Am | 2021 |
Critical Care |
Opportunities for quality improvement in the morbidity pattern of older adults undergoing pulmonary lobectomy for cancer | De León, L. E. Rochefort, M. M. Bravo-Iñiguez, C. E. Fox, S. W. Tarascio, J. N. Cardin, K. DuMontier, C. Frain, L. N. Jaklitsch, M. T. | J Geriatr Oncol | 2021 |
Aged |
Palliative sedation in patients with advanced cancer in a specialized unit in a middle-income country: A retrospective cohort study | de Araujo, C. Z. S. de Araújo, L. Z. S. Nassar Junior, A. P. | Palliat Support Care | 2021 |
Cancer |
Development and Implementation of a Multicomponent Protocol to Promote Sleep and Reduce Delirium in a Medical Intensive Care Unit | Darby, A. Northam, K. Austin, C. A. Chang, L. Campbell-Bright, S | Ann Pharmacother | 2021 |
critical care |
Effect of Interventions With a Clinical Decision Support System for Hospitalized Older Patients: Systematic Review Mapping Implementation and Design Factors | Damoiseaux-Volman, B. A. van der Velde, N. Ruige, S. G. Romijn, J. A. Abu-Hanna, A. Medlock, S. | JMIR Med Inform | 2021 |
aged |
Sevoflurane-Remifentanil Versus Propofol-Remifentanil Anesthesia During Noncardiac Surgery for Patients with Coronary Artery Disease - A Prospective Study Between 2016 and 2017 at a Single Center | Dai, Z. Lin, M. Li, Y. Gao, W. Wang, P. Lin, J. Wan, Z. Jiang, Y. | Med Sci Monit | 2021 |
Acute Coronary Syndrome, Coronary Artery Disease, Propofol |
Symptom trajectories for palliative care inpatients with and without hyperactive delirium in the last week of life | Dai, Y. Walpole, G. Ding, J. Scanlon, C. Ho, L. Khoo, R. H. Huang, C. Cook, A. William, L. Johnson, C. E. | J Adv Nurs | 2021 |
end of life |
Subtypes of delirium after ischaemic stroke-predisposing factors and outcomes: a prospective observational study (PROPOLIS) | Czyzycki, M. Klimiec-Moskal, E. Chrobak, A. A. Pera, J. Slowik, A. Dziedzic, T. | Eur J Neurol | 2021 |
delirium |
Effectiveness of a Delirium Prevention Initiative on an Inpatient Neuroscience Unit | Cyrus, T. Wenthold, R. Hall, B. Tu, L. Hedquist, K. Omodt, J. Kozub, E. Guthrie, P. F. | J Neurosci Nurs | 2021 |
Clinical Competence |
Association Between Cerebral Desaturation and Postoperative Delirium in Thoracotomy With One-Lung Ventilation: A Prospective Cohort Study | Cui, F. Zhao, W. Mu, D. L. Zhao, X. Li, X. Y. Wang, D. X. Jia, H. Q. Dai, F. Meng, L. | Anesth Analg | 2021 |
Aged |
Factors for Timely Identification of Possible Occurrence of Delirium in Palliative Care: A Prospective Observational Study | Corli, O. Santucci, C. Uggeri, S. Bosetti, C. Cattaneo, M. Ermolli, D. Varrassi, G. Myrcik, D. Paladini, A. Rekatsina, M. Gerosa, C. Ornaghi, M. Roccasalva, A. Santambrogio, P. Beretta, M. | Adv Ther | 2021 |
*Delirium/chemically induced/diagnosis/epidemiology |
A Processed Electroencephalogram-Based Brain Anesthetic Resistance Index Is Associated With Postoperative Delirium in Older Adults: A Dual Center Study | Cooter Wright, M. Bunning, T. Eleswarpu, S. S. Heflin, M. T. McDonald, S. R. Lagoo-Deenadalayan, S. Whitson, H. E. Martinez-Camblor, P. Deiner, S. G. Berger, M. | Anesth Analg | 2021 |
age factors, anesthesia, methods, delirium, surgery/prevention & control, Electroencephalography, drug effects |
Implementation and Routinization of the ABCDE Bundle: A Mixed Methods Evaluation | Collinsworth, A. W. Brown, R. Cole, L. Jungeblut, C. Kouznetsova, M. Qiu, T. Richter, K. M. Smith, S. Masica, A. L. | Dimens Crit Care Nurs | 2021 |
Adult |
Prediction of delirium using data mining: A systematic review | Chua, S. J. Wrigley, S. Hair, C. Sahathevan, R | J Clin Neurosci | 2021 |
