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 |
---|---|---|---|---|
Discharge from hospital with newly administered antipsychotics after intensive care unit delirium - Incidence and contributing factors | Lambert, J. Vermassen, J. Fierens, J. Peperstraete, H. Petrovic, M. Colpaert, K. | J Crit Care | 2021 |
Antipsychotics |
Dexmedetomidine or Propofol for Sedation in Mechanically Ventilated Adults with Sepsis | Hughes, C. G. Mailloux, P. T. Devlin, J. W. Swan, J. T. Sanders, R. D. Anzueto, A. Jackson, J. C. Hoskins, A. S. Pun, B. T. Orun, O. M. Raman, R. Stollings, J. L. Kiehl, A. L. Duprey, M. S. Bui, L. N. O'Neal, H. R., Jr. Snyder, A. Gropper, M. A. Guntupall | N Engl J Med | 2021 |
Adult |
Repeated Preoperative Intranasal Administration of Insulin Decreases the Incidence of Postoperative Delirium in Elderly Patients Undergoing Laparoscopic Radical Gastrointestinal Surgery: A Randomized, Placebo-Controlled, Double-Blinded Clinical Study | Huang, Q. Li, Q. Qin, F. Yuan, L. Lu, Z. Nie, H. Gong, G. | Am J Geriatr Psychiatry | 2021 |
Postoperative delirium |
The diagnostic threshold of Cornell assessment of pediatric delirium in detection of postoperative delirium in pediatric surgical patients | Hong, H. Guo, C. Liu, Z. H. Wang, B. J. Zhou, S. Z. Mu, D. L. Wang, D. X. | BMC Pediatr | 2021 |
Child |
Ketamine vs. haloperidol for prevention of cognitive dysfunction and postoperative delirium: A phase IV multicentre randomised placebo-controlled double-blind clinical trial | Hollinger, A. Rüst, C. A. Riegger, H. Gysi, B. Tran, F. Brügger, J. Huber, J. Toft, K. Surbeck, M. Schmid, H. R. Rentsch, K. Steiner, L. Siegemund, M. | J Clin Anesth | 2021 |
Adult |
Delirium care knowledge in critical care nurses: A multiple-choice question-based quiz | Ho, M. H. Traynor, V. Chen, K. H. Montayre, J. Lin, Y. K. Chang, H. R. | Nurs Crit Care | 2021 |
critical care nursing |
Comparison of hospital course and outcome in hospital-acquired vs pre-existing delirium | Guillory, J. Fitz-Gerald, C. Banik, A. Sterwald, C. Ashiofu, E. Knox, E. Muyco, M. A. Verlage, M. Abdali, A. O'Malley, P. W. Rezai, A. Bush, P. Brown, E. S. North, C. S. | Ann Clin Psychiatry | 2021 | |
Dexmedetomidine reduces postoperative cognitive and behavioral dysfunction in adults submitted to general anesthesia for non-cardiac surgery: meta-analysis of randomized clinical trials | Govêia, C. S. Miranda, D. B. Oliveira, L. V. B. Praxedes, F. B. Moreira, L. G. Guimarães, G. M. N. | Braz J Anesthesiol | 2021 |
Delirium |
An exploration of the reliability and usability of two delirium screening tools in an Australian intensive care unit: A pilot study | Ewers, R. Bloomer, M. J. Hutchinson, A. | Intensive Crit Care Nurs | 2021 |
Confusion assessment methods -ICU |
Haloperidol and Quetiapine for the Treatment of ICU-Associated Delirium in a Tertiary Pediatric ICU: A Propensity Score-Matched Cohort Study | Cronin, M. T. Di Gennaro, J. L. Watson, R. S. Dervan, L. A. | Paediatr Drugs | 2021 |
Antipsychotic Agents/therapeutic use |
Post-operative delirium in older hip fracture patients: a new onset or was it already there? | Costa-Martins, I. Carreteiro, J. Santos, A. Costa-Martins, M. Artilheiro, V. Duque, S. Campos, L. Chedas, M. | Eur Geriatr Med | 2021 |
