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 |
---|---|---|---|---|
Family intervention improves outcomes for patients with delirium: Systematic review and meta-analysis | McKenzie, J. Joy, A. | Australas J Ageing | 2020 |
caregivers |
Effectiveness and Safety of Intrathecal Ziconotide: Final Results of the Patient Registry of Intrathecal Ziconotide Management (PRIZM) | McDowell, G. C. Saulino, M. F. Wallace, M. Grigsby, E. J. Rauck, R. L. Kim, P. Vanhove, G. F. Ryan, R. Huang, I. Z. Deer, T. | Pain medicine (Malden, Mass.) | 2020 |
adult |
Management Effort for Delirium and Insomnia in Patients with Acute Ischemic Stroke (MEDIAS) Study | Matsuzono, K. Mashiko, T. Ozawa, T. Miura, K. Suzuki, M. Furuya, K. Ozawa, M. Anan, Y. Shimazaki, H. Koide, R. Tanaka, R. Fujimoto, S. | Psychiatry Clin Neurosci | 2020 | |
High Prevalence of Oropharyngeal Dysphagia in Acutely Hospitalized Patients Aged 80 Years and Older | Mateos-Nozal, J. Montero-Errasquín, B. Sánchez García, E. Romero Rodríguez, E. Cruz-Jentoft, A. J. | J Am Med Dir Assoc | 2020 |
Dysphagia |
Dexmedetomidine in medical cardiac intensive care units. Data from a multicenter prospective registry | Mateos Gaitan, R. Vicent, L. Rodriguez-Queralto, O. Lopez-de-Sa, E. Elorriaga, A. Pastor, G. Bañeras, J. Lorenzo, B. García-Rubira, J. C. Corbi, M. Ariza, A. Martínez-Sellés, M. | Int J Cardiol | 2020 |
Adverse effects |
Myocardial Function in Patients With Radiation-Associated Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement: A Layer-Specific Strain Analysis Study | Martinez, C. Cicenia, M. Sprynger, M. Postolache, A. Ilardi, F. Dulgheru, R. Radermecker, M. Esposito, G. Marechal, P. Marechal, V. Donis, N. Tridetti, J. Nguyen Trung, M. L. Sugimoto, T. Tsugu, T. Go, Y. Y. Coisne, A. Montaigne, D. Fattouch, K. Nchimi, A | JACC: Cardiovascular Imaging | 2020 |
CoreValve self-expandable biologic prosthesis |
Prevalence and clinical correlates of non-convulsive status epilepticus in elderly patients with acute confusional state: A systematic literature review | Manfredonia, F. Saturno, E. Lawley, A. Gasverde, S. Cavanna, A. E. | J Neurol Sci | 2020 |
Acute confusional state |
Downstream consequences of abnormal cognitive screening in older adults seen pretreatment in a geriatric oncology clinic | Malik, U. Alam, Z. Loucks, A. Jin, R. Yokom, D. Watt, S. Berger, A. Romanovsky, L. Puts, M. Alibhai, S. M. H. | J Geriatr Oncol | 2020 |
Cognitive impairment |
A Study of the Psychometric Properties of the "Stanford Proxy Test for Delirium" (S-PTD): A New Screening Tool for the Detection of Delirium | Maldonado, J. R. Sher, Y. I. Benitez-Lopez, M. A. Savant, V. Garcia, R. Ament, A. De Guzman, E. | Psychosomatics | 2020 |
S-ptd |
Family Identification of Delirium in the Emergency Department in Patients With and Without Dementia: Validity of the Family Confusion Assessment Method (FAM-CAM) | Mailhot, T. Darling, C. Ela, J. Malyuta, Y. Inouye, S. K. Saczynski, J. | J Am Geriatr Soc | 2020 |
Fam-cam |
Frailty Is Associated With Postoperative Delirium But Not With Postoperative Cognitive Decline in Older Noncardiac Surgery Patients | Mahanna-Gabrielli, E. Zhang, K. Sieber, F. E. Lin, H. M. Liu, X. Sewell, M. Deiner, S. G. Boockvar, K. S. | Anesth Analg | 2020 |
