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 |
---|---|---|---|---|
Preoperative medication use and development of postoperative delirium and cognitive dysfunction | Heinrich, M. Nottbrock, A. Borchers, F. Mörgeli, R. Kruppa, J. Winterer, G. Slooter, A. J. C. Spies, C. | Clin Transl Sci | 2021 | |
Radiological, Chemical, and Pharmacological Cholinergic System Parameters and Neurocognitive Disorders in Older Presurgical Adults | Heinrich, M. Müller, A. Lammers-Lietz, F. Borchers, F. Mörgeli, R. Kruppa, J. Zacharias, N. Winterer, G. Slooter, A. J. C. Spies, C. D. | J Gerontol A Biol Sci Med Sci | 2021 |
Anticholinergic medication |
Predictors and Sequelae of Postoperative Delirium in a Geriatric Patient Population With Hip Fracture | Haynes, M. S. Alder, K. D. Toombs, C. Amakiri, I. C. Rubin, L. E. Grauer, J. N | J Am Acad Orthop Surg Glob Res Rev | 2021 |
Postoperative Delirium Hip fracture Dementia Geriatric Preoperative dementia |
Visual Analytics in Delirium Management | Hackl, W. O. Netzer, M. Nantschev, R. Schaller, M. Ammenwerth, E. | Stud Health Technol Inform | 2021 |
Aged |
Characterizing Sleep Disruption and Delirium in Children After Cardiac Surgery: A Feasibility Study | Gregory, J. L. Brown, A. T. Kudchadkar, S. R. | Pediatr Crit Care Med | 2021 | |
One-Year Medicare Costs Associated With Delirium in Older Patients Undergoing Major Elective Surgery | Gou, R. Y. Hshieh, T. T. Marcantonio, E. R. Cooper, Z. Jones, R. N. Travison, T. G. Fong, T. G. Abdeen, A. Lange, J. Earp, B. Schmitt, E. M. Leslie, D. L. Inouye, S. K. | JAMA Surg | 2021 | |
Implementing Delirium Screening in an Intermediate Care Unit | Gaa, C. A. Akintade, B. F. | J Dr Nurs Pract | 2021 |
confusion assessment method |
Malocclusion of Molar Teeth Is Associated with Activities of Daily Living Loss and Delirium in Elderly Critically Ill Older Patients | Fujinami, Y. Hifumi, T. Ono, Y. Saito, M. Okazaki, T. Shinohara, N. Akiyama, K. Kunikata, M. Inoue, S. Kotani, J. Kuroda, Y. | J Clin Med | 2021 |
ICU prognosis |
Electroencephalography of mechanically ventilated patients at high risk of delirium | Eskioglou, E. Iaquaniello, C. Alvarez, V. Rüegg, S. Schindler, K. Rossetti, A. O. Oddo, M. | Acta Neurol Scand | 2021 |
Eeg |
Risk Factors and Antipsychotic Usage Patterns Associated With Terminal Delirium in a Veteran Long-Term Care Hospice Population | Ellsworth, E. M. Bacigalupo, K. J. Palla, K. R. Limaye, S. S. Walkosz, M. J. Szczecinski, S. T. Suda, K. J. | Fed Pract | 2021 | |
Does cognitive decline/dementia increase Delirium risk after stroke? | Ding, G. Hua, S. Chen, J. Yang, S. Xie, R. | Psychogeriatrics | 2021 |
Cognitive Dysfunction |
Heterogeneity in design and analysis of ICU delirium randomized trials: a systematic review | Colantuoni, E. Koneru, M. Akhlaghi, N. Li, X. Hashem, M. D. Dinglas, V. D. Neufeld, K. J. Harhay, M. O. Needham, D. M. | Trials | 2021 |
Adult |
The frequency and quality of delirium documentation in discharge summaries | Chuen, V. L. Chan, A. C. H. Ma, J. Alibhai, S. M. H. Chau, V. | BMC Geriatr | 2021 |
Delirium/diagnosis/epidemiology |
Using data linkage for national surveillance of clinical quality indicators for dementia care among Australian aged care users | Cations, M. Lang, C. Ward, S. A. Caughey, G. E. Crotty, M. Whitehead, C. Ahern, S. Maddison, J. Inacio, M. C. | Sci Rep | 2021 | |