Cognitive assessment |
The Use of Tablet Computers to Reduce Preoperative Anxiety in Children Before Anesthesia: A Randomized Controlled Study | Clausen, N. G. Madsen, D. Rosenkilde, C. Hasfeldt-Hansen, D. Larsen, L. G. Hansen, T. G. | J Perianesth Nurs | 2021 |
emergence delirium |
A gap existed between physicians' perceptions and performance of pain, agitation-sedation and delirium assessments in Chinese intensive care units | Chen, K. Yang, Y. L. Li, H. L. Xiao, D. Wang, Y. Zhang, L. Zhou, J. X. | BMC Anesthesiol | 2021 |
Analgesia |
Association of Depressive Symptoms With Postoperative Delirium and CSF Biomarkers for Alzheimer's Disease Among Hip Fracture Patients | Chan, C. K. Sieber, F. E. Blennow, K. Inouye, S. K. Kahn, G. Leoutsakos, J. S. Marcantonio, E. R. Neufeld, K. J. Rosenberg, P. B. Wang, N. Y. Zetterberg, H. Lyketsos, C. G. Oh, E. S. | Am J Geriatr Psychiatry | 2021 |
Alzheimer’s disease |
Delirium as a predictor of mortality and disability among hospitalized patients in Zambia | Banerdt, J. K. Mateyo, K. Wang, L. Lindsell, C. J. Riviello, E. D. Saylor, D. Heimburger, D. C. Ely, E. W. | PLoS One | 2021 | |
Incidence and Risk Factors of Emergence Delirium after Anesthesia in Elderly Patients at a Postanesthesia Care Unit in Ethiopia: Prospective Observational Study | Assefa, M. T. Chekol, W. B. Melesse, D. Y. Nigatu, Y. A. | Patient Relat Outcome Meas | 2021 |
delirium |
Impact of SARS-CoV-2 Infection on Cognitive Function: A Systematic Review | Alnefeesi, Y. Siegel, A. Lui, L. M. W. Teopiz, K. M. Ho, R. C. M. Lee, Y. Nasri, F. Gill, H. Lin, K. Cao, B. Rosenblat, J. D. McIntyre, R. S. | Front Psychiatry | 2021 |
Covid-19 |
Cognitive disorders associated with hospitalization of COVID-19: Results from an observational cohort study | Zhou, J. Liu, C. Sun, Y. Huang, W. Ye, K. | Brain Behav Immun | 2021 |
Adult |
Probable delirium is a presenting symptom of COVID-19 in frail, older adults: a cohort study of 322 hospitalised and 535 community-based older adults | Zazzara, M. B. Penfold, R. S. Roberts, A. L. Lee, K. A. Dooley, H. Sudre, C. H. Welch, C. Bowyer, R. C. E. Visconti, A. Mangino, M. Freidin, M. B. El-Sayed Moustafa, J. S. Small, K. S. Murray, B. Modat, M. Graham, M. S. Wolf, J. Ourselin, S. Martin, F. C. | Age Ageing | 2021 |
Aged |
Association between intensive care unit delirium and delusional memory after critical care in mechanically ventilated patients | Yoshino, Y. Unoki, T. Sakuramoto, H. Ouchi, A. Hoshino, H. Matsuishi, Y. Mizutani, T. | Nurs Open | 2021 |
delirium |
Delirium screening for patients in the intensive care unit: A prospective validation study of the iCAM-ICU by nurse researchers and bedside nurses in routine practice | Yang, F. Ji, M. Wu, Y. Feng, Y. Li, J. Ren, D. Ely, E. W. | Int J Nurs Stud | 2021 |
Confusion |
Six-Minute Walk Test Predicts Postoperative Delirium After Transcatheter Aortic Valve Replacement | Yamashita, A. Suzuki, S. Otsuka, T. Matsuda, H. Ando, H. Sugimura, K. Maekawa, E. Meguro, K. Ako, J. Okamoto, H. | J Cardiothorac Vasc Anesth | 2021 |
Clinical Frailty Scale |