Aged |
2019-NCoV: What every neurologist should know? | Mahajan, N. Singla, M. Singh, B. Sajja, V. Bansal, P. Paul, B. Goel, P. Midha, R. Bansal, R. Singh, G. | Annals of Indian Academy of Neurology | 2020 |
alanine aminotransferase |
Age, Comorbidities and Fear of Fall: mortality predictors associated with fall-related fractures | Magdalini, V. Petros, I. Constantinos, T. Garyfalia, S. P. Emmanouil, P. Christos, K. George, K. Kalliopi, A. George, S. Symeon, H. P. | Maedica (Buchar) | 2020 | |
Stress-Induced Behavioral Quiescence and Abnormal Rest-Activity Rhythms During Critical Illness | Maas, M. B. Lizza, B. D. Kim, M. Abbott, S. M. Gendy, M. Reid, K. J. Zee, P. C. | Crit Care Med | 2020 | |
Incidence and risk factors of delirium in icu patients | Ma, W. Zheng, J. Xu, S. Huo, Z. | International Journal of Clinical and Experimental Medicine | 2020 |
stomach tube |
Age, preoperative higher serum cortisol levels, and lower serum acetylcholine levels predict delirium after percutaneous coronary intervention in acute coronary syndrome patients accompanied with renal dysfunction | Ma, J. Fan, M. Wang, Z. | Indian Journal of Psychiatry | 2020 |
IE33 |
Non-Pharmacologic Multicomponent Interventions Preventing Delirium in Hospitalized People | Ludolph, P. Stoffers-Winterling, J. Kunzler, A. M. Rösch, R. Geschke, K. Vahl, C. F. Lieb, K. | J Am Geriatr Soc | 2020 |
delirium |
Usefulness of postoperative serum translocator protein as a predictive marker for delirium after breast cancer surgery in elderly women | Lu, G. W. Chou, Y. E. Jin, W. L. Su, X. B. | J Int Med Res | 2020 |
Translocator protein |
Characteristics, Symptom Management, and Outcomes of 101 Patients With COVID-19 Referred for Hospital Palliative Care | Lovell, N. Maddocks, M. Etkind, S. N. Taylor, K. Carey, I. Vora, V. Marsh, L. Higginson, I. J. Prentice, W. Edmonds, P. Sleeman, K. E. | J Pain Symptom Manage | 2020 |
Covid-19 |
Characterisation of ICU sleep by a commercially available activity tracker and its agreement with patient-perceived sleep quality | Louzon, P. Andrews, J. Torres, X. Pyles, E. Ali, M. Du, Y. Devlin, J. | BMJ Open Respir Res | 2020 |
equipment evaluations |
Surgical treatment of hip fracture in centenarians: Complications and independent risk factors of death | López, Torres, II Sanz-Ruiz, P. Montero-Fernández, N. Chana, F. Serra-Rexach, J. A. Benjumea-Carrasco, A. Vaquero-Martín, J. | Injury | 2020 |
Centenarians |
Long-term survival of femoral neck fracture patients aged over ninety years: Arthroplasty compared with nonoperative treatment | Liu, Y. Zhang, C. W. Zhao, X. D. | BMC Musculoskeletal Disorders | 2020 |
albumin |
Subjective memory complaints predict poorer functional recovery during the first year following hip-fracture surgery among elderly adults | Liu, H. Y. Wang, H. P. Chen, C. Y. Wu, C. C. Hua, M. S. Lin, Y. E. Lin, Y. C. Shyu, Y. L. | Int J Geriatr Psychiatry | 2020 |
hip fracture |
Delirium Severity Trajectories and Outcomes in ICU Patients: Defining a Dynamic Symptom Phenotype | Lindroth, H. Khan, B. A. Carpenter, J. S. Gao, S. Perkins, A. J. Khan, S. H. Wang, S. Jones, R. N. Boustani, M. A. | Ann Am Thorac Soc | 2020 | |