Geriatric fracture centre vs usual care after proximal femur fracture in older patients: what are the benefits? Results of a large international prospective multicentre study | Blauth, M. Joeris, A. Rometsch, E. Espinoza-Rebmann, K. Wattanapanom, P. Jarayabhand, R. Poeze, M. Wong, M. K. Kwek, E. B. K. Hegeman, J. H. Perez-Uribarri, C. Guerado, E. Revak, T. J. Zohner, S. Joseph, D. Gosch, M. | BMJ Open | 2021 |
Aged |
Effects of dexmedetomidine on neurocognitive disturbance after elective non-cardiac surgery in senile patients: a systematic review and meta-analysis | Bi, X. Wei, J. Zhang, X. | J Int Med Res | 2021 |
China |
Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients (Review) | Burton JK, Craig LE, Yong SQ, Siddiqi N, Teale EA, Woodhouse R, Barugh AJ, Shepherd AM, Brunton A, Freeman SC, Sutton AJ, Quinn TJ | Cochrane Database of Systematic Reviews | 2021 | |
Incidence and risk factors for postoperative delirium after liver transplantation: a systematic review and meta-analysis | Zhou, S. Deng, F. Zhang, J. Chen, G. | Eur Rev Med Pharmacol Sci | 2021 | |
The perioperative application of continuous cerebral autoregulation monitoring for cerebral protection in elderly patients | Zhang, Y. Tan, J. Li, P. Zhang, X. Yang, Y. Liu, Y. Fu, Q. Cao, J. Mi, W. Zhang, H. Li, H. | Ann Palliat Med | 2021 |
Aged |
Prospective Randomized Controlled Pilot Study of High-Intensity Lightbox Phototherapy to Prevent ICU-Acquired Delirium Incidence | Zhang, K. S. Pelleg, T. Hussain, S. Kollipara, V. Loschner, A. Foroozesh, M. B. Rubio, E. Biscardi, F. Ie, S. R. | Cureus | 2021 |
bright light therapy |
Neurocognitive disorders in the elderly: altered functional resting-state hyperconnectivities in postoperative delirium patients | Winterer, J. M. Ofosu, K. Borchers, F. Hadzidiakos, D. Lammers-Lietz, F. Spies, C. Winterer, G. Zacharias, N. | Transl Psychiatry | 2021 |
Aged |
Relationships between preoperative cortical thickness, postoperative electroencephalogram slowing, and postoperative delirium | White, M. F. Tanabe, S. Casey, C. Parker, M. Bo, A. Kunkel, D. Nair, V. Pearce, R. A. Lennertz, R. Prabhakaran, V. Lindroth, H. Sanders, R. D. | Br J Anaesth | 2021 |
cortical slowing |
COVID-19 in adults with dementia: clinical features and risk factors of mortality-a clinical cohort study on 125 patients | Vrillon, A. Mhanna, E. Aveneau, C. Lebozec, M. Grosset, L. Nankam, D. Albuquerque, F. Razou Feroldi, R. Maakaroun, B. Pissareva, I. Cherni Gherissi, D. Azuar, J. François, V. Hourrègue, C. Dumurgier, J. Volpe-Gillot, L. Paquet, C. | Alzheimers Res Ther | 2021 |
Aged, 80 and over |
Risk Factors for Delirium after Vascular Surgery: A Systematic Review and Meta-Analysis | Visser, L. Prent, A. Banning, L. B. D. van Leeuwen, B. L. Zeebregts, C. J. Pol, R. A. | Ann Vasc Surg | 2021 | |
Etiologies of Delirium in Consecutive COVID-19 Inpatients and the Relationship Between Severity of Delirium and COVID-19 in a Prospective Study With Follow-Up | Velásquez-Tirado, J. D. Trzepacz, P. T. Franco, J. G. | J Neuropsychiatry Clin Neurosci | 2021 |
Covid-19 |
Increased Emergency Department Hallway Length of Stay is Associated with Development of Delirium | van Loveren, K. Singla, A. Sinvani, L. Calandrella, C. Perera, T. Brave, M. Becker, L. Li, T. | West J Emerg Med | 2021 |