Area Under Curve |
Determinants of Non-emergency Use of Control Interventions in Older Canadian Psychiatric Inpatients: Analysizing the InterRAI Mental Health Electronic Health Records | Cheung, G. Mah, T. M. Barak, Y. Hirdes, J. P. | Front Psychiatry | 2021 |
aggression |
Assessment of preoperative frailty and identification of patients at risk for postoperative delirium in cardiac intensive care units: a prospective observational study | Cheng, H. W. Liu, C. Y. Chen, Y. S. Shih, C. C. Chen, W. Y. Chiou, A. F. | Eur J Cardiovasc Nurs | 2021 |
Anxiety |
Preoperative prognostic nutritional index is useful factor for predicting postoperative delirium after primary total joint arthroplasty | Chen, J. Zheng, C. Zhong, J. Zhao, G. Shi, J. Huang, G. Wei, Y. Wang, S. Yu, J. Xia, J. | BMC Musculoskelet Disord | 2021 |
Aged |
Case-control study on the interplay between immunoparalysis and delirium after cardiac surgery | CheheiliSobbi, S. Peters van Ton, A. M. Wesselink, E. M. Looije, M. F. Gerretsen, J. Morshuis, W. J. Slooter, A. J. C. Abdo, W. F. Pickkers, P. van den Boogaard, M. | J Cardiothorac Surg | 2021 |
*Cardiac Surgical Procedures/adverse effects |
Diagnostic accuracy of the "4 A's Test" delirium screening tool for the postoperative cardiac surgery ward | Chang, Y. Ragheb, S. M. Oravec, N. Kent, D. Nugent, K. Cornick, A. Hiebert, B. Rudolph, J. L. MacLullich, A. M. J. Arora, R. C. | J Thorac Cardiovasc Surg | 2021 |
4at |
Meta-analysis of ICU Delirium Biomarkers and Their Alignment With the NIA-AA Research Framework | Chan, C. K. Song, Y. Greene, R. Lindroth, H. Khan, S. Rios, G. Khan, B. Wang, S | Am J Crit Care | 2021 |
Alzheimer Disease |
Sedation strategy and ICU delirium: a multicentre, population-based propensity score-matched cohort study | Casault, C. Soo, A. Lee, C. H. Couillard, P. Niven, D. Stelfox, T. Fiest, K. | BMJ Open | 2021 |
Adult |
Health outcomes after the implementation of multidisciplinary clinical guidelines for the care of hip fractures | Casanova Querol, T. Santiago Bautista, J. M. Lafuente Salinas, M. Güell Farré, E. Girós Torres, J. Martín-Baranera, M. Miralles Basseda, R. | Rev Clin Esp (Barc) | 2021 |
Atención continuada |
Pharmacological and non-pharmacological interventions to prevent delirium in critically ill patients: a systematic review and network meta-analysis | Burry, L. D. Cheng, W. Williamson, D. R. Adhikari, N. K. Egerod, I. Kanji, S. Martin, C. M. Hutton, B. Rose, L. | Intensive Care Med | 2021 |
Adult |
Dexmedetomidine for Facilitating Mechanical Ventilation Extubation in Difficult-to-Wean ICU Patients: Systematic Review and Meta-Analysis of Clinical Trials | Buckley, M. S. Smithburger, P. L. Wong, A. Fraser, G. L. Reade, M. C. Klein-Fedyshin, M. Ardiles, T. Kane-Gill, S. L. | J Intensive Care Med | 2021 |
Adult |
Risk factors for postoperative delirium: An umbrella review of systematic reviews | Bramley, P. McArthur, K. Blayney, A. McCullagh, I. | Int J Surg | 2021 |
*Cognitive Dysfunction |
Inadequate emergence after anesthesia for elective cancer surgery: a single-center cohort study | Braga, A. Abelha, F. | Braz J Anesthesiol | 2021 |
Cancer surgeries |
Asthma and delirium episodes during hospitalization | Bozek, A. Fiolka, R. Zajac, M. | Aging Med (Milton) | 2021 |
asthma |
A pragmatic assessment of proton pump inhibitors vs. histamine type 2 receptor antagonists on clinically important gastrointestinal bleeding and mortality when used for stress ulcer prophylaxis in the ICU | Boyd, C. Hassig, T. MacLaren, R. | Pharmacotherapy | 2021 |
critical illness |
