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 |
---|---|---|---|---|
Factors associated with the severity of delirium | Tachibana, M. Inada, T. Ichida, M. Kojima, S. Shioya, M. Wakayama, K. Ozaki, N. | Hum Psychopharmacol | 2021 |
Drs-r98 |
Screening for delirium in the intensive care unit using eDIS-ICU - A purpose-designed app: A pilot study | Sutt, A. L. Flaws, D. Gunn, H. Eeles, E. Lye, I. Irvine, L. Patterson, S. Bagshaw, T. O'Luanaigh, C. Tronstad, O. Fraser, J. | Aust Crit Care | 2021 |
Delirium |
Association Among Preoperative Cognitive Performance, Regional Cerebral Oxygen Saturation, and Postoperative Delirium in Older Portuguese Patients | Susano, M. J. Dias, M. Seixas, F. S. Vide, S. Grasfield, R. Abelha, F. J. Crosby, G. Culley, D. J. Amorim, P. | Anesth Analg | 2021 |
Age Factors |
Sleep and circadian rhythm disturbances in intensive care unit (ICU)-acquired delirium: a case-control study | Sun, T. Sun, Y. Huang, X. Liu, J. Yang, J. Zhang, K. Kong, G. Han, F. Hao, D. Wang, X. | J Int Med Res | 2021 |
Adolescent |
Terminal Delirium in Hospice: The Experiences and Perspectives of Caregivers Providing Care to Terminally Ill Patients in Home Settings | Soroka, J. T. Fling, K. J. Heibel, J. M. Kutcher, G. R. Ward, S. J. | Am J Hosp Palliat Care | 2021 |
caregivers |
Estimates of Geriatric Delirium Frequency in Noncardiac Surgeries and Its Evaluation Across the Years: A Systematic Review and Meta-analysis | Silva, A. R. Regueira, P. Albuquerque, E. Baldeiras, I. Cardoso, A. L. Santana, I. Cerejeira, J. | J Am Med Dir Assoc | 2021 |
Delirium |
The Effects of Bispectral Index-Guided Anesthesia on Postoperative Delirium in Elderly Patients: A Systematic Review and Meta-Analysis | Shan, W. Chen, B. Huang, L. Zhou, Y. | World Neurosurg | 2021 |
Bispectral index |
Validation of the Delirium Diagnostic Tool-Provisional (DDT-Pro) in a skilled nursing facility and comparison to the 4 'A's test (4AT) | Sepúlveda, E. Bermúdez, E. González, D. Cotino, P. Viñuelas, E. Palma, J. Ciutat, M. Grau, I. Vilella, E. Trzepacz, P. T. Franco, J. G. | Gen Hosp Psychiatry | 2021 |
Delirium diagnosis |
Evaluation of Delirium in Critically Ill Patients Prescribed Melatonin or Ramelteon | Romero, N. Dube, K. M. Lupi, K. E. DeGrado, J. R. | Ann Pharmacother | 2021 |
agitation |
Delirium and delirium severity predict the trajectory of the Hierarchical Assessment of Balance and Mobility (HABAM) in hospitalised older people: findings from the DECIDE Study | Richardson, S. Murray, J. Davis, D. Stephan, B. C. M. Robinson, L. Brayne, C. Barnes, L. Parker, S. Sayer, A. Dodds, R. Allan, L. | J Gerontol A Biol Sci Med Sci | 2021 |
Epidemiology |
Common biomarkers of physiologic stress and associations with delirium in patients with intracerebral hemorrhage | Reznik, M. E. Kalagara, R. Moody, S. Drake, J. Margolis, S. A. Cizginer, S. Mahta, A. Rao, S. S. Stretz, C. Wendell, L. C. Thompson, B. B. Asaad, W. F. Furie, K. L. Jones, R. N. Daiello, L. A. | J Crit Care | 2021 |
Biomarkers |
Effects of Preoperative Anxiety on Postoperative Delirium in Elderly Patients Undergoing Elective Orthopedic Surgery: A Prospective Observational Cohort Study | Ren, A. Zhang, N. Zhu, H. Zhou, K. Cao, Y. Liu, J. | Clin Interv Aging | 2021 |
Aged |