Adolescent |
Delirium in Children Undergoing Hematopoietic Cell Transplantation: A Multi-Institutional Point Prevalence Study | Traube, C. Gerber, L. M. Mauer, E. A. Small, K. Broglie, L. Chopra, Y. R. Duncan, C. N. Ebens, C. L. Fitzgerald, J. C. Freedman, J. L. Hudspeth, M. P. Hurley, C. Mahadeo, K. M. McArthur, J. Shapiro, M. C. Sharron, M. P. Wall, D. A. Zinter, M. S. Greenwald | Front Oncol | 2021 |
cancer |
Agreement Between the Mini-Cog in the Preoperative Clinic and on the Day of Surgery and Association With Postanesthesia Care Unit Delirium: A Cohort Study of Cognitive Screening in Older Adults | Tiwary, N. Treggiari, M. M. Yanez, N. D. Kirsch, J. R. Tekkali, P. Taylor, C. C. Schenning, K. J. | Anesth Analg | 2021 |
Aged |
A qualitative analysis of clinicians' communication strategies with family members of patients experiencing hospital-acquired delirium | Taylor, G. B. Radhakrishnan, N. Fisher, C. L. Price, C. Tighe, P. Le, T. Bylund, C. L. | Geriatr Nurs | 2021 | |
A scalable approach for developing clinical risk prediction applications in different hospitals | Sun, H. Depraetere, K. Meesseman, L. De Roo, J. Vanbiervliet, M. De Baerdemaeker, J. Muys, H. von Dossow, V. Hulde, N. Szymanowsky, R. | J Biomed Inform | 2021 |
Acute kidney injury |
The Relative Impact of Specific Postoperative Complications on Older Patients Undergoing Hip Fracture Repair | Stahl, C. C. Funk, L. M. Schumacher, J. R. Zarzaur, B. L. Scarborough, J. E. | Jt Comm J Qual Patient Saf | 2021 | |
Brain MRI after critical care admission: A longitudinal imaging study | Sprung, J. Warner, D. O. Knopman, D. S. Petersen, R. C. Mielke, M. M. Jack, C. R., Jr. Martin, D. P. Hanson, A. C. Schroeder, D. R. Przybelski, S. A. Schulte, P. J. Laporta, M. L. Weingarten, T. N. Vemuri, P. | J Crit Care | 2021 |
AD-signature cortex |
Effect of age on dexmedetomidine treatment for ventilated patients with sepsis: a post-hoc analysis of the DESIRE trial | Sato, T. Kawazoe, Y. Miyagawa, N. Yokokawa, Y. Kushimoto, S. Miyamoto, K. Ohta, Y. Morimoto, T. Yamamura, H. | Acute Med Surg | 2021 |
Delirium |
Effects of comprehensive geriatric care models on postoperative outcomes in geriatric surgical patients: a systematic review and meta-analysis | Saripella, A. Wasef, S. Nagappa, M. Riazi, S. Englesakis, M. Wong, J. Chung, F. | BMC Anesthesiol | 2021 |
Adverse outcomes |
Influence of Age on Postoperative Neurological Outcomes after Surgery of Acute Type A Aortic Dissection | Salem, M. Salib, M. Friedrich, C. Salem, M. Puehler, T. Schoettler, J. Schoeneich, F. Cremer, J. Haneya, A. | J Clin Med | 2021 |
acute type A aortic dissection |
Associations between caregiver-detected delirium and symptoms of depression and anxiety in family caregivers of critically ill patients: a cross-sectional study | Rosgen, B. K. Krewulak, K. D. Davidson, J. E. Ely, E. W. Stelfox, H. T. Fiest, K. M. | BMC Psychiatry | 2021 |
Adult |
A Core Outcome Set for Research Evaluating Interventions to Prevent and/or Treat Delirium in Critically Ill Adults: An International Consensus Study (Del-COrS) | Rose, L. Burry, L. Agar, M. Campbell, N. L. Clarke, M. Lee, J. Marshall, J. C. Devlin, J. W. Blackwood, B. Needham, D. M. Siddiqi, N. Page, V. | Crit Care Med | 2021 | |
