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 |
---|---|---|---|---|
Inpatient gastrostomy in Huntington's disease: Nationwide analysis of utilization and outcomes compared to amyotrophic lateral sclerosis | Hamedani, A. G. Pauly, M. Thibault, D. P. Gonzalez-Alegre, P. Willis, A. W. | Clinical Parkinsonism and Related Disorders | 2020 |
Huntington’s disease Health services research Outcome research Gastrostomy |
The Observational Scale of Level of Arousal: A brief tool for assessing and monitoring level of arousal in patients with delirium outside the ICU | Hall, R. Stíobhairt, A. Allerhand, M. MacLullich, A. M. J. Tieges, Z. | Int J Geriatr Psychiatry | 2020 |
arousal |
Development of disturbance of consciousness is associated with increased severity in acute pancreatitis | Hágendorn, R. Vincze, Á Izbéki, F. Gajdán, L. Gódi, S. Illés, A. Sarlós, P. Farkas, N. Erőss, B. Lillik, V. Illés, D. Varjú, P. Márta, K. Török, I. Papp, M. Vitális, Z. Bod, B. Hamvas, J. Szepes, Z. Takács, T. Czakó, L. Márton, Z. Szentes | Pancreatology | 2020 |
Acute pancreatitis |
Prophylactic Physostigmine for Extreme and Refractory Adult Emergence Delirium, Aimed at Increasing Patient Safety and Reducing Health Care Workplace Violence: A Case Report | Gutman, D. A. Hassid, M. Jeanes, Z. Redding, A. T. Romeo, D. | A and A Practice | 2020 |
adult |
No Brain Is an Island | Guay, C. S. Avidan, M. S. | Anesth Analg | 2020 |
Brain |
The role of physical exercise and rehabilitation in delirium | Gual, N. García-Salmones, M. Brítez, L. Crespo, N. Udina, C. Pérez, L. M. Inzitari, M. | European Geriatric Medicine | 2020 |
brain function |
The incidence of prolonged post-electroconvulsive therapy delirium: A retrospective study | Grover, S. Kumar, A. Chakrabarti, S. Avasthi, A. | Indian J Psychiatry | 2020 |
Electroconvulsive therapy |
Postoperative Delirium in Patients after Hip Fracture Tratment Postoperative Delirium in Patients after Hip Fracture Tratment | Grle, M. Markotić, V. Prlić, J. Grle, I. Miljko, M. | Psychiatr Danub | 2020 | |
Intensive Care Unit Delirium, Clinical Observations, and Patients' Statements: A Case Study | Granberg-Axèll, A. Bergbom, I. | Dimensions of critical care nursing : DCCN | 2020 |
adult |
Assessment of the Decision-Making Capacity for Clinical Research Participation in Patients With Advanced Cancer in the Last Weeks of Life | Goswami, R. Moore, J. Bruera, E. Hui, D. | Journal of Pain and Symptom Management | 2020 |
adult |
Reducing Delirium in Hospitalized Adults Through a Structured Sleep Promotion Program | Gode, A. Kozub, E. Joerger, K. Lynch, C. Roche, M. Kirven, J. | J Nurs Care Qual | 2020 | |
Preoperative Cognitive Assessment Recommendations for the Older Adult | Glover, N. P. Tola, D. H. Norcross, W. Naumuk, L. Tocchi, C. | J Perianesth Nurs | 2020 |
Mini-Cog |
Use of Direct In-Person Observation in the Care of Hospitalized Older Adults with Cognitive Impairment: A Systematic Review | Gilmore-Bykovskyi, A. L. Fuhr, H. Jin, Y. Benson, C. | J Gerontol Nurs | 2020 | |
The consistent burden in published estimates of delirium occurrence in medical inpatients over four decades: a systematic review and meta-analysis study | Gibb, K. Seeley, A. Quinn, T. Siddiqi, N. Shenkin, S. Rockwood, K. Davis, D. | Age Ageing | 2020 |
delirium |
Loss of Independence in Older Patients after Operation for Colorectal Cancer | Gearhart, S. L. Do, E. M. Owodunni, O. Gabre-Kidan, A. A. Magnuson, T. | J Am Coll Surg | 2020 | |
Time to Block: Early Regional Anesthesia Improves Pain Control in Geriatric Hip Fractures | Garlich, J. M. Pujari, A. Debbi, E. M. Yalamanchili, D. R. Moak, Z. B. Stephenson, S. K. Stephan, S. R. Polakof, L. S. Johnson, C. R. Noorzad, A. S. Little, M. T. M. Moon, C. N. Black, J. T. Anand, K. K. Lin, C. A. | J Bone Joint Surg Am | 2020 |
Brain |
Encephalopathy in patients with COVID-19: A review | Garg, R. K. Paliwal, V. K. Gupta, A. | J Med Virol | 2020 |
Brain |
Prevalence and risk factors of postoperative delirium after spinal surgery: a meta-analysis | Gao, H. Ma, H. J. Li, Y. J. Yin, C. Li, Z. | J Orthop Surg Res | 2020 |