Topological data analysis (TDA) enhances bispectral EEG (BSEEG) algorithm for detection of delirium | Yamanashi, T. Kajitani, M. Iwata, M. Crutchley, K. J. Marra, P. Malicoat, J. R. Williams, J. C. Leyden, L. R. Long, H. Lo, D. Schacher, C. J. Hiraoka, K. Tsunoda, T. Kobayashi, K. Ikai, Y. Kaneko, K. Umeda, Y. Kadooka, Y. Shinozaki, G. | Sci Rep | 2021 | |
New Cutoff Scores for Delirium Screening Tools to Predict Patient Mortality | Yamanashi, T. Iwata, M. Crutchley, K. J. Sullivan, E. J. Malicoat, J. R. Anderson, Z. M. Marra, P. S. Chang, G. Kaneko, K. Shinozaki, E. Lee, S. Shinozaki, G. | J Am Geriatr Soc | 2021 |
Cam-icu |
Intraoperative dexmedetomidine for prevention of postoperative delirium in elderly patients with mild cognitive impairment | Xin, X. Chen, J. Hua, W. Wang, H. | Int J Geriatr Psychiatry | 2021 |
Aged |
The risk factors for postoperative delirium in adult patients after hip fracture surgery: a systematic review and meta-analysis | Wu, J. Yin, Y. Jin, M. Li, B. | Int J Geriatr Psychiatry | 2021 |
Blood Transfusion |
Preoperative Delirium Nursing Model Initiatives to Determine the Incidence of Postoperative Delirium Among Elderly Orthopaedic Patients | Wu, H. Kapur, A. Gibson, B. Bubb, K. Alrawashdeh, M. Cipkala-Gaffin, J. | Orthop Nurs | 2021 | |
Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice | Williams Roberson, S. Patel, M. B. Dabrowski, W. Ely, E. W. Pakulski, C. Kotfis, K. | Curr Neuropharmacol | 2021 |
barbiturates |
A Systematic Review of Delirium Biomarkers and Their Alignment with the NIA-AA Research Framework | Wang, S. Lindroth, H. Chan, C. Greene, R. Serrano-Andrews, P. Khan, S. Rios, G. Jabbari, S. Lim, J. Saykin, A. J. Khan, B. | J Am Geriatr Soc | 2021 |
Alzheimerʼs disease |
Development and validation of the Terminal Delirium-Related Distress Scale to assess irreversible terminal delirium | Uchida, M. Akechi, T. Morita, T. Shima, Y. Igarashi, N. Miyashita, M. | Palliat Support Care | 2021 |
Cancer |
Targeted metabolomics analysis of postoperative delirium | Tripp, B. A. Dillon, S. T. Yuan, M. Asara, J. M. Vasunilashorn, S. M. Fong, T. G. Metzger, E. D. Inouye, S. K. Xie, Z. Ngo, L. H. Marcantonio, E. R. Libermann, T. A. Otu, H. H. | Sci Rep | 2021 | |
Hospitalized older adult: predictors of functional decline | Tavares, J. P. A. Nunes, Lanv Grácio, J. C. G. | Rev Lat Am Enfermagem | 2021 |
Activities of Daily Living |
Postoperative delirium in patients undergoing tumor resection with reconstructive surgery for oral cancer | Takahashi, N. Hiraki, A. Kawahara, K. Nagata, M. Yoshida, R. Matsuoka, Y. Tanaka, T. Obayashi, Y. Sakata, J. Nakashima, H. Arita, H. Shinohara, M. Nakayama, H. | Mol Clin Oncol | 2021 |
early postoperative ambulation |
Prevalence of ICU Delirium in Postoperative Pediatric Cardiac Surgery Patients | Staveski, S. L. Pickler, R. H. Khoury, P. R. Ollberding, N. J. Donnellan, A. L. Mauney, J. A. Lincoln, P. A. Baird, J. D. Gilliland, F. L. Merritt, A. D. Presnell, L. B. Lanese, A. R. Lisanti, A. J. Large, B. J. Fineman, L. D. Gibson, K. H. Mohler, L. A. | Pediatr Crit Care Med | 2021 |
Adolescent |
Physostigmine for prevention of postoperative delirium and long-term cognitive dysfunction in liver surgery: A double-blinded randomised controlled trial | Spies, C. D. Knaak, C. Mertens, M. Brockhaus, W. R. Shadenok, A. Wiebach, J. Kunzmann, K. Feldheiser, A. Pratschke, J. Müller, O. Kipping, V. Fabian, M. Abels, W. Borchers, F. Akyüz, L. Ely, E. W. Wernecke, K. D. Menon, D. K. Piper, S. K. | Eur J Anaesthesiol | 2021 | |