Postoperative delirium is associated with decreased recovery of ambulation one-month after surgery | Robinson, T. N. Kovar, A. Carmichael, H. Overbey, D. M. Goode, C. M. Jones, T. S. | Am J Surg | 2021 |
Aged |
Emergence delirium in children: a Brazilian survey | Quintão, V. C. Sales, C. K. O. Herrera, E. M. Ellerkmann, R. K. Rosen, H. D. Carmona, M. J. C. | Braz J Anesthesiol | 2021 |
Anesthesia |
Perioperative dexmedetomidine administration to prevent delirium in adults after non-cardiac surgery: A systematic review and meta-analysis | Qin, C. Jiang, Y. Lin, C. Li, A. Liu, J. | J Clin Anesth | 2021 |
Adult |
Probable Delirium as a Risk Factor for Adverse Surgical Outcomes in Geriatric Patients With Acute Hip Fracture: Preoperative Assessment Using a Short Screening Tool | Perkins, J. L. Perera, S. Beach, M. Esper, S. A. Gruen, G. S. Neft, M. | AANA J | 2021 |
Adverse outcomes |
Cognitive Stimulation in an Intensive Care Unit: A Qualitative Evaluation of Barriers to and Facilitators of Implementation | Parker, A. M. Aldabain, L. Akhlaghi, N. Glover, M. Yost, S. Velaetis, M. Lavezza, A. Mantheiy, E. Albert, K. Needham, D. M. | Crit Care Nurse | 2021 | |
Does Delirium Phenomenology in Persons with Advanced Cancer Follow a Specific Pattern? | Pallotti, M. C. Lopez-Fidalgo, J. Centeno, C. Celin, D. Biasco, G. Giovannini, M. Maltoni, M. Noguera, A. | J Palliat Med | 2021 |
Mdas |
Dexmedetomidine, Delirium, and Adverse Outcomes: Analysis of the STS 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 |
cardiac surgery |
Factors associated with delirium after cardiac surgery: A prospective cohort study | Ordóñez-Velasco, L. M. Hernández-Leiva, E. | Ann Card Anaesth | 2021 |
Body mass index |
Baseline sleep as a predictor of delirium after surgical aortic valve replacement: A feasibility study | Oldham, M. A. Pigeon, W. R. Chapman, B. Yurcheshen, M. Knight, P. A. Lee, H. B. | Gen Hosp Psychiatry | 2021 |
Apnea/hypopnea index |
What Does a Diagnosis of Depression Mean for Patients Undergoing Colorectal Surgery? | Oduyale, O. K. Eltahir, A. A. Stem, M. Prince, E. Zhang, G. Q. Safar, B. Efron, J. E. Atallah, C. | J Surg Res | 2021 |
Colorectal surgery |
A randomized double-blind placebo-controlled trial of intravenous thiamine for prevention of delirium following allogeneic hematopoietic stem cell transplantation | Nakamura, Z. M. Deal, A. M. Park, E. M. Quillen, L. J. Chien, S. A. Stanton, K. E. McCabe, S. D. Heiling, H. M. Wood, W. A. Shea, T. C. Rosenstein, D. L. | J Psychosom Res | 2021 |
Cognitive impairment |
The 4-DSD: A New Tool to Assess Delirium Superimposed on Moderate to Severe Dementia | Morandi, A. Grossi, E. Lucchi, E. Zambon, A. Faraci, B. Severgnini, J. MacLullich, A. Smith, H. Pandharipande, P. Rizzini, A. Galeazzi, M. Massariello, F. Corradi, S. Raccichini, A. Scrimieri, A. Morichi, V. Gentile, S. Lucchini, F. Pecorella, L. Mossello | J Am Med Dir Assoc | 2021 |
Delirium |
Are dexmedetomidine and olanzapine suitable to control delirium in critically ill elderly patients? A retrospective cohort study | Liu, S. Zhao, R. Yang, R. Zhao, H. Ji, C. Duan, M. Liu, J. | Biomed Pharmacother | 2021 |
Critical illness |