Hyperactive delirium in patients after non-traumatic subarachnoid hemorrhage | Reimann, F. Rinner, T. Lindner, A. Kofler, M. Ianosi, B. A. Schiefecker, A. J. Beer, R. Schmutzhard, E. Pfausler, B. Helbok, R. Rass, V. | J Crit Care | 2021 |
Critical care |
Prescribing Practices of Valproic Acid for Agitation and Delirium in the Intensive Care Unit | Quinn, N. J. Hohlfelder, B. Wanek, M. R. Duggal, A. Torbic, H. | Ann Pharmacother | 2021 |
Aged |
Delirium and Mortality in Coronavirus Disease 2019 (COVID-19) - A Systematic Review and Meta-analysis | Pranata, R. Huang, I. Lim, M. A. Yonas, E. Vania, R. Kuswardhani, R. A. T. | Arch Gerontol Geriatr | 2021 |
Aged Covid-19 |
Dexmedetomidine vs. total intravenous anaesthesia in paediatric emergence delirium: A network meta-analysis | Petre, M. A. Levin, D. N. Englesakis, M. Maynes, J. T. Pechlivanoglou, P. Aoyama, K. | Eur J Anaesthesiol | 2021 | |
Delirium prevalence in a Colombian hospital, association with geriatric syndromes and complications during hospitalization | Peralta-Cuervo, A. F. Garcia-Cifuentes, E. Castellanos-Perilla, N. Chavarro-Carvajal, D. A. Venegas-Sanabria, L. C. Cano-Gutiérrez, C. A. | Rev Esp Geriatr Gerontol | 2021 |
Aged |
Anticholinergic load and delirium in end-of-life patients | Pasina, L. Rizzi, B. Nobili, A. Recchia, A. | Eur J Clin Pharmacol | 2021 |
Anticholinergic drugs |
Patients, family members and providers perceive family-administered delirium detection tools in the adult ICU as feasible and of value to patient care and family member coping: a qualitative focus group study | Parsons Leigh, J. Krewulak, K. D. Zepeda, N. Farrier, C. E. Spence, K. L. Davidson, J. E. Stelfox, H. T. Fiest, K. M. | Can J Anaesth | 2021 |
Adaptation, Psychological |
Serum melatonin concentration in critically ill patients randomized to sedation or non-sedation | Oxlund, J. Knudsen, T. Strøm, T. Lauridsen, J. T. Jennum, P. J. Toft, P. | Ann Intensive Care | 2021 |
Circadian |
Depression predicts cognitive and functional decline one month after coronary artery bypass graft surgery (Neuropsychiatric Outcomes After Heart Surgery study) | Oldham, M. A. Lin, I. H. Hawkins, K. A. Li, F. Y. Yuh, D. D. Lee, H. B. | Int J Geriatr Psychiatry | 2021 |
Aged |
Effect of deep neuromuscular blockade on serum cytokines and postoperative delirium in elderly patients undergoing total hip replacement: A prospective single-blind randomised controlled trial | Oh, C. S. Lim, H. Y. Jeon, H. J. Kim, T. H. Park, H. J. Piao, L. Kim, S. H. | Eur J Anaesthesiol | 2021 |
Aged |
Cerebral autoregulation in the operating room and intensive care unit after cardiac surgery | Nakano, M. Nomura, Y. Whitman, G. Sussman, M. Schena, S. Kilic, A. Choi, C. W. Akiyoshi, K. Neufeld, K. J. Lawton, J. Colantuoni, E. Yamaguchi, A. Wen, M. Smielewski, P. Brady, K. Bush, B. Hogue, C. W. Brown, C. H. th | Br J Anaesth | 2021 |
Aged |
Propofol plus low-dose dexmedetomidine infusion and postoperative delirium in older patients undergoing cardiac surgery | Momeni, M. Khalifa, C. Lemaire, G. Watremez, C. Tircoveanu, R. Van Dyck, M. Kahn, D. Rosal Martins, M. Mastrobuoni, S. De Kerchove, L. Zango, S. H. Jacquet, L. M. | Br J Anaesth | 2021 |
Aged |