Delirium |
Prognostic factors for discharge to home and residing at home 12 months after hip fracture: an Anoia hip study | Gamboa-Arango, A. Duaso, E. Malafarina, V. Formiga, F. Marimón, P. Sandiumenge, M. Salgado, M. T. Escalante, E. Lumbreras, C. Tarrida, A. | Aging Clinical and Experimental Research | 2020 |
aged |
Safety of the muscarinic receptor-antagonist (R,R)-penehyclidine fumarate in healthy subjects: A phase 1 randomized, double-blind, single-dose escalation study | Fu, C. Zhang, X. Pei, Q. Guo, C. Yang, X. Yang, S. Huang, J. Yang, G. | Int J Clin Pharmacol Ther | 2020 |
Administration, Oral |
Discriminant Performance of Dysexecutive and Frontal Release Signs for Delirium in Patients With High Dementia Prevalence: Implications for Neural Network Impairment | Franco, J. G. Trzepacz, P. T. Velásquez-Tirado, J. D. Ocampo, M. V. Serna, P. A. Giraldo, A. M. López, C. Zuluaga, A. Zaraza-Morales, D. | Psychosomatics | 2020 |
abnormal reflex |
Survey of psychiatrists and psychiatry residents in Colombia about their preventive and therapeutic practices in delirium | Franco, J. G. Oviedo Lugo, G. F. Patarroyo Rodriguez, L. Bernal Miranda, J. Molano, J. C. Rojas Moreno, M. Cardeño, C. Velasquez Tirado, J. D. | Revista Colombiana de Psiquiatria | 2020 |
Antipsychotics Delirium Health education Primary prevention Quality of healthcare Therapeutics |
Adverse Events, Functional Decline, and Access to Allied Health Therapies for Patients With Dementia During Acute Hospitalization | Fox, A. MacAndrew, M. Wyles, K. Yelland, C. Beattie, E. | J Appl Gerontol | 2020 |
acute care |
Outcomes of video-assisted thoracoscopic surgery lobectomy in septuagenarians | Fong, L. S. Ko, V. McLaughlin, A. Okiwelu, N. L. Newman, M. A. Passage, J. Sanders, L. H. A. Joshi, P. V. | ANZ J Surg | 2020 |
lobectomy |
Depressive and/or anxiety scoring instruments used as screening tools for predicting postoperative delirium after cardiac surgery: A pilot study | Falk, A. Eriksson, M. Stenman, M. | Intensive Crit Care Nurs | 2020 |
Cardiac surgery |
Preoperative Depression and Plasma Cortisol Levels as Predictors of Delirium after Cardiac Surgery | Eshmawey, M. Arlt, S. Ledschbor-Frahnert, C. Guenther, U. Popp, J. | Dementia and Geriatric Cognitive Disorders | 2020 |
hydrocortisone |
Dexmedetomidine versus nalbuphine in prevention of emergence agitation following adenotonsillectomy in pediatrics | Elagamy, A. E. Mahran, M. G. Mahmoud, A. Z. | Egyptian Journal of Anaesthesia | 2020 |
NCT04058899 |
Predicting Intense Levels of Child Anxiety During Anesthesia Induction at Hospital Arrival | Eijlers, R. Staals, L. M. Legerstee, J. S. Berghmans, J. M. Strabbing, E. M. van der Schroeff, M. P. Wijnen, R. M. H. Kind, L. S. Hillegers, M. H. J. Dierckx, B. Utens, Emwj | J Clin Psychol Med Settings | 2020 |
Anxiety |
A systematic review and meta-analysis evaluating geriatric consultation on older trauma patients | Eagles, D. Godwin, B. Cheng, W. Moors, J. Figueira, S. Khoury, L. Fournier, K. Lampron, J. | J Trauma Acute Care Surg | 2020 | |
Association between incident delirium and 28- and 90-day mortality in critically ill adults: a secondary analysis | Duprey, M. S. van den Boogaard, M. van der Hoeven, J. G. Pickkers, P. Briesacher, B. A. Saczynski, J. S. Griffith, J. L. Devlin, J. W. | Crit Care | 2020 |
Coma |
Delirium in Meningitis and Encephalitis: Emergence and Prediction in a 6-Year Cohort | Dittrich, T. Marsch, S. Rüegg, S. De Marchis, G. M. Tschudin-Sutter, S. Sutter, R. | J Intensive Care Med | 2020 |
delirium |
Neuropsychiatric aspects of COVID-19 pandemic: A selective review | Dinakaran, D. Manjunatha, N. Naveen Kumar, C. Suresh, B. M. | Asian J Psychiatr | 2020 |
Covid-19 |
Psychometric properties of the intensive care delirium screening checklist when used by bedside nurses in clinical practice: a prospective descriptive study | Detroyer, E. Timmermans, A. Segers, D. Meyfroidt, G. Dubois, J. Van Assche, A. Joosten, E. Milisen, K. | BMC Nurs | 2020 |
Delirium |