Association between glucose variability and postoperative delirium in acute aortic dissection patients: an observational study | Lin, Y. J. Lin, L. Y. Peng, Y. C. Zhang, H. R. Chen, L. W. Huang, X. Z. Chen, Q. | J Cardiothorac Surg | 2021 |
Acute Disease |
Frailty is associated with a higher risk of developing delirium and cognitive impairment among patients with diabetic kidney disease: A longitudinal population-based cohort study | Lee, S. Y. Wang, J. Chao, C. T. Chien, K. L. Huang, J. W. | Diabet Med | 2021 |
chronic kidney disease |
Multi-Component Care Bundle in Geriatric Fracture Hip for Reducing Post-Operative Delirium | Lam, D. M. H. Wang, C. Lee, A. K. H. Chung, Y. F. Lau, T. W. Fang, C. Leung, F. Chan, T. C. W. | Geriatr Orthop Surg Rehabil | 2021 |
delirium |
Occurrence of Delirium during ECMO Therapy in a Critical Care Unit in Poland-A Cross-Sectional Pilot Study | Krupa, S. Friganovic, A. Mędrzycka-Dąbrowska, W. | Int J Environ Res Public Health | 2021 |
Critical Care |
Steroids to reduce the impact on delirium (STRIDE): a double-blind, randomised, placebo-controlled feasibility trial of pre-operative dexamethasone in people with hip fracture | Kluger, M. T. Skarin, M. Collier, J. Rice, D. A. McNair, P. J. Seow, M. Y. Connolly, M. J. | Anaesthesia | 2021 |
delirium |
Elevated plasma levels of galectin-3 binding protein are associated with post-stroke delirium - A pilot study | Klimiec-Moskal, E. Pasinska, P. Kowalska, K. Klimkowicz-Mrowiec, A. Pera, J. Slowik, A. Dziedzic, T. | J Neuroimmunol | 2021 |
Delirium |
Postoperative delirium after cardiac surgery of elderly patients as an independent risk factor for prolonged length of stay in intensive care unit and in hospital | Kirfel, A. Menzenbach, J. Guttenthaler, V. Feggeler, J. Mayr, A. Coburn, M. Wittmann, M. | Aging Clin Exp Res | 2021 |
Cardiac surgery |
ED-DEL: Development of a change package and toolkit for delirium in the emergency department | Kennedy, M. Webb, M. Gartaganis, S. Hwang, U. Biese, K. Stuck, A. Lesser, A. Hshieh, T. Inouye, S. K. | J Am Coll Emerg Physicians Open | 2021 |
aging |
Elevated Monocyte Chemoattractant Protein-1 as the Independent Risk Factor of Delirium after Cardiac Surgery. A Prospective Cohort Study | Kaźmierski, J. Miler, P. Pawlak, A. Jerczyńska, H. Woźniak, J. Frankowska, E. Brzezińska, A. Woźniak, K. Krejca, M. Wilczyński, M. | J Clin Med | 2021 |
cardiac surgery |
Prevalence of and factors associated with physical restraint use in the intensive care unit: a multicenter prospective observational study in Japan | Kawai, Y. Hamamoto, M. Miura, A. Yamaguchi, M. Masuda, Y. Iwata, M. Kanbe, M. Ikematsu, Y. | Intern Emerg Med | 2021 |
Associated factors |
Added value of anxiolytic benzodiazepines in predictive models on severe delirium in patients with acute decompensated heart failure: A retrospective analysis | Kawada, K. Fukuda, H. Kubo, T. Ohta, T. Ishida, T. Morisawa, S. Kawazoe, T. Okamoto, M. Fujita, H. Jobu, K. Morita, Y. Ueba, T. Kitaoka, H. Miyamura, M. | PLoS One | 2021 | |
Sagittal alignment changes and postoperative complications following surgery for adult spinal deformity in patients with Parkinson's disease: a multi-institutional retrospective cohort study | Kawabata, A. Yoshii, T. Sakai, K. Hirai, T. Yuasa, M. Inose, H. Matsukura, Y. Morishita, S. Tomori, M. Torigoe, I. Kusano, K. Otani, K. Arai, Y. Shindo, S. Okawa, A. | BMC Musculoskelet Disord | 2021 |