Delirium REduction after administration of melatonin in acute ischemic stroke (DREAMS): A propensity score-matched analysis | Mengel, A. Zurloh, J. Boßelmann, C. Brendel, B. Stadler, V. Sartor-Pfeiffer, J. Meisel, A. Fleischmann, R. Ziemann, U. Poli, S. Stefanou, M. I. | Eur J Neurol | 2021 |
delirium |
Incidence, Risk Factors and Impact on Long-Term Outcome of Postoperative Delirium After Transcatheter Aortic Valve Replacement | Mauri, V. Reuter, K. Körber, M. I. Wienemann, H. Lee, S. Eghbalzadeh, K. Kuhn, E. Baldus, S. Kelm, M. Nickenig, G. Veulemans, V. Jansen, F. Adam, M. Rudolph, T. K. | Front Cardiovasc Med | 2021 |
Tavr |
Predisposing and Precipitating Factors for Delirium in the Very Old (≥80 Years): A Prospective Cohort Study of 3,076 Patients | Marquetand, J. Bode, L. Fuchs, S. Ernst, J. von Känel, R. Boettger, S. | Gerontology | 2021 |
80 years |
Delirium and Functional Recovery in Patients Discharged to Skilled Nursing Facilities After Hospitalization for Heart Failure | Madrigal, C. Kim, J. Jiang, L. Lafo, J. Bozzay, M. Primack, J. Correia, S. Erqou, S. Wu, W. C. Rudolph, J. L. | JAMA Netw Open | 2021 |
Activities of Daily Living |
Prevalence of high-risk medications in patients enrolled in the Hospital Elder Life Program | Macias Tejada, J. A. Klumph, M. Heslin, K. Khan, A. Malone, M. L. | J Am Geriatr Soc | 2021 |
antipsychotics |
Acupuncture Treatment of Delirium in Older Adults Hospitalized in Internal Medicine Departments: An Open-Label Pragmatic Randomized-Controlled Trial | Levy, I. Gavrieli, S. Hefer, T. Attias, S. Schiff, A. Oliven, R. Wisberg-Levi, S. Hanchinsky, R. Schiff, E. | J Geriatr Psychiatry Neurol | 2021 |
acupuncture |
Impact of an orthogeriatric collaborative care model for older adults with hip fracture in a community hospital setting | Lee, J. C. Koo, K. Wong, E. K. C. Naqvi, R. Wong, C. L. | Can J Surg | 2021 | |
Cardiac Delirium Index for Predicting the Occurrence of Postoperative Delirium in Adult Patients After Coronary Artery Bypass Grafting | Lechowicz, K. Szylińska, A. Listewnik, M. Drożdżal, S. Tomska, N. Rotter, I. Kotfis, K. | Clin Interv Aging | 2021 |
Aged |
Delirium documentation in hospitalized pediatric patients with cancer | Lastrapes, K. Dang, M. Cassel, J. B. Orr, T. Proffitt, T. Del Fabbro, E. | Palliat Support Care | 2021 |
Delirium |
Efficacy of two integrated geriatric care pathways for the treatment of hip fractures: a cross-cultural comparison | Kusen, J. Q. van der Vet, P. C. R. Wijdicks, F. J. G. Verleisdonk, Ejjm Link, B. C. Houwert, R. M. Knobe, M. van der Velde, D. Babst, R. Beeres, F. J. P. | Eur J Trauma Emerg Surg | 2021 |
Clinical pathway |
Depressed mood, associated factors, and understanding of delirium among caregivers of patients with delirium | Kim, S. Y. Jhon, M. Kang, H. J. Lee, J. Y. Kim, S. W. Kim, J. M. Shin, I. S. | Int J Psychiatry Med | 2021 |
caregiver |
Scheduled Prophylactic 6-Hourly IV AcetaminopheN to Prevent Postoperative Delirium in Older CaRdiac SurgicAl Patients (PANDORA): protocol for a multicentre randomised controlled trial | Khera, T. Mathur, P. A. Banner-Goodspeed, V. M. Narayanan, S. McGourty, M. Kelly, L. Palihnich, K. Novack, L. Davis, R. Talmor, D. Marcantonio, E. R. Subramaniam, B. | BMJ Open | 2021 |
Acetaminophen |
Serum Biomarkers in Postoperative Delirium after Esophagectomy | Khan, S. H. Lindroth, H. Jawed, Y. Wang, S. Nasser, J. Seyffert, S. Naqvi, K. Perkins, A. J. Gao, S. Kesler, K. Khan, B. | Ann Thorac Surg | 2021 |