Intraoperative clonidine to prevent postoperative emergence delirium following sevoflurane anesthesia in pediatric patients: a randomized clinical trial | Sousa-Júnior, F. A. Souza, A. S. R. Lima, L. C. Santos Í, G. M. Menezes, L. A. P. Ratis, Papl Couceiro, T. C. M. | Braz J Anesthesiol | 2021 |
Anesthesia |
Training hospital inpatient nursing to know (THINK) delirium: A nursing educational program | Solberg, L. M. Campbell, C. S. Jones, K. Vaughn, I. Suryadevara, U. Fernandez, C. Shorr, R. | Geriatr Nurs | 2021 |
Delirium |
Delirium is associated with an increased morbidity and in-hospital mortality in cancer patients: Results from a prospective cohort study | Seiler, A. Blum, D. Deuel, J. W. Hertler, C. Schettle, M. Zipser, C. M. Ernst, J. Schubert, M. von Känel, R. Boettger, S. | Palliat Support Care | 2021 |
Cancer patients |
Delirium Triage Screen/Brief Confusion Assessment Method in Adult Orthopaedic and Hematological Patients: A Validation Study | Sederstrom, J. R. Aliory, C. D. Hanneman, E. M. Buras, M. R. | Orthop Nurs | 2021 | |
"SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?" running heading Single Question in Delirium" (Bcan-D-20-01665) | Sands, M. B. Sharma, S. Carpenter, L. Hartshorn, A. Lee, J. T. Lujic, S. Congdon, M. E. Buchanan, A. M. Agar, M. Vardy, J. L. | BMC Cancer | 2021 |
Cancer |
Factors Impacting Early Mobilization Following Hip Fracture: An Observational Study | Said, C. M. Delahunt, M. Ciavarella, V. Al Maliki, D. Boys, A. M. Vogrin, S. Berney, S. | J Geriatr Phys Ther | 2021 | |
Risk factors of postoperative delirium in the knee and hip replacement patients: a systematic review and meta-analysis | Rong, X. Ding, Z. C. Yu, H. D. Yao, S. Y. Zhou, Z. K. | J Orthop Surg Res | 2021 |
Hip replacement |
Characteristics of Younger and Older Adults with Hospital-Acquired Delirium: a Claims Data Study Spanning 14 years | Rohatgi, N. Weng, Y. Ahuja, N. Lansberg, M. G. | J Gen Intern Med | 2021 |
Aged |
Factors Associated with Hospital-Acquired Delirium in Patients 18-65 Years Old | Rohatgi, N. Weng, Y. Ahuja, N. Lansberg, M. G. | J Gen Intern Med | 2021 |
Adolescent |
Implementation of a multicomponent intervention sign to reduce delirium in orthopaedic inpatients (MIND-ORIENT): a quality improvement project | Reppas-Rindlisbacher, C. Siddhpuria, S. Wong, E. K. Lee, J. Y. Gabor, C. Curkovic, A. Khalili, Y. Mavrak, C. De Freitas, S. Eshak, K. Patterson, C. | BMJ Open Qual | 2021 |
evidence-based practice |
Anticholinergic Burden Does Not Influence Delirium Subtype or the Delirium-Mortality Association in Hospitalized Older Adults: Results from a Prospective Cohort Study | Rawle, M. J. McCue, L. Sampson, E. L. Davis, D. Vickerstaff, V. | Drugs Aging | 2021 | |
Incidence and Risk Factors of Delirium in the Intensive Care Unit: A Prospective Cohort | Rahimi-Bashar, F. Abolhasani, G. Manouchehrian, N. Jiryaee, N. Vahedian-Azimi, A. Sahebkar, A. | Biomed Res Int | 2021 |
Adult |
Implementing Delirium Prevention in the Era of COVID-19 | Radhakrishnan, N. S. Mufti, M. Ortiz, D. Maye, S. T. Melara, J. Lim, D. Rosenberg, E. I. Price, C. C. | J Alzheimers Dis | 2021 |
Aged |