Follow-Up Studies |
Factors associated with post-electroconvulsive therapy delirium: A retrospective chart review study | Jo, Y. T. Joo, S. W. Lee, J. Joo, Y. H. | Medicine (Baltimore) | 2021 |
Adult |
Association of Delirium during Critical Illness With Mortality: Multicenter Prospective Cohort Study | Hughes, C. G. Hayhurst, C. J. Pandharipande, P. P. Shotwell, M. S. Feng, X. Wilson, J. E. Brummel, N. E. Girard, T. D. Jackson, J. C. Ely, E. W. Patel, M. B. | Anesth Analg | 2021 | |
Validating the Mandarin version of the Memorial delirium assessment scale in general medical hospital patients | Hu, C. H. Chiu, Y. C. Liu, S. I. Ko, K. T. | Asia Pac Psychiatry | 2021 |
confusion assessment method |
How do delirium motor subtypes differ in phenomenology and contributory aetiology? a cross-sectional, multisite study of liaison psychiatry and palliative care patients | Glynn, K. McKenna, F. Lally, K. O'Donnell, M. Grover, S. Chakrabarti, S. Avasthi, A. Mattoo, S. K. Sharma, A. Gosh, A. Shah, R. Hickey, D. Fitzgerald, J. Davis, B. O'Regan, N. Adamis, D. Williams, O. Awan, F. Dunne, C. Cullen, W. McInerney, S. McFarland, | BMJ Open | 2021 |
Adult |
Frailty, post-operative delirium and functional status at discharge in patients with hip fracture | Gandossi, C. M. Zambon, A. Oliveri, G. Codognola, M. Szabo, H. Cazzulani, I. Ferrara, M. C. Mottadelli, C. Galeazzi, M. Amoroso, I. Zarcone, C. Principato, G. Corsi, M. Mazzola, P. Zatti, G. Foti, G. Bellelli, G. | Int J Geriatr Psychiatry | 2021 |
delirium |
The Safety and Efficacy Evaluation of Dexmedetomidine for Procedural Sedation and Postoperative Behaviors in Pediatric Populations: A Systematic Review and Meta-analysis | Gan, L. Zhao, X. Chen, X. | Ann Pharmacother | 2021 |
delirium |
Association between frailty and postoperative delirium: a meta-analysis of cohort study | Fu, D. Tan, X. Zhang, M. Chen, L. Yang, J. | Aging Clin Exp Res | 2021 |
Cohort studies |
Incidence and factors associated with delirium in children in a single pediatric intensive care unit in Brazil | Flores, A. E. R. Oura, K. H. U. Rocha, P. K. Belela-Anacleto, A. S. C. Kusahara, D. M. | J Pediatr Nurs | 2021 |
Delirium |
Long-Term Outcomes in Intensive Care Unit 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 |
critical care |
Impact of Religiosity on Delirium Severity Among Critically Ill Shi'a Muslims: A Prospective Multi-Center Observational Study | Farzanegan, B. Elkhatib, T. H. M. Elgazzar, A. E. Moghaddam, K. G. Torkaman, M. Zarkesh, M. Goharani, R. Bashar, F. R. Hajiesmaeili, M. Shojaei, S. Madani, S. J. Vahedian-Azimi, A. Hatamian, S. Mosavinasab, S. M. M. Khoshfetrat, M. Khatir, A. K. Miller, A | J Relig Health | 2021 |
Critical Illness |
Depression as a predictor of postoperative delirium after cardiac surgery: a systematic review and meta-analysis | Falk, A. Kåhlin, J. Nymark, C. Hultgren, R. Stenman, M. | Interact Cardiovasc Thorac Surg | 2021 |
Cardiac surgery |
The delirium screening tool 4AT in routine clinical practice: prediction of mortality, sensitivity and specificity | Evensen, S. Hylen Ranhoff, A. Lydersen, S. Saltvedt, I. | Eur Geriatr Med | 2021 |
4at |