biomarkers |
Drug-related problems of antipsychotics in treating delirium among elderly patients: A real-world observational study | Jenraumjit, R. Somboon, J. Chainan, S. Chuenchom, P. Wongpakaran, N. Wongpakaran, T. | J Clin Pharm Ther | 2021 |
antipsychotics |
Effect of Melatonin on Delirium After on-Pump Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial | Javaherforoosh Zadeh, F. Janatmakan, F. Shafaeebejestan, E. Jorairahmadi, S | Iran J Med Sci | 2021 |
Delirium |
A polysomnography study examining the association between sleep and postoperative delirium in older hospitalized cardiac surgical patients | Ibala, R. Mekonnen, J. Gitlin, J. Hahm, E. Y. Ethridge, B. R. Colon, K. M. Marota, S. Ortega, C. Pedemonte, J. C. Cobanaj, M. Chamadia, S. Qu, J. Gao, L. Barbieri, R. Akeju, O. | J Sleep Res | 2021 |
cardiac surgery |
Delirium in older patients undergoing aortic valve replacement: incidence, predictors, and cognitive prognosis | Humbert, M. Büla, C. J. Muller, O. Krief, H. Monney, P. | BMC Geriatr | 2021 |
Activities of Daily Living |
A clinical risk analysis of early post-operative delirium after laparoscopic colorectal cancer surgery in elderly patients: a retrospective study | Hiraki, M. Tanaka, T. Ishii, H. Sadashima, E. Miura, D. Sunami, T. Hanafusa, K. Sato, H. Kitahara, K. | Int J Colorectal Dis | 2021 |
Aged |
Nurses' experiences of delirium and how to identify delirium-A qualitative study | Helgesen, A. K. Adan, Y. H. Dybvik Bjørglund, C. Weberg-Haugen, C. Johannessen, M. Åsmul Kristiansen, K. Vasskog Risan, E. Relusco, M. L. Skaarer-Heen, H. M. Sørensen, T. S. Vedå, L. Abrahamsen Grøndahl, V. | Nurs Open | 2021 |
Delirium/diagnosis |
Preoperative Comparison of Three Anticholinergic Drug Scales in Older Adult Patients and Development of Postoperative Delirium: A Prospective Observational Study | Heinrich, M. Müller, A. Cvijan, A. Mörgeli, R. Kruppa, J. Winterer, G. Slooter, A. J. C. Spies, C. D. | Drugs Aging | 2021 | |
Characterization of Nocturnal Neuroactive Medication Use and Related Sleep Documentation in Critically Ill Adults | Hamidi, A. Roberts, R. J. Weinhouse, G. L. Szumita, P. M. Degrado, J. R. Dube, K. M. Kovacevic, M. P. Choi, M. Sevinsky, R. Duprey, M. S. Devlin, J. W. | Crit Care Explor | 2021 |
antipsychotics |
Optimal interval and duration of CAM-ICU assessments for delirium detection after cardiac surgery | Hamadnalla, H. Sessler, D. I. Troianos, C. A. Fang, J. Rivas, E. Ma, C. Mascha, E. J. Turan, A. | J Clin Anesth | 2021 |
Anesthesia |
Is there evidence for using anticonvulsants in the prevention and/or treatment of delirium among older adults? | Gupta, A. Joshi, P. Bhattacharya, G. Lehman, M. Funaro, M. Tampi, D. J. Tampi, R. R. | Int Psychogeriatr | 2021 |
anticonvulsants |
Is there evidence for using anticonvulsants in the prevention and/or treatment of delirium among older adults? | Gupta, A. Joshi, P. Bhattacharya, G. Lehman, M. Funaro, M. Tampi, D. J. Tampi, R. R. | Int Psychogeriatr | 2021 |
anticonvulsants |
Association of CSF Alzheimer's disease biomarkers with postoperative delirium in older adults | Fong, T. G. Vasunilashorn, S. M. Gou, Y. Libermann, T. A. Dillon, S. Schmitt, E. Arnold, S. E. Kivisäkk, P. Carlyle, B. Oh, E. S. Vlassakov, K. Kunze, L. Hshieh, T. Jones, R. N. Marcantonio, E. R. Inouye, S. K. | Alzheimers Dement (N Y) | 2021 |