Early mobilisation of ventilated patients in the intensive care unit: A survey of critical care clinicians in an Australian tertiary hospital | Lin, F. Phelan, S. Chaboyer, W. Mitchell, M. | Aust Crit Care | 2020 |
Attitudes |
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. | Journal of Cardiothoracic and Vascular Anesthesia | 2020 |
adult |
Derivation and Validation of a Risk Stratification System for Predicting Postoperative Cognitive Impairment | Liao, Y. Su, X. Ouyang, W. Li, L. Chen, S. Chou, J. Le, Y. | J Invest Surg | 2020 |
Postoperative cognitive dysfunction |
Effects of anesthesia depth on postoperative cognitive function and inflammation: a systematic review and meta-analysis | Li, Y. Zhang, B. | Minerva Anestesiol | 2020 | |
Prevalence, outcome and prognostic factors of neuropsychiatric systemic lupus erythematosus: A real world single center study | Li, X. Xiang, X. Sun, J. Liu, S. Liu, Y. Feng, L. Li, C. Li, Z. | Mod Rheumatol | 2020 |
Neuropsychiatric systemic lupus erythematosus |
Postoperative Delirium Following Joint Replacement in Patients With Dementia in New South Wales, Australia: A State-Wide Retrospective Cohort Study | Li, X. Du, W. Parkinson, A. Glasgow, N. | Research in gerontological nursing | 2020 |
adult |
Effect of dexmedetomidine on prevention of postoperative nausea and vomiting in pediatric strabismus surgery: a randomized controlled study | Li, S. Liu, T. Xia, J. Jia, J. Li, W. | BMC Ophthalmol | 2020 |
Dexmedetomidine |
Toxicity and survival outcomes of autologous stem cell transplant in multiple myeloma patients with renal insufficiency: an institutional comparison between two eras | Li, A. Y. Atenafu, E. G. Bernard, R. S. Masih-Khan, E. Reece, D. Franke, N. Tiedemann, R. Prica, A. Trudel, S. Kukreti, V. Chen, C. I. | Bone Marrow Transplant | 2020 | |
Risk Prediction for Adverse Outcomes for Frail Older Persons with Complex Healthcare and Social Care Needs Admitted to a Community Virtual Ward Model | Lewis, C. O'Caoimh, R. Patton, D. O'Connor, T. Moore, Z. Nugent, L. E. | Clin Interv Aging | 2020 |
case management |
The role of melatonin and melatonin receptor agonist in the prevention of sleep disturbances and delirium in intensive care unit - a clinical review | Lewandowska, K. Małkiewicz, M. A. Siemiński, M. Cubała, W. J. Winklewski, P. J. Mędrzycka-Dąbrowska, W. A. | Sleep Med | 2020 |
Delirium |
Neurological manifestations associated with COVID-19: a review and a call for action | Leonardi, M. Padovani, A. McArthur, J. C. | Journal of Neurology | 2020 |
acroparesthesia |
"You've got to keep moving, keep going": Understanding older patients' experiences and perceptions of delirium and nonpharmacological delirium prevention strategies in the acute hospital setting | Lee-Steere, K. Liddle, J. Mudge, A. Bennett, S. McRae, P. Barrimore, S. E. | J Clin Nurs | 2020 |
adult |
The effect of dexmedetomidine on postoperative behaviour change in children: a randomised controlled trial | Lee-Archer, P. F. von Ungern-Sternberg, B. S. Reade, M. Betts, M. Haenke, D. Keys, A. Rance, T. Gibbons, K. Long, D. | Anaesthesia | 2020 |