Prevalence and risk factors of delirium in psychogeriatric outpatients | Quispel-Aggenbach, D. W. P. Schep-de Ruiter, E. P. R. van Bergen, W. Bolling, J. R. Zuidema, S. U. Luijendijk, H. J. | Int J Geriatr Psychiatry | 2021 |
Aged |
Prevalence and risk factors for delirium in critically ill patients with COVID-19 (COVID-D): a multicentre cohort study | Pun, B. T. Badenes, R. Heras La Calle, G. Orun, O. M. Chen, W. Raman, R. Simpson, B. K. Wilson-Linville, S. Hinojal Olmedillo, B. Vallejo de la Cueva, A. van der Jagt, M. Navarro Casado, R. Leal Sanz, P. Orhun, G. Ferrer Gómez, C. Núñez Vázquez, K. Pi | Lancet Respir Med | 2021 |
Aged |
Risk prediction models for emergence delirium in paediatric general anaesthesia: a systematic review | Petre, M. A. Saha, B. Kasuya, S. Englesakis, M. Gai, N. Peliowski, A. Aoyama, K. | BMJ Open | 2021 |
Anesthesia, General/ adverse effects |
The Effects of Propofol or Dexmedetomidine Sedation on Postoperative Recovery in Elderly Patients Receiving Lower Limb Surgery under Spinal Anesthesia: A Retrospective Propensity Score-Matched Analysis | Park, J. W. Kim, E. K. Lee, H. T. Park, S. Do, S. H. | J Clin Med | 2021 |
dexmedetomidine |
High proportion of thiamine deficiency in referred cancer patients with delirium: a retrospective descriptive study | Onishi, H. Sato, I. Uchida, N. Takahashi, T. Furuya, D. Ebihara, Y. Yoshioka, A. Ito, H. Ishida, M. | Eur J Clin Nutr | 2021 | |
Association between discontinuation of benzodiazepine receptor agonists and post-operative delirium among inpatients with liaison intervention: A retrospective cohort study | Omichi, C. Ayani, N. Oya, N. Matsumoto, Y. Tanaka, M. Morimoto, T. Kadotani, H. Narumoto, J. | Compr Psychiatry | 2021 |
Benzodiazepines/adverse effects |
The Independent Association of Prestroke Psychiatric Symptoms and Acute Phase Delirium with Poststroke Mortality at One Year in Nigeria | Ojagbemi, A. Bello, T. Owolabi, M. Baiyewu, O. | J Stroke Cerebrovasc Dis | 2021 |
Delirium/diagnosis/ mortality/psychology |
Depression predicts long-term cognitive impairment in survivors of critical illness | Nordness, M. F. Bipin Patel, M. Erickson, C. R. Kiehl, A. Jackson, J. C. Raman, R. Pandharipande, P. P. Ely, E. W. Wilson, J. E. | J Trauma Acute Care Surg | 2021 |
Aged |
Effects of uncomfortable care and histamine H2-antagonists on delirium in acute stroke: A propensity score analysis | Nakamizo, T. Kanda, T. Kudo, Y. Sugawara, E. Hashimoto, E. Okazaki, A. Usuda, M. Nagai, T. Hara, H. Johkura, K. | J Neurol Sci | 2021 |
Delirium/epidemiology/etiology |
Family automated voice reorientation (FAVoR) intervention for mechanically ventilated patients in the intensive care unit: Study protocol for a randomized controlled trial | Munro, C. L. Liang, Z. Ji, M. Elías, M. N. Chen, X. Calero, K. Ely, E. W. | Contemp Clin Trials | 2021 |
Cognition |
Evaluation of a delirium awareness podcast for undergraduate nursing students in Northern Ireland: a pre-/post-test study | Mitchell, G. Scott, J. Carter, G. Wilson, C. B. | BMC Nurs | 2021 |
Constructivist pedagogy |
Impact of delirium in acute cardiac care unit after transcatheter aortic valve replacement | Luque, T. Noriega, F. J. McInerney, A. Travieso, A. Corrochano, D. Tirado-Conte, G. Ferrera, C. Fossati, S. Jimenez-Quevedo, P. Nuñez-Gil, I. Gonzalo, N. Escaned, J. Macaya, C. Fernández-Ortiz, A. Nombela-Franco, L. Viana-Tejedor, A. | Int J Cardiol | 2021 |