AD biomarkers |
Impact of Delirium and Its Motor Subtypes on Stroke Outcomes | Fialho Silva, I. T. Assis Lopes, P. Timotio Almeida, T. Ramos, S. C. Caliman Fontes, A. T. Guimarães Silva, D. Martins Soares, C. Oliveira Carneiro, L. Souza, I. F. B. Ferreira Abreu, F. Nascimento Silva, G. Mascarenhas de Souza, L. Brito Pinheiro, T. de | Stroke | 2021 |
cognition |
The experience of delirium in palliative care settings for patients, family, clinicians and volunteers: A qualitative systematic review and thematic synthesis | Featherstone, I. Hosie, A. Siddiqi, N. Grassau, P. Bush, S. H. Taylor, J. Sheldon, T. Johnson, M. J. | Palliat Med | 2021 |
Delirium |
The association of post-operative delirium with patient-reported outcomes and mortality after lung transplantation | DeBolt, C. L. Gao, Y. Sutter, N. Soong, A. Leard, L. Jeffrey, G. Kleinhenz, M. E. Calabrese, D. Greenland, J. Venado, A. Hays, S. R. Shah, R. Kukreja, J. Trinh, B. Kolaitis, N. A. Douglas, V. Diamond, J. M. Smith, P. Singer, J. | Clin Transplant | 2021 |
Critical care medicine |
Does rocking motion calm delirious patients in ICU? A multicentre randomised clinical trial protocol (RockingICU) | Collet, M. O. Nielsen, G. M. Bang, B. Laerkner, E. Fischer, S. Langvad, A. Thorn, L. Lange, T. Egerod, I. | Acta Anaesthesiol Scand | 2021 |
delirium |
Do specific delirium aetiologies have different associations with death? A longitudinal cohort of hospitalised patients | Chalmers, L. A. Searle, S. D. Whitby, J. Tsui, A. Davis, D. | Eur Geriatr Med | 2021 |
Aetiology |
Development and External Validation of a Delirium Prediction Model for Hospitalized Patients With Coronavirus Disease 2019 | Castro, V. M. Sacks, C. A. Perlis, R. H. McCoy, T. H. | J Acad Consult Liaison Psychiatry | 2021 |
Covid-19 |
Incidence and risk factors of delirium in surgical intensive care unit | Ali, M. A. Hashmi, M. Ahmed, W. Raza, S. A. Khan, M. F. Salim, B. | Trauma Surg Acute Care Open | 2021 |
brain |
Economic Impact of Poststroke Delirium and Associated Risk Factors: Findings From a Prospective Cohort Study | Zipser, C. M. Deuel, J. W. Held, J. P. O. Ernst, J. Schubert, M. Weller, M. Luft, A. R. von Känel, R. Boettger, S. | Stroke | 2021 |
costs |
Development and validation of a delirium risk assessment tool in older patients admitted to the Emergency Department Observation Unit | Zucchelli, A. Apuzzo, R. Paolillo, C. Prestipino, V. De Bianchi, S. Romanelli, G. Padovani, A. Marengoni, A. Bellelli, G. | Aging Clin Exp Res | 2021 |
Delirium |
Differences in efficacy and safety of midazolam vs. dexmedetomidine in critically ill patients: A meta-analysis of randomized controlled trial | Zhou, W. J. Liu, M. Fan, X. P. | Exp Ther Med | 2021 |
critically ill |
Risk factors of postoperative delirium after liver transplantation: a systematic review and meta-analysis | Zhou, J. Xu, X. Liang, Y. Zhang, X. Tu, H. Chu, H. | Minerva Anestesiol | 2021 | |
Derivation and validation of a novel comorbidity-based delirium risk index to predict postoperative delirium using national administrative healthcare database | Zhong, X. Lin, J. Y. Li, L. Barrett, A. M. Poeran, J. Mazumdar, M. | Health Serv Res | 2021 |