behaviour changes |
Developing delirium best practice: a systematic review of education interventions for healthcare professionals working in inpatient settings | Lee, S. Y. Fisher, J. Wand, A. P. F. Milisen, K. Detroyer, E. Sockalingam, S. Agar, M. Hosie, A. Teodorczuk, A. | European Geriatric Medicine | 2020 |
behavior change |
Outcomes of the Extreme Elderly Undergoing Anaesthesia and Surgery amongst Southeast Asians | Lee, S. J. Ng, O. Thong, S. Y. | Anesthesiology Research and Practice | 2020 |
dynamic hip screw |
Predictors of New-Onset Physical Restraint Use in Critically Ill Adults | Lawson, T. N. Tan, A. Thrane, S. E. Happ, M. B. Mion, L. C. Tate, J. Balas, M. C. | Am J Crit Care | 2020 | |
Decision-making for older patients undergoing emergency laparotomy: defining patient and clinician values and priorities | Law, J. Welch, C. Javanmard-Emamghissi, H. Clark, M. Bisset, C. N. O'Neil, P. Moug, S. J. | Colorectal Dis | 2020 |
Emergency laparotomy |
Delirium prevalence and prevention in patients with acute brain injury: A prospective before-and-after intervention study | Larsen, L. K. Møller, K. Petersen, M. Egerod, I. | Intensive & critical care nursing | 2020 |
adult |
Comparison of Hydromorphone versus Fentanyl-based Sedation in Extracorporeal Membrane Oxygenation: A Propensity-Matched Analysis | Landolf, K. M. Rivosecchi, R. M. Goméz, H. Sciortino, C. M. Murray, H. N. Padmanabhan, R. R. Sanchez, P. G. Harano, T. Sappington, P. L. | Pharmacotherapy | 2020 |
acute respiratory distress syndrome |
Collaborative Delirium Prevention in the Age of COVID-19 | LaHue, S. C. James, T. C. Newman, J. C. Esmaili, A. M. Ormseth, C. H. Ely, E. W. | J Am Geriatr Soc | 2020 |
Aged |
Intra-operative hyperoxia and the risk of delirium in elderly patients after cardiac surgery | Kupiec, A. Adamik, B. Forkasiewicz-Gardynik, K. Goździk, W. | Aging (Albany NY) | 2020 |
cardiac surgery |
Clinical profile and predictor of adverse outcome in children with acute encephalitis syndrome: A cross-sectional study | Kuntal, M. Swarnkar, K. | Journal of Krishna Institute of Medical Sciences University | 2020 |
immunoglobulin M |
Intraoperative Optimization of Both Depth of Anesthesia and Cerebral Oxygenation in Elderly Patients Undergoing Coronary Artery Bypass Graft Surgery-A Randomized Controlled Pilot Trial | Kunst, G. Gauge, N. Salaunkey, K. Spazzapan, M. Amoako, D. Ferreira, N. Green, D. W. Ballard, C. | J Cardiothorac Vasc Anesth | 2020 |
cardiac anesthesia |
Establishment of an enhanced recovery after surgery protocol in minimally invasive heart valve surgery | Kubitz, J. C. Schulte-Uentrop, L. Zoellner, C. Lemke, M. Messner-Schmitt, A. Kalbacher, D. Sill, B. Reichenspurner, H. Koell, B. Girdauskas, E. | PLoS One | 2020 | |
Preoperative cognitive impairment associated with oversedation during recovery from anesthesia | Kruthiventi, S. C. Laporta, M. L. Deljou, A. Knopman, D. S. Petersen, R. C. Schroeder, D. R. Sprung, J. Weingarten, T. N. | J Anesth | 2020 |
Anesthesia |