Brain Network Dysfunction in Poststroke Delirium and Spatial Neglect: An fMRI Study | Boukrina, O. Kowalczyk, M. Koush, Y. Kong, Y. Barrett, A. M. | Stroke | 2021 |
MRI, functional |
Preventing Delirium and Promoting Long-Term Brain Health: A Clinical Trial Design for the Perioperative Cognitive Enhancement (PROTECT) Trial | Atkins, K. J. Scott, D. A. Silbert, B. Pike, K. E. Evered, L. | J Alzheimers Dis | 2021 |
Anesthesia and analgesia |
Prevalence of Severe Neurocognitive Impairment and Its Association with Socio-Demographics and Functionality Among Ugandan Older Persons: A Hospital-Based Study | Atim, L. M. Kaggwa, M. M. Mamun, M. A. Ashaba, S. Maling, S. | Clin Interv Aging | 2021 |
Aged |
Clinical Aspects of Palliative Sedation in Prospective Studies. A Systematic Review | Arantzamendi, M. Belar, A. Payne, S. Rijpstra, M. Preston, N. Menten, J. Van der Elst, M. Radbruch, L. Hasselaar, J. Centeno, C. | J Pain Symptom Manage | 2021 |
*Hospice and Palliative Care Nursing |
Psychometric Properties of Nursing Delirium Screening Scale in Patients Admitted to Intensive Care Units | Amirajam, Z. Asadi-Noran, E. Molaei, B. Adiban, V. Heidarzadeh, M. Hassanpour-Darghah, M. | Indian J Crit Care Med | 2021 |
Delirium |
Delirium researchers' perspectives of the challenges in delirium biomarker research: A qualitative study | Amgarth-Duff, I. Hosie, A. Caplan, G. A. Agar, M. | PLoS One | 2021 |
Biomarkers/blood |
Addition of Valerian and Lemon Balm Extract to Quetiapine Reduces Agitation in Critically Ill Patients with Delirium: A Pilot Randomized Clinical Trial | Alikiaie, B. Shahmoradi, E. Yekdaneh, A. Mousavi, S. | Indian J Crit Care Med | 2021 |
Delirium |
Spinal block and delirium in oncologic patients after laparoscopic surgery in the Trendelenburg position: A randomized controlled trial | Mitsunaga, J. K. Junior Calsavara, V. F. Onari, E. S. Arantes, V. M. Akamine, C. P. Handa, A. M. Quezada, M. M. C. Ito, F. Y. Porto, A. C. S. Giroud Joaquim, E. H. Nakamura, G. | PLoS One | 2021 | |
Perioperative Vascular Biomarker Profiling in Elective Surgery Patients Developing Postoperative Delirium: A Prospective Cohort Study | Menzenbach, J. Frede, S. Petras, J. Guttenthaler, V. Kirfel, A. Neumann, C. Mayr, A. Wittmann, M. Coburn, M. Klaschik, S. Hilbert, T. | Biomedicines | 2021 |
Ccl2 |
Preliminary Study of Serum Biomarkers Associated With Delirium After Major Cardiac Surgery | McKay, T. B. Rhee, J. Colon, K. Adelsberger, K. Turco, I. Mueller, A. Qu, J. Akeju, O. | J Cardiothorac Vasc Anesth | 2021 |
Fgf |
Stratified delirium risk using prescription medication data in a state-wide cohort | McCoy, T. H., Jr. Castro, V. M. Hart, K. L. Perlis, R. H. | Gen Hosp Psychiatry | 2021 |
Cohort study |
Nutritional Risk at intensive care unit admission and outcomes in survivors of critical illness | Mart, M. F. Girard, T. D. Thompson, J. L. Whitten-Vile, H. Raman, R. Pandharipande, P. P. Heyland, D. K. Ely, E. W. Brummel, N. E. | Clin Nutr | 2021 |
Activities of daily living |
Risk Factors for Delirium Are Different in the Very Old: A Comparative One-Year Prospective Cohort Study of 5,831 Patients | Marquetand, J. Bode, L. Fuchs, S. Hildenbrand, F. Ernst, J. von Kaenel, R. Boettger, S. | Front Psychiatry | 2021 |
comparison |
Plasma interleukin-6 is a potential predictive biomarker for postoperative delirium among acute type a aortic dissection patients treated with open surgical repair | Lv, X. C. Lin, Y. Wu, Q. S. Wang, L. Hou, Y. T. Dong, Y. Chen, L. W. | J Cardiothorac Surg | 2021 |
Adult |