Lasso |
The Association Between Frailty and Delirium Among Hospitalized Patients: An Updated Meta-Analysis | Zhang, X. M. Jiao, J. Xie, X. H. Wu, X. J. | J Am Med Dir Assoc | 2021 |
Frailty |
Effectiveness of Bundle Interventions on ICU Delirium: A Meta-Analysis | Zhang, S. Han, Y. Xiao, Q. Li, H. Wu, Y. | Crit Care Med | 2021 | |
Development and validation of a predictive score for ICU delirium in critically ill patients | Zhang, H. Yuan, J. Chen, Q. Cao, Y. Wang, Z. Lu, W. Bao, J. | BMC Anesthesiol | 2021 |
Delirium |
Comparison of the '4-item assessment test' and 'nursing delirium screening scale' delirium screening tools on nonintensive care unit wards: A prospective mixed-method approach | Zastrow, I. Tohsche, P. Loewen, T. Vogt, B. Feige, M. Behnke, M. Wolff, A. Kiefmann, R. Olotu, C. | Eur J Anaesthesiol | 2021 | |
Effects of general versus regional anaesthesia on circadian melatonin rhythm and its association with postoperative delirium in elderly patients undergoing hip fracture surgery: study protocol for a prospective cohort clinical trial | Yuan, Y. Song, Y. Wang, G. Jia, Y. Zhou, Y. Mi, X. Jia, X. Wang, X. Liu, C. Li, Y. Shi, C. Han, Y. Guo, X. Zhang, W. Li, Z. | BMJ Open | 2021 |
Aged |
Association Between Dexamethasone and Delirium in Critically Ill Patients: A Retrospective Cohort Study of a Large Clinical Database | Wu, Z. Li, H. Liao, K. Wang, Y. | J Surg Res | 2021 |
Delirium |
Perioperative risk factors for recovery room delirium after elective non-cardiovascular surgery under general anaesthesia | Wu, J. Gao, S. Zhang, S. Yu, Y. Liu, S. Zhang, Z. Mei, W. | Perioper Med (Lond) | 2021 |
Delirium |
Management of delirium within intraoperative settings for older adults with hip fracture: a scoping review | White, L. B. Coyne, E. Grealish, L. | J Clin Nurs | 2021 |
Anaesthesia |
Delirium screening tools validated in the context of palliative care: A systematic review | Watt, C. L. Scott, M. Webber, C. Sikora, L. Bush, S. H. Kabir, M. Boland, J. W. Woodhouse, R. Sands, M. B. Lawlor, P. G. | Palliat Med | 2021 |
Adult |
The Relationship of Postoperative Delirium and Unplanned Perioperative Hypothermia in Surgical Patients | Wagner, D. Hooper, V. Bankieris, K. Johnson, A. | J Perianesth Nurs | 2021 |
noncardiac surgery |
Proteome-Wide Analysis using SOMAscan Identifies and Validates Chitinase-3-Like Protein 1 as a Risk and Disease Marker of Delirium Among Older Adults Undergoing Major Elective Surgery | Vasunilashorn, S. M. Dillon, S. T. Chan, N. Y. Fong, T. G. Joseph, M. Tripp, B. Xie, Z. Ngo, L. H. Lee, C. G. Elias, J. A. Otu, H. H. Inouye, S. Marcantonio, E. R. Libermann, T. A. | J Gerontol A Biol Sci Med Sci | 2021 |
inflammation |
Delirium in your house: a survey during General Practitioner-programmed home visits | Tremolizzo, L. Bargossi, L. Storti, B. Ferrarese, C. Bellelli, G. Appollonio, I. | Aging Clin Exp Res | 2021 |
4at |
Dexmedetomidine for hyperactive delirium at the end of life: An open-label single arm pilot study with dose escalation in adult patients admitted to an inpatient palliative care unit | Thomas, B. Lo, W. A. Nangati, Z. Barclay, G. | Palliat Med | 2021 |
Adult |
Significant decrease in delirium referrals after changing hypnotic from benzodiazepine to suvorexant | Tachibana, M. Inada, T. Ichida, M. Kojima, S. Arai, T. Naito, K. Ozaki, N. | Psychogeriatrics | 2021 |