Non-contact monitoring of agitation and use of a sheltering device in patients with dementia in emergency departments: a feasibility study | Kroll, L. Böhning, N. Müßigbrodt, H. Stahl, M. Halkin, P. Liehr, B. Grunow, C. Kujumdshieva-Böhning, B. Freise, C. Hopfenmüller, W. Friesdorf, W. Jockers-Scherübl, M. Somasundaram, R. | BMC Psychiatry | 2020 |
Dementia, agitation |
COVID-19: ICU delirium management during SARS-CoV-2 pandemic | Kotfis, K. Williams Roberson, S. Wilson, J. E. Dabrowski, W. Pun, B. T. Ely, E. W. | Crit Care | 2020 |
Betacoronavirus |
COVID-19: What do we need to know about ICU delirium during the SARS-CoV-2 pandemic? | Kotfis, K. Williams Roberson, S. Wilson, J. Pun, B. Ely, E. W. Jeżowska, I. Jezierska, M. Dabrowski, W. | Anaesthesiol Intensive Ther | 2020 |
Pics |
The impact of acute kidney injury in the perioperative period on the incidence of postoperative delirium in patients undergoing coronary artery bypass grafting—observational cohort study | Kotfis, K. Ślozowska, J. Listewnik, M. Szylińska, A. Rotter, I. | International Journal of Environmental Research and Public Health | 2020 |
creatinine |
Association between Preoperative Obstructive Sleep Apnea and Preoperative Positive Airway Pressure with Postoperative Intensive Care Unit Delirium | King, C. R. Fritz, B. A. Escallier, K. Ju, Y. E. S. Lin, N. McKinnon, S. Avidan, M. S. Palanca, B. J. | JAMA Network Open | 2020 |
adult |
Risk factors and outcomes of sepsis-associated delirium in intensive care unit patients: A secondary data analysis | Kim, Y. Jin, Y. Jin, T. Lee, S. M. | Intensive Crit Care Nurs | 2020 |
Delirium |
Factors affecting the post-anesthetic recovery score and length of stay in the recovery room in elderly patients with hypertension | Kim, S. Kwon, M. | Medico-Legal Update | 2020 |
aged |
Comparative efficacy and acceptability of pharmacological interventions for the treatment and prevention of delirium: A systematic review and network meta-analysis | Kim, M. S. Rhim, H. C. Park, A. Kim, H. Han, K. M. Patkar, A. A. Pae, C. U. Han, C. | J Psychiatr Res | 2020 |
Antipsychotics |
Pre-operative hemoglobin level and use of sedative-hypnotics are independent risk factors for post-operative delirium following total knee arthroplasty | Kijima, E. Kayama, T. Saito, M. Kurosaka, D. Ikeda, R. Hayashi, H. Kubota, D. Hyakutake, T. Marumo, K. | BMC Musculoskelet Disord | 2020 |
Anemia |
Decreasing Delirium Through Music: A Randomized Pilot Trial | Khan, S. H. Xu, C. Purpura, R. Durrani, S. Lindroth, H. Wang, S. Gao, S. Heiderscheit, A. Chlan, L. Boustani, M. Khan, B. A. | Am J Crit Care | 2020 | |
Time trends of delirium rates in the intensive care unit | Khan, S. H. Lindroth, H. Hendrie, K. Wang, S. Imran, S. Perkins, A. J. Gao, S. Vahidy, F. S. Boustani, M. Khan, B. A. | Heart Lung | 2020 |
Delirium |
Neurological complications in recipients after living donor liver transplantation | Khalil, M. Elbanhawy, I. Elsherbiny, A. Amer, H. Ahmed, S. | Neurology India | 2020 |
ammonia |
International drive to illuminate delirium: A developing public health blueprint for action | Khachaturian, A. S. Hayden, K. M. Devlin, J. W. Fleisher, L. A. Lock, S. L. Cunningham, C. Oh, E. S. Fong, T. G. Fick, D. M. Marcantonio, E. R. Iyengar, V. Rockwood, K. Kuchel, G. A. Eckenhoff, R. G. MacLullich, A. M. J. Jones, R. N. Davis, D. D'Antonio, | Alzheimers Dement | 2020 | |