Aortic Valve/surgery |
Preoperative Prognostic Nutritional Index Value is Related to Postoperative Delirium in Elderly Patients After Noncardiac Surgery: A Retrospective Cohort Study | Liu, H. Dai, M. Guan, H. Gao, X. Zhou, Y. Sun, X. Zhou, J. Hu, X. Li, X. Song, Y. Han, Y. Cao, J. | Risk Manag Healthc Policy | 2021 |
elderly patients |
Implementation of ABCDEF care bundle in intensive care units: A cross-sectional survey | Liang, S. Chau, J. P. C. Lo, S. H. S. Li, S. Gao, M. | Nurs Crit Care | 2021 |
ABCDEF care bundle |
Lymphocyte and NK Cell Counts Can Predict Sepsis-Associated Delirium in Elderly Patients | Li, D. Zhang, J. Bai, G. Chen, J. Cheng, W. Cui, N. | Front Aging Neurosci | 2021 |
NK cell |
Safety and Efficacy of Dexmedetomidine in Acutely Ill Adults Requiring Noninvasive Ventilation: A Systematic Review and Meta-analysis of Randomized Trials | Lewis, K. Piticaru, J. Chaudhuri, D. Basmaji, J. Fan, E. Møller, M. H. Devlin, J. W. Alhazzani, W. | Chest | 2021 |
dexmedetomidine |
Pharmacological strategies to prevent postoperative delirium: a systematic review and network meta-analysis | Lee, J. M. Cho, Y. J. Ahn, E. J. Choi, G. J. Kang, H. | Anesth Pain Med (Seoul) | 2021 |
Delirium |
Evaluation of Melatonin Practices for Delirium in Pediatric Critically Ill Patients | Laudone, T. W. Beck, S. D. Lahr, H. J. | J Pediatr Pharmacol Ther | 2021 |
antipsychotic |
Results from a double blinded, randomised, placebo-controlled, feasibility trial of melatonin for the treatment of delirium in older medical inpatients | Lange, P. W. Clayton-Chubb, D. I. Watson, R. Maier, A. B. | Intern Med J | 2021 |
Aged |
Delirium, Cerebral Perfusion, and High-Frequency Vital-Sign Monitoring in the Critically Ill. The CONFOCAL-2 Feasibility Study | Khan, J. M. Wood, M. D. Lee, K. F. H. Maslove, D. Muscedere, J. English, S. W. Ball, I. Slessarev, M. Boyd, J. G. | Ann Am Thorac Soc | 2021 |
cerebral oxygenation |
Preoperative brain MRI features and occurrence of postoperative delirium | Kant, I. M. J. de Bresser, J. van Montfort, S. J. T. Mutsaerts, Hjmm Witkamp, T. D. Buijsrogge, M. Spies, C. Hendrikse, J. Slooter, A. J. C. | J Psychosom Res | 2021 |
Aged |
Intraoperative monitoring parameters and postoperative delirium: Results of a prospective cross-sectional trial | Jung, C. Hinken, L. Fischer-Kumbruch, M. Trübenbach, D. Fielbrand, R. Schenk, I. Diegmann, O. Krauß, T. Scheinichen, D. Schultz, B. | Medicine (Baltimore) | 2021 |
Adult |
Development of the AL-O-A Score for Delirium Screening in Acute Internal Medicine: a Monocentric Prospective Study | John, G. Bovet, V. Verdon, V. Zender, H. Donzé, J. | J Gen Intern Med | 2021 |
adult |
Intravenous Iron in a Prehabilitation Program for Older Surgical Patients: Prospective Cohort Study | Janssen, T. L. Steyerberg, E. W. van Gammeren, A. J. Ho, G. H. Gobardhan, P. D. van der Laan, L. | J Surg Res | 2021 |
Abdomen/surgery |
Comparative associations between anticholinergic burden and emergency department visits for anticholinergic adverse events in older Korean adults: a nested case-control study using national claims data for validation of a novel country-specific scale | Hwang, S. Chung, J. E. Jun, K. Ah, Y. M. Kim, K. I. Lee, J. Y. | BMC Pharmacol Toxicol | 2021 |