Delirium and Associated Length of Stay and Costs in Critically Ill Patients | Dziegielewski, C. Skead, C. Canturk, T. Webber, C. Fernando, S. M. Thompson, L. H. Foster, M. Ristovic, V. Lawlor, P. G. Chaudhuri, D. Dave, C. Herritt, B. Bush, S. H. Kanji, S. Tanuseputro, P. Thavorn, K. Rosenberg, E. Kyeremanteng, K. | Crit Care Res Pract | 2021 | |
Opioid Use Increases the Risk of Delirium in Critically Ill Adults Independently of Pain | Duprey, M. S. Dijkstra-Kersten, S. M. A. Zaal, I. J. Briesacher, B. A. Saczynski, J. S. Griffith, J. L. Devlin, J. W. Slooter, A. J. C. | Am J Respir Crit Care Med | 2021 |
delirium |
Association Between Incident Delirium Treatment With Haloperidol and Mortality in Critically Ill Adults | uprey, M. S. Devlin, J. W. van der Hoeven, J. G. Pickkers, P. Briesacher, B. A. Saczynski, J. S. Griffith, J. L. van den Boogaard, M. | Crit Care Med | 2021 | |
Descriptive analysis of the unwarranted continuation of antipsychotics for the management of ICU delirium during transitions of care: A multicenter evaluation across New Jersey | Dixit, D. Andrews, L. B. Radparvar, S. Adams, C. Kumar, S. T. Cardinale, M. | Am J Health Syst Pharm | 2021 |
ICU delirium |
Cluster nursing can reduce postoperative delirium and improve the negative emotions and quality of life of elderly ICU patients | Di, J. Wang, X. Chen, J. | Am J Transl Res | 2021 |
Cluster nursing |
Cluster nursing can reduce postoperative delirium and improve the negative emotions and quality of life of elderly ICU patients | Di, J. Wang, X. Chen, J. | Am J Transl Res | 2021 |
Cluster nursing |
Influence of intraoperative and postoperative factors on the predictive capacity of the delirium risk model for cardiac surgery patients (DELIPRECAS): An observational multicentre study | de la Varga-Martínez, O. Gómez-Pesquera, E. Muñoz-Moreno, M. F. Marcos-Vidal, J. M. López-Gómez, A. Rodenas-Gómez, F. Ramasco, F. Álvarez-Refojo, F. Barón, M. S. Tamayo, E. Heredia-Rodríguez, M. Gómez-Sánchez, E. | J Clin Anesth | 2021 |
Cardiac Surgical Procedures/adverse effects |
Older trauma patients are at high risk of delirium, especially those with underlying dementia or baseline frailty | Ní Chróinín D Francis, N. Wong, P. Kim, Y. D. Nham, S. D'Amours, S. | Trauma Surg Acute Care Open | 2021 |
cognition |
The Impact of Monitoring Depth of Anesthesia and Nociception on Postoperative Cognitive Function in Adult Multiple Trauma Patients | Cotae, A. M. Ţigliş, M. Cobilinschi, C. Băetu, A. E. Iacob, D. M. Grinţescu, I. M. | Medicina (Kaunas) | 2021 |
Adult |
Outcomes of trimodality CROSS regimen in older adults with locally advanced esophageal cancer | Cooper, L. Dezube, A. R. De León, L. E. Kucukak, S. Mazzola, E. Dumontier, C. Mamon, H. Enzinger, P. Jaklitsch, M. T. Frain, L. N. Wee, J. O. | Eur J Surg Oncol | 2021 |
Cross |
Nursing intervention to prevent delirium in critically ill adults | Contreras, C. C. T. Páez-Esteban, A. N. Rincon-Romero, M. K. Carvajal, R. R. Herrera, M. M. Castillo, Ahdd | Rev Esc Enferm USP | 2021 | |
Changes in Sedation Practices in Association with Delirium Screening in Infants After Cardiopulmonary Bypass | Chomat, M. R. Said, A. S. Mann, J. L. Wallendorf, M. Bickhaus, A. Figueroa, M. | Pediatr Cardiol | 2021 |
Cornell Assessment of Pediatric Delirium |
Risk factors of postoperative delirium after cardiac surgery: a meta-analysis | Chen, H. Mo, L. Hu, H. Ou, Y. Luo, J. | J Cardiothorac Surg | 2021 |