Relationship Between Delirium and Ventilatory Outcomes in the Medical Intensive Care Unit | Kerber, K. Zangmeister, J. McNett, M. | Crit Care Nurse | 2020 | |
Delirium after cardiac arrest: Phenotype, prediction, and outcome | Keijzer, H. M. Klop, M. van Putten, M. J. A. M. Hofmeijer, J. | Resuscitation | 2020 |
clonazepam |
Acute Inflammation Alters Brain Energy Metabolism in Mice and Humans: Role in Suppressed Spontaneous Activity, Impaired Cognition, and Delirium | Kealy, J. Murray, C. Griffin, E. W. Lopez-Rodriguez, A. B. Healy, D. Tortorelli, L. S. Lowry, J. P. Watne, L. O. Cunningham, C. | J Neurosci | 2020 | |
Incidental Durotomy is Associated with Increased Risk of Delirium in Patients Aged 65 and Older | Kazarian, E. R. Lopez, W. Y. Eizember, S. Blucher, J. A. Culley, D. J. Javedan, H. Kang, J. D. Schoenfeld, A. J. | Spine (Phila Pa 1976) | 2020 | |
Scheduled intravenous acetaminophen versus nonsteroidal anti-inflammatory drugs (NSAIDs) for better short-term outcomes after esophagectomy for esophageal cancer | Kawakami, J. Abe, T. Higaki, E. Hosoi, T. Fukaya, M. Komori, K. Ito, S. Nakatochi, M. Nagino, M. Shimizu, Y. | Surg Today | 2020 |
Esophageal surgery |
Experience of morphine therapy for refractory dyspnea as palliative care in advanced heart failure patients | Kawaguchi, J. Hamatani, Y. Hirayama, A. Nishimura, K. Nakai, E. Nakamura, E. Miyata, M. Kawano, Y. Takada, Y. Anchi, Y. Funabashi, S. Kuroda, K. Azechi, M. Takahama, H. Anzai, T. Yasuda, S. Kitaoka, H. Izumi, C. | J Cardiol | 2020 |
Dyspnea |
Delirium and Developmental Disability: Improving Specificity of a Pediatric Delirium Screen∗ | Kaur, S. Silver, G. Samuels, S. Rosen, A. H. Weiss, M. Mauer, E. A. Gerber, L. M. Greenwald, B. M. Traube, C. | Pediatric Critical Care Medicine | 2020 |
article |
Hyperactive Terminal Delirium in Hospice Patients: A Retrospective Cohort Study | Kates, J. | J Hosp Palliat Nurs | 2020 | |
Incidence & Risk Factors of Postoperative Delirium After Spinal Surgery in Older Patients | Kang, T. Park, S. Y. Lee, J. H. Lee, S. H. Park, J. H. Kim, S. K. Suh, S. W. | Sci Rep | 2020 | |
C-reactive protein to albumin ratio as a novel inflammatory biomarker for postoperative delirium in patients undergoing transcatheter aortic valve replacement | Kalyoncuoğlu, M. Biter, H. İ Durmuş, G. Baştan, B. Can, M. M. | Haseki Tip Bulteni | 2020 |
biological marker |
Emergence delirium in children undergoing dental surgery under general anesthesia | Jooma, Z. Perrie, H. Scribante, J. Kleyenstuber, T. | Paediatr Anaesth | 2020 |
Paediatric Anesthesia Emergence Delirium score |
Alteration of consciousness as initial presentation in COVID-19: Observation | Joob, B. Wiwanitkit, V. | Annals of Indian Academy of Neurology | 2020 |
altered state of consciousness |
A systematic review of the impact of delirium on allied health interventions: A surprising lack of data | Johnson, D. Maylin, E. Hayes, L. Hair, C. Kraemer, T. Lau, M. Brodtmann, A. Sahathevan, R. | Neurology Asia | 2020 |
arthroplasty |