Anticholinergic syndromes |
Evaluation of QTc Interval Effects of Antipsychotic Medications for Intensive Care Unit Delirium in Pediatric Patients | Hutchins, L. M. Shipman, A. Zimmerman, K. O. Heath, T. S. | J Pediatr Pharmacol Ther | 2021 |
QTc interval prolongation |
Implementing a Rapid, Two-Step Delirium Screening Protocol in Acute Care: Barriers and Facilitators | Husser, E. K. Fick, D. M. Boltz, M. Shrestha, P. Siuta, J. Malloy, S. Overstreet, A. Leslie, D. L. Ngo, L. Jung, Y. Inouye, S. K. Marcantonio, E. R. | J Am Geriatr Soc | 2021 |
delirium |
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 |
Elderly patients |
Personalized Blood Pressure Management During Cardiac Surgery With Cerebral Autoregulation Monitoring: A Randomized Trial | Hogue, C. W. Brown, C. H. th Hori, D. Ono, M. Nomura, Y. Balmert, L. C. Srdanovic, N. Grafman, J. Brady, K. | Semin Thorac Cardiovasc Surg | 2021 |
Blood pressure |
Clinical Features and Outcomes of Patients with Dementia Compared to an Aging Cohort Hospitalized During the Initial New York City COVID-19 Wave | Harb, A. A. Chen, R. Chase, H. S. Natarajan, K. Noble, J. M. | J Alzheimers Dis | 2021 |
Aged |
Perioperative Multidisciplinary Delirium Prevention: A Longitudinal Case Report | Hamlet, K. M. Pasternak, E. Rabai, F. Mufti, M. Hernaiz Alonso, C. Price, C. C. | A A Pract | 2021 | |
Cerebrospinal Fluid Concentration of Neurogranin in Hip Fracture Patients with Delirium | Halaas, N. B. Zetterberg, H. Idland, A. V. Knapskog, A. B. Watne, L. O. Blennow, K. | J Alzheimers Dis | 2021 |
Alzheimer’s disease |
A retrospective study of factors associated with persistent delirium | Goto, H. Yamauchi, T. Okumura, K. Matsuoka, K. Toritsuka, M. Yasuno, F. Uemura, H. Kuki, K. Makinodan, M. Kishimoto, T. | Psychogeriatrics | 2021 |
Case-Control Studies |
Association Between Early Tracheostomy and Delirium in Older Adults in the United States | Gazda, A. J. Kwak, M. J. Jani, P. Dinh, K. Hussain, R. Dronavalli, G. Warner, M. Salas De Armas, I. Kumar, S. Nathan, S. Kar, B. Gregoric, I. D. Patel, B. Akkanti, B. | J Cardiothorac Vasc Anesth | 2021 |
delirium |
Poor outcomes of delirium in the intensive care units are amplified by increasing age: A retrospective cohort study | Gao, W. Zhang, Y. P. Jin, J. F. | World J Emerg Med | 2021 |
Aging |
Postoperative Delirium is Associated With Prolonged Head and Neck Resection and Reconstruction Surgery: An Institutional Study | Edwards, D. A. Medhavy, A. Hoffman, O. G. Hoffman, G. R. | J Oral Maxillofac Surg | 2021 |
Aged |
Delirium Assessment in Critically Ill Older Adults: Considerations During the COVID-19 Pandemic | Duggan, M. C. Van, J. Ely, E. W. | Crit Care Clin | 2021 |
Aged |
Delirium occurrence in older Irish adults admitted to an acute medical hospital: a prospective cohort study | Dolan, C. Mohd Zubir, M. Melvin, V. McCarthy, G. Meagher, D. Adamis, D. | Ir J Psychol Med | 2021 |
Delirium |
Clinical utility of brain computed tomography in prediction of post-stroke delirium | Czyzycki, M. Glen, A. Slowik, A. Chrzan, R. Dziedzic, T. | J Neural Transm (Vienna) | 2021 |