Association of early and later depressive symptoms with functional outcome after ischemic stroke | Lopatkiewicz, A. M. Pera, J. Slowik, A. Dziedzic, T. | J Neural Transm (Vienna) | 2021 |
Cognitive decline |
Development and validation of a postoperative delirium prediction model for pediatric patients: A prospective, observational, single-center study | Lin, N. Liu, K. Feng, J. Chen, R. Ying, Y. Lv, D. Zhou, Y. Xu, H. | Medicine (Baltimore) | 2021 |
Adolescent |
Patients' experiences of delirium: A systematic review and meta-summary of qualitative research | Kuusisto-Gussmann, E. Höckelmann, C. von der Lühe, V. Schmädig, R. Baltes, M. Stephan, A. | J Adv Nurs | 2021 |
delirium |
Effects of case-based confusion assessment methods for intensive care unit training on delirium knowledge and delirium assessment accuracy of intensive care units: A quasi-experimental study | Kim, Y. N. Kim, D. H. | Nurse Educ Today | 2021 |
Critical Illness |
Bridging the Gap Between the Intensive Care Unit and the Acute Medical Care Unit | Kim, E. Kast, C. Afroz-Hossain, A. Qiu, M. Pappas, K. Sinvani, L. | Am J Crit Care | 2021 | |
Preoperative MRI brain phenotypes are related to postoperative delirium in older individuals | Kant, I. M. J. Slooter, A. J. C. Jaarsma-Coes, M. van Montfort, S. J. T. Witkamp, T. D. Pasma, W. Hendrikse, J. de Bresser, J. | Neurobiol Aging | 2021 |
Brain phenotypes |
Pre-Existing Psychiatric Illness Is Associated With an Increased Risk of Delirium in Patients With Acute Respiratory Distress Syndrome | Kalra, S. S. Jaber, J. Alzghoul, B. N. Hyde, R. Parikh, S. Urbine, D. Reddy, R. | J Intensive Care Med | 2021 |
Ards |
Development and internal validation of a predictive model of cognitive decline 36 months following elective surgery | Jones, R. N. Tommet, D. Steingrimsson, J. Racine, A. M. Fong, T. G. Gou, Y. Hshieh, T. T. Metzger, E. D. Schmitt, E. M. Tabloski, P. A. Travison, T. G. Vasunilashorn, S. M. Abdeen, A. Earp, B. Kunze, L. Lange, J. Vlassakov, K. Dickerson, B. C. Marcantonio | Alzheimers Dement (Amst) | 2021 |
cognitive decline |
The performance of the Dutch Safety Management System frailty tool to predict the risk of readmission or mortality in older hospitalised cardiac patients | Jepma, P. Verweij, L. Tijssen, A. Heymans, M. W. Flierman, I. Latour, C. H. M. Peters, R. J. G. Scholte Op Reimer, W. J. M. Buurman, B. M. Ter Riet, G. | BMC Geriatr | 2021 |
Aged |
Outcomes of transcatheter aortic valve replacement in patients with cognitive dysfunction | Jain, V. Kalra, A. Panhwar, M. S. Bansal, A. Nowacki, A. Bhatia, K. Gupta, T. Ineman, N. L. Khan, S. U. Krishnaswamy, A. Reed, G. W. Puri, R. Kapadia, S. R. Svensson, L. G. Kanaa, N. A. Lahorra, J. A. | J Am Geriatr Soc | 2021 |
cognitive impairment |
The Importance of Delirium and Delirium Prevention in Older Adults During Lockdowns | Inouye, S. K. | JAMA | 2021 |
Aged |
Association of Pain With Atrial Fibrillation and Delirium After Cardiac Surgery: A DECADE Sub-Study | Ince, I. Chiu, A. Sagir, A. Chahar, P. Lin, J. Douglas, A. Adi, A. Fang, J. Mao, G. Turan, A. | J Cardiothorac Vasc Anesth | 2021 |
atrial fibrillation |
Higher versus lower mean arterial pressure target management in older patients having non-cardiothoracic surgery: A prospective randomized controlled trial | Hu, A. M. Qiu, Y. Zhang, P. Zhao, R. Li, S. T. Zhang, Y. X. Zheng, Z. H. Hu, B. L. Yang, Y. L. Zhang, Z. J. | J Clin Anesth | 2021 |
Aged |
Are Patients Taking Benzodiazepines at Increased Risk for Complications Following Primary Total Knee Arthroplasty? | Hernandez, N. M. Cunningham, D. J. Hinton, Z. W. Wu, C. J. Seyler, T. M. | J Arthroplasty | 2021 |
Arthroplasty, Replacement, Knee/adverse effects |