Etiology, Clinical Profile and Outcome of Encephalopathy in Elderly | John, B. Loomba, V. John, M. | J Assoc Physicians India | 2020 |
Aged |
Ultrasound-guided continuous thoracic paravertebral block alleviates postoperative delirium in elderly patients undergoing esophagectomy: A randomized controlled trial | Jin, L. Yao, R. Heng, L. Pang, B. Sun, F. G. Shen, Y. Zhong, J. F. Zhao, P. P. Wu, C. Y. Li, B. P. | Medicine (Baltimore) | 2020 |
Aged |
Cognitive Impairment Level and Elderly Hip Fracture: Implications in Rehabilitation Nursing | Jiménez Mola, S. Calvo-Lobo, C. Idoate Gil, J. Seco Calvo, J. | Rehabil Nurs | 2020 | |
Long-term outcomes of major abdominal surgery and postoperative delirium after multimodal prehabilitation of older patients | Janssen, T. L. Steyerberg, E. W. van Hoof-de Lepper, Ccha Seerden, T. C. J. de Lange, D. C. Wijsman, J. H. Ho, G. H. Gobardhan, P. D. van der Laan, L. | Surg Today | 2020 |
Functional outcomes |
Young age and severity of motor function are risk factors for psychosis after subthalamic nucleus deep brain stimulation for Parkinson's disease | Ito, M. Sasaki, F. Katsuta, N. Sekimoto, S. Jo, T. Nakamura, R. Nakajima, A. Oyama, G. Shimo, Y. Iwamuro, H. Umemura, A. Ohnuma, T. Hattori, N. | Psychiatry and Clinical Neurosciences | 2020 |
dopamine receptor stimulating agent |
Impact of frailty and mild cognitive impairment on delirium after cardiac surgery in older patients | Itagaki, A. Sakurada, K. Matsuhama, M. Yajima, J. Yamashita, T. Kohzuki, M. | J Cardiol | 2020 |
Cardiac surgery |
Preoperative Risk Assessment for Delirium After Hepatic Resection in the Elderly: a Prospective Multicenter Study | Ishihara, A. Tanaka, S. Ueno, M. Iida, H. Kaibori, M. Nomi, T. Hirokawa, F. Ikoma, H. Nakai, T. Eguchi, H. Shinkawa, H. Hayami, S. Maehira, H. Shibata, T. Kubo, S. | J Gastrointest Surg | 2020 |
Frailty |
Emergence Delirium in Elderly Patients as a Potential Predictor of Subsequent Postoperative Delirium: A Descriptive Correlational Study | Huang, J. Qi, H. Lv, K. Chen, X. Zhuang, Y. Yang, L. | J Perianesth Nurs | 2020 |
correlation |
Does Alzheimer's Disease and Related Dementias Modify Delirium Severity and Hospital Outcomes? | Hshieh, T. T. Fong, T. G. Schmitt, E. M. Marcantonio, E. R. Xu, G. Gou, Y. R. Travison, T. G. Metzger, E. D. Jones, R. N. Inouye, S. K. | J Am Geriatr Soc | 2020 |
Alzheimer’s disease and related dementias |
A Multicomponent Nonpharmacological Intervention to Prevent Delirium for Hospitalized People with Advanced Cancer: A Phase II Cluster Randomized Waitlist Controlled Trial (The PRESERVE Pilot Study) | Hosie, A. Phillips, J. Lam, L. Kochovska, S. Noble, B. Brassil, M. Kurrle, S. Cumming, A. Caplan, G. A. Chye, R. Ely, E. W. Lawlor, P. G. Bush, S. H. Davis, J. M. Lovell, M. Parr, C. Williams, S. Hauser, K. McArdle, S. Jacquier, K. Phillipson, C. Kuwahata | J Palliat Med | 2020 |
cancer |
The Validity and Reliability of the Japanese Version of the Cornell Assessment of Pediatric Delirium | Hoshino, H. Matsuishi, Y. Enomoto, Y. Shimojo, N. Kido, T. Matsuzaki, A. Matsubara, M. Kato, H. Hoshino, T. Traube, C. Silver, G. Kawano, S. Inoue, Y. | Pediatr Crit Care Med | 2020 | |