Brain atrophy |
Risk factors for long-term cognitive impairment in ICU survivors: A multicenter, prospective cohort study | Collet, M. O. Egerod, I. Thomsen, T. Wetterslev, J. Lange, T. Ebdrup, B. H. Perner, A. | Acta Anaesthesiol Scand | 2021 | |
Integration of family caregivers in delirium prevention care for hospitalized older adults: A case study analysis | Cohen, C. Pereira, F. Kampel, T. Bélanger, L. | J Adv Nurs | 2021 |
Aged |
Investigating how electroencephalogram measures associate with delirium: A systematic review | Boord, M. S. Moezzi, B. Davis, D. Ross, T. J. Coussens, S. Psaltis, P. J. Bourke, A. Keage, H. A. D. | Clin Neurophysiol | 2021 |
Delirium |
Pharmacologic Management of Intensive Care Unit Delirium: Clinical Prescribing Practices and Outcomes in More Than 8500 Patient Encounters | Boncyk, C. S. Farrin, E. Stollings, J. L. Rumbaugh, K. Wilson, J. E. Marshall, M. Feng, X. Shotwell, M. S. Pandharipande, P. P. Hughes, C. G. | Anesth Analg | 2021 | |
Predictors of delirium in older patients at the emergency department: a prospective multicentre derivation study | Béland, E. Nadeau, A. Carmichael, P. H. Boucher, V. Voyer, P. Pelletier, M. Gouin, É Daoust, R. Berthelot, S. Lamontagne, M. E. Morin, M. Lemire, S. Vu, T. T. M. Émond, M. | CJEM | 2021 |
Delirium |
Hemochromatosis Mutations, Brain Iron Imaging, and Dementia in the UK Biobank Cohort | Atkins, J. L. Pilling, L. C. Heales, C. J. Savage, S. Kuo, C. L. Kuchel, G. A. Steffens, D. C. Melzer, D. | J Alzheimers Dis | 2021 |
Cohort |
Awareness of Delirium by ICU Nurses | Asmar, I. T. Yaseen, K. S. Jaghama, M. K. Khawaja, Y. F. Alwredat, A. A. Sadaqa, M. H. | Crit Care Nurs Q | 2021 | |
Psychiatric Clinical Profiles and Pharmacological Interactions in COVID-19 Inpatients Referred to a Consultation Liaison Psychiatry Unit: a Cross-Sectional Study | Arbelo, N. López-Pelayo, H. Sagué, M. Madero, S. Pinzón-Espinosa, J. Gomes-da-Costa, S. Ilzarbe, L. Anmella, G. Llach, C. D. Imaz, M. L. Cámara, M. M. Pintor, L. | Psychiatr Q | 2021 |
Covid-19 |
Octogenarian patients' sleep and delirium experiences in hospital and four years after aortic valve replacement: a qualitative interview study | Amofah, H. A. Broström, A. Instenes, I. Fridlund, B. Haaverstad, R. Kuiper, K. Ranhoff, A. H. Norekvål, T. M. | BMJ Open | 2021 |
Aged, 80 and over |
Delirium and quality of life in critically ill patients: a prospective cohort study | Luz, L. F. D. S. Santos, M. C. D. Ramos, T. A. Almeida, C. B. Rover, M. C. Dal'Pizzol, C. P. Pohren, C. L. D. S. Martins, A. V. D. S. Boniatti, M. M. | Rev Bras Ter Intensiva | 2020 |
adult |
Bispectral Index Monitoring With Density Spectral Array for Delirium Detection | Luo, A. Muraida, S. Pinchotti, D. Richardson, E. Ye, E. Hollingsworth, B. Win, A. Myers, O. Langsjoen, J. Valles, E. Zolyomi, A. Quinn, D. K. | Psychosomatics | 2020 |
bispectral index monitoring |
Delirium prediction in the intensive care unit: a temporal approach | Lucini, F. R. Fiest, K. M. Stelfox, H. T. Lee, J. | Annu Int Conf IEEE Eng Med Biol Soc | 2020 |
Alberta |
Impact of place of residence, frailty and other factors on rehabilitation outcomes post hip fracture | Low, S. Wee, E. Dorevitch, M. | Age Ageing | 2020 |
clinical frailty scale |