Age Factors |
Diagnosis of overweight or obese malnutrition spells DOOM for hip fracture patients: A prospective audit | Bell, J. J. Pulle, R. C. Lee, H. B. Ferrier, R. Crouch, A. Whitehouse, S. L. | Clin Nutr | 2021 |
Body mass index |
Risk factors for delirium among hospitalized patients in Zambia | Mateyo, K. Yan, Y. Liu, D. Zuo, Y. Di Gravio, C. Thome, J. C. Riviello, E. D. Saylor, D. Ely, E. W. Heimburger, D. C. | PLoS One | 2021 | |
Risk factors associated with treatment of hyperactive postoperative delirium in elderly patients following hip fracture surgery under regional anesthesia: a nationwide population-based study | Ahn, E. J. Bang, S. R. | Braz J Anesthesiol | 2021 |
Anesthesia |
Incidence of delirium in the critical care unit and risk factors in the Central Region, Saudi Arabia | Abazid, R. M. Al-Harbi, S. A. Allihimy, A. S. Aldrewesh, D. A. Alkuraydis, S. A. Alhammad, I. M. Elbashir, A. Y. Widyan, A. M. Abohamr, S. I. | Saudi Med J | 2021 |
Saudi |
The risk factors of postoperative delirium in patients with hip fracture: implication for clinical management | Xu, W. Ma, H. Li, W. Zhang, C. | BMC Musculoskelet Disord | 2021 |
Delirium/diagnosis/epidemiology/etiology |
Nationwide mortality trends of delirium in Australia and the United States from 2006 to 2016 | Wu, H. Mach, J. Le Couteur, D. G. Hilmer, S. N. | Australas J Ageing | 2021 |
delirium |
The Use of Near-Infrared Spectroscopy and/or Transcranial Doppler as Non-Invasive Markers of Cerebral Perfusion in Adult Sepsis Patients With Delirium: A Systematic Review | Wood, M. D. Boyd, J. G. Wood, N. Frank, J. Girard, T. D. Ross-White, A. Chopra, A. Foster, D. Griesdale, D. E. G. | J Intensive Care Med | 2021 |
cerebral autoregulation |
Midazolam Premedication Immediately Before Surgery Is Not Associated With Early Postoperative Delirium | Wang, M. L. Min, J. Sands, L. P. Leung, J. M. | Anesth Analg | 2021 | |
The Effect of a Quality Improvement Intervention on Sleep and Delirium in Critically Ill Patients in a Surgical ICU | Tonna, J. E. Dalton, A. Presson, A. P. Zhang, C. Colantuoni, E. Lander, K. Howard, S. Beynon, J. Kamdar, B. B. | Chest | 2021 |
critical care |
Association between components of the delirium syndrome and outcomes in hospitalised adults: a systematic review and meta-analysis | Tieges, Z. Quinn, T. MacKenzie, L. Davis, D. Muniz-Terrera, G. MacLullich, A. M. J. Shenkin, S. D. | BMC Geriatr | 2021 |
Cognition |
The Prognostic Performance of Frailty for Delirium and Functional Decline in Vascular Surgery Patients | Thillainadesan, J. Mudge, A. M. Aitken, S. J. Hilmer, S. N. Cullen, J. S. Yumol, M. F. Close, J. C. T. Norris, C. M. Kerdic, R. Naganathan, V. | J Am Geriatr Soc | 2021 |
delirium |
Efficacy of quetiapine for delirium prevention in hospitalized older medical patients: a randomized double-blind controlled trial | Thanapluetiwong, S. Ruangritchankul, S. Sriwannopas, O. Chansirikarnjana, S. Ittasakul, P. Ngamkala, T. Sukumalin, L. Charernwat, P. Saranburut, K. Assavapokee, T. | BMC Geriatr | 2021 |
Aged |
Effects of Slowness, Frailty, Insufficient Intake, and Delirium in Patients Following Cardiac Surgery: A Cohort Study | Teng, C. H. Hsu, R. B. Chi, N. H. Wang, S. S. Chen, Y. S. Chen, S. Y. Chen, C. C. | J Cardiovasc Nurs | 2021 |