Aged |
Haloperidol, clonidine and resolution of delirium in critically ill patients: a prospective cohort study | Smit, L. Dijkstra-Kersten, S. M. A. Zaal, I. J. van der Jagt, M. Slooter, A. J. C. | Intensive Care Med | 2021 |
Clonidine/therapeutic use |
Acute-onset delirium in intensive care COVID patients: association of imperfect brain repair with foodborne micro-pollutants | Schneider, F. Agin, A. Baldacini, M. Maurer, L. Schenck, M. Alemann, M. Solis, M. Helms, J. Villette, C. Artzner, T. Kremer, S. Heintz, D. | Eur J Neurol | 2021 |
Covid |
Delirium in acute stroke: A prospective, cross-sectional, cohort study | Rollo, E. Callea, A. Brunetti, V. Vollono, C. Marotta, J. Imperatori, C. Frisullo, G. Broccolini, A. Della Marca, G. | Eur J Neurol | 2021 |
Cam-icu |
Preoperative Cognitive Impairment and the Prevalence of Postoperative Delirium in Elderly Cancer Patients-A Prospective Observational Study | Ristescu, A. I. Pintilie, G. Moscalu, M. Rusu, D. Grigoras, I. | Diagnostics (Basel) | 2021 |
Mini-Cog test |
Delirium in Patients with SARS-CoV-2 Infection: A Multicenter Study | Rebora, P. Rozzini, R. Bianchetti, A. Blangiardo, P. Marchegiani, A. Piazzoli, A. Mazzeo, F. Cesaroni, G. Chizzoli, A. Guerini, F. Bonfanti, P. Morandi, A. Faraci, B. Gentile, S. Bna, C. Savelli, G. Citerio, G. Valsecchi, M. G. Mazzola, P. Bellelli, G. | J Am Geriatr Soc | 2021 |
Aged |
Machine Learning to Develop and Internally Validate a Predictive Model for Post-operative Delirium in a Prospective, Observational Clinical Cohort Study of Older Surgical Patients | Racine, A. M. Tommet, D. D'Aquila, M. L. Fong, T. G. Gou, Y. Tabloski, P. A. Metzger, E. D. Hshieh, T. T. Schmitt, E. M. Vasunilashorn, S. M. Kunze, L. Vlassakov, K. Abdeen, A. Lange, J. Earp, B. Dickerson, B. C. Marcantonio, E. R. Steingrimsson, J. Travi | J Gen Intern Med | 2021 |
Aged |
Low Vitamin D Levels and Risk of Incident Delirium in 351,000 Older UK Biobank Participants | Pilling, L. C. Jones, L. C. Masoli, J. A. H. Delgado, J. Atkins, J. L. Bowden, J. Fortinsky, R. H. Kuchel, G. A. Melzer, D. | J Am Geriatr Soc | 2021 |
biomarker |
Delirium in older adults is associated with development of new dementia: a systematic review and meta-analysis | Pereira, J. V. Aung Thein, M. Z. Nitchingham, A. Caplan, G. A. | Int J Geriatr Psychiatry | 2021 |
delirium |
Mortality and Medical Complications of Subtrochanteric Fracture Fixation | Panteli, M. Giannoudi, M. P. Lodge, C. J. West, R. M. Pountos, I. Giannoudis, P. V. | J Clin Med | 2021 |
complications |
Predicting Delirium Risk Using an Automated Mayo Delirium Prediction Tool: Development and Validation of a Risk-Stratification Model | Pagali, S. R. Miller, D. Fischer, K. Schroeder, D. Egger, N. Manning, D. M. Lapid, M. I. Pignolo, R. J. Burton, M. C. | Mayo Clin Proc | 2021 |
Aged |
Effectiveness of Quetiapine as a Sedative Adjunct in Mechanically Ventilated Adults Without Delirium | Ohman, K. L. Schultheis, J. M. Kram, S. J. Cox, C. E. Gilstrap, D. L. Yang, Z. Kram, B. L. | Ann Pharmacother | 2021 |
Adjuvants, Pharmaceutic/administration & dosage/ therapeutic use |