The incidence and predictors of postoperative delirium (POD) after brain tumor resection in adults: A cross-sectional survey | Hong Chen, M. N. Jiang, H. Chen, B. Fan, L. Shi, W. Jin, Y. Ren, X. Lang, L. Zhu, F. | World neurosurgery | 2020 |
adult |
A Systematic Review of Risk Factors for Sleep Disruption in Critically Ill Adults | Honarmand, K. Rafay, H. Le, J. Mohan, S. Rochwerg, B. Devlin, J. W. Skrobik, Y. Weinhouse, G. L. Drouot, X. Watson, P. L. McKinley, S. Bosma, K. J. | Critical care medicine | 2020 |
adult |
Neurotoxicity in chronic lithium poisoning | Hlaing, P. M. Isoardi, K. Z. Page, C. B. Pillans, P. | Intern Med J | 2020 |
chronic poisoning |
Postoperative delirium in patients undergoing surgery for bone metastases | Hindiskere, S. Kim, H. S. Han, I. | Medicine (Baltimore) | 2020 |
Aged |
Delirium in patients of the Intensive Care Unit of a health institution in Montería, Colombia | Herrera Herrera, J. L. Oyola López, E. Llorente Pérez, Y. J. | Revista Cientifica de la Sociedad Espanola de Enfermeria Neurologica | 2020 |
adult |
Total Hip Arthroplasty in Patients With Dementia | Hernandez, N. M. Cunningham, D. J. Jiranek, W. A. Bolognesi, M. P. Seyler, T. M. | J Arthroplasty | 2020 |
complications |
Neurologic Features in Severe SARS-CoV-2 Infection | Helms, J. Kremer, S. Merdji, H. Clere-Jehl, R. Schenck, M. Kummerlen, C. Collange, O. Boulay, C. Fafi-Kremer, S. Ohana, M. Anheim, M. Meziani, F. | N Engl J Med | 2020 |
Adult |
Association between delirium prediction scores and days spent with delirium | Heesakkers, H. Devlin, J. W. Slooter, A. J. C. van den Boogaard, M. | J Crit Care | 2020 |
Critical illness |
Association of Hypoactive and Hyperactive Delirium With Cognitive Function After Critical Illness | Hayhurst, C. J. Marra, A. Han, J. H. Patel, M. B. Brummel, N. E. Thompson, J. L. Jackson, J. C. Chandrasekhar, R. Ely, E. W. Pandharipande, P. P. Hughes, C. G. | Crit Care Med | 2020 | |
Mental disorders of geriatric inpatients: symptom characteristics and treatment outcome | Haupt, M. Jänner, M. Richert, F. | Int Psychogeriatr | 2020 |
clinical symptomatology |
Video Glasses Reduce Preoperative Anxiety Compared With Portable Multimedia Player in Children: A Randomized Controlled Trial | Hashimoto, Y. Chaki, T. Hirata, N. Tokinaga, Y. Yoshikawa, Y. Yamakage, M. | J Perianesth Nurs | 2020 |
anesthesia |
Assessing Risks of Polypharmacy Involving Medications With Anticholinergic Properties | Hanlon, P. Quinn, T. J. Gallacher, K. I. Myint, P. K. Jani, B. D. Nicholl, B. I. Lowrie, R. Soiza, R. L. Neal, S. R. Lee, D. Mair, F. S. | Ann Fam Med | 2020 |
anticholinergic burden |
Melatonin and its analogues for the prevention of postoperative delirium: A systematic review and meta-analysis | Han, Y. Wu, J. Qin, Z. Fu, W. Zhao, B. Li, X. Wang, W. Sha, T. Sun, M. Li, J. Zeng, Z. Chen, Z. | J Pineal Res | 2020 |
melatonin |
Proteomic Analysis of Preoperative CSF Reveals Risk Biomarkers of Postoperative Delirium | Han, Y. Chen, W. Song, Y. Yuan, Y. Li, Z. Zhou, Y. Liu, T. Han, D. Mi, X. Li, M. Wang, G. Zhong, L. Zhou, J. Guo, X. | Front Psychiatry | 2020 |
cerebrospinal fluid |