Development of a postoperative delirium risk scoring tool using data from the Australian and New Zealand Hip Fracture Registry: an analysis of 6672 patients 2017-2018 | Oberai, T. Oosterhoff, J. H. F. Woodman, R. Doornberg, J. N. Kerkhoffs, G. Jaarsma, R. | Arch Gerontol Geriatr | 2021 |
Aged, 80 and over |
Does implementation of a tailored intervention increase adherence to a National Safety and Quality Standard? A study to improve delirium care | Oberai, T. Laver, K. Woodman, R. Crotty, M. Kerkhoffs, G. Jaarsma, R. | Int J Qual Health Care | 2021 |
elderly |
Delirium in Burn Patients: Developing a Mobile Application for Assessment and Diagnosis | Mohseni Moallem Kolaei, N. Ayatollahi, H. Elyasi, F. | J Burn Care Res | 2021 | |
Combination of delirium and coma predicts psychiatric symptoms at twelve months in critically ill patients: A longitudinal cohort study | Miyamoto, K. Shibata, M. Shima, N. Nakashima, T. Kida, M. Matsumoto, H. Oka, N. Yazaki, A. Uchigaki, A. Takemoto, A. Kato, S. | J Crit Care | 2021 |
Activity of daily living disability |
Implementation of the Family HELP Protocol: A Feasibility Project for a West Texas ICU | McClay, R. | Healthcare (Basel) | 2021 |
Icu |
Prevention and Management of Delirium in the Intensive Care Unit | Mart, M. F. Williams Roberson, S. Salas, B. Pandharipande, P. P. Ely, E. W. | Semin Respir Crit Care Med | 2021 | |
Haloperidol for preventing delirium in ICU patients: a systematic review and meta-analysis | Marra, A. Vargas, M. Buonanno, P. Iacovazzo, C. Kotfis, K. Servillo, G. | Eur Rev Med Pharmacol Sci | 2021 |
Delirium |
Delirium in trauma patients: a 1-year prospective cohort study of 2026 patients | Marquetand, J. Gehrke, S. Bode, L. Fuchs, S. Hildenbrand, F. Ernst, J. von Känel, R. Boettger, S. | Eur J Trauma Emerg Surg | 2021 |
Delirium |
Subsyndromal Delirium in Cardiac Surgery Patients: Risk Factors and Outcomes of the Different Trajectories | Mailhot, T. Cossette, S. Maheu-Cadotte, M. A. Fontaine, G. Denault, A. Y. | J Cardiovasc Nurs | 2021 | |
Low-Dose Trazodone for Delirium in Patients with Cancer Who Received Specialist Palliative Care: A Multicenter Prospective Study | Maeda, I. Inoue, S. Uemura, K. Tanimukai, H. Hatano, Y. Yokomichi, N. Amano, K. Tagami, K. Yoshiuchi, K. Ogawa, A. Iwase, S | J Palliat Med | 2021 |
cancer |
Preoperative anxiety predicted the incidence of postoperative delirium in patients undergoing total hip arthroplasty: a prospective cohort study | Ma, J. Li, C. Zhang, W. Zhou, L. Shu, S. Wang, S. Wang, D. Chai, X. | BMC Anesthesiol | 2021 |
Anxiety |
Perioperative Dexmedetomidine Supplement Decreases Delirium Incidence After Adult Cardiac Surgery: A Randomized, Double-Blind, Controlled Study | Likhvantsev, V. V. Landoni, G. Grebenchikov, O. A. Ovezov, A. M. Skripkin, Y. V. Lembo, R. Gaevskiy, D. I. Tereshina, A. A. Yavorovskiy, A. G. | J Cardiothorac Vasc Anesth | 2021 |
Adult |
An observational study of hypoactive delirium in the post-anesthesia recovery unit of a pediatric hospital | Lee-Archer, P. F. von Ungern-Sternberg, B. S. Reade, M. C. Law, K. C. Long, D. | Paediatr Anaesth | 2021 |
emergence delirium |
A prospective observational cohort pilot study of the association between midazolam use and delirium in elderly endoscopy patients | Lee, D. Petersen, F. Wu, M. Chapman, G. Hayman, M. Tomkins, K. Fernando, J. | BMC Anesthesiol | 2021 |
Anaesthesia |