Delirium in a tertiary PICU: Risk factors and outcomes* | Dervan, L. A. Di Gennaro, J. L. Farris, R. W. D. Watson, R. S. | Pediatric Critical Care Medicine | 2020 |
age |
Factors associated with ABCDE bundle adherence in critically ill adults requiring mechanical ventilation: An observational design | DeMellow, J. M. Kim, T. Y. Romano, P. S. Drake, C. Balas, M. C. | Intensive Crit Care Nurs | 2020 |
ABCDE bundle |
Clinical practice in the management of postoperative delirium by Chinese anesthesiologists: a cross-sectional survey designed by the European Society of Anaesthesiology | Delp, S. Mei, W. Spies, C. D. Neuner, B. Aldecoa, C. Bettelli, G. Bilotta, F. Sanders, R. D. Kramer, S. Weiss, B. | J Int Med Res | 2020 |
China |
Development of a Palliative Care Toolkit for the COVID-19 Pandemic | deLima Thomas, J. Leiter, R. E. Abrahm, J. L. Shameklis, J. C. Kiser, S. B. Gelfand, S. L. Sciacca, K. R. Reville, B. Siegert, C. A. Zhang, H. Lai, L. Sato, R. Smith, L. N. Kamdar, M. M. Greco, L. Lee, K. A. Tulsky, J. A. Lawton, A. J. | J Pain Symptom Manage | 2020 |
Covid-19 |
Adherence to recommended practices for perioperative anesthesia care for older adults among US anesthesiologists: Results from the ASA Committee on Geriatric Anesthesia-Perioperative Brain Health Initiative ASA member survey | Deiner, S. Fleisher, L. A. Leung, J. M. Peden, C. Miller, T. Neuman, M. D. Neuman, M. D. Akhtar, S. Arora, S. Bentov, I. Bhandary, S. Brzezinski, M. Burstrom, R. E. Deiner, S. Evans, K. Leung, J. Lewis, M. C. Mahboobi, S. McSwain, J. Rooke, A. Whittington | Perioperative Medicine | 2020 |
aged |
Evaluation of an Educational Intervention Utilizing Nurse "Champions" and Nurses' Documentation of Intensive Care Unit Delirium | DeForge, C. E. Yip, N. H. Dzierba, A. L. Ryan, P. G. Larson, E. L. | Dimens Crit Care Nurs | 2020 |
Cognitive interventions |
Effect of early cognitive interventions on delirium in critically ill patients: a systematic review | Deemer, K. Zjadewicz, K. Fiest, K. Oviatt, S. Parsons, M. Myhre, B. Posadas-Calleja, J. | Can J Anaesth | 2020 |
Cognitive interventions |
C-Reactive Protein and Procalcitonin Levels May Not Predict Delirium in Critically Ill Children | Dechnik, A. Mauer, E. A. Gerber, L. M. Traube, C. | Pediatr Crit Care Med | 2020 | |
‘Nonagenarians’ with a hip fracture: is a different orthogeriatric treatment strategy necessary? | de Groot, R. Nijmeijer, W. S. Folbert, E. C. Vollenbroek-Hutten, M. M. R. Hegeman, J. H. | Archives of Osteoporosis | 2020 |
cannulated screw |
A quality improvement project for delirium prevention and management over the Greater Manchester Critical Care Network | Davis, J. Berry, K. McIntyre, R. Conway, D. Thomas, A. Hanison, J. | Journal of the Intensive Care Society | 2020 |
Delirium Critical Care Critical Illness Delirium Care Bundles Patient Care Bundles |
Relationship Between Pain, Opioid Treatment, and Delirium in Older Emergency Department Patients | Daoust, R. Paquet, J. Boucher, V. Pelletier, M. Gouin, É Émond, M. | Acad Emerg Med | 2020 | |
Impact of Early Reinitiation of Neuropsychiatric Medications on Agitation and Delirium in the Intensive Care Unit: A Retrospective Study | Cucci, M. D. Cunningham, B. S. Patel, J. S. Shimer, A. T. Mofleh, D. I. Mullen, C. L. | Ann Pharmacother | 2020 |
agitation |
Valproic Acid for the Management of Agitation and Delirium in the Intensive Care Setting: A Retrospective Analysis | Crowley, K. E. Urben, L. Hacobian, G. Geiger, K. L. | Clin Ther | 2020 |
agitation |
Multimodal Pain Management and Postoperative Outcomes in Lumbar Spine Fusion Surgery: A Population-based Cohort Study | Cozowicz, C. Bekeris, J. Poeran, J. Zubizarreta, N. Schwenk, E. Girardi, F. Memtsoudis, S. G. | Spine (Phila Pa 1976) | 2020 | |
Systematic symptom and problem assessment at admission to the palliative care ward - Perspectives and prognostic impacts | Coym, A. Ullrich, A. Hackspiel, L. K. Ahrenholz, M. Bokemeyer, C. Oechsle, K. | BMC Palliative Care | 2020 |
adult |
What are we asking for when requesting "Specialling" for the confused hospitalised older person? A concept analysis | Coyle, M. A. Wilson, V. Lapkin, S. Traynor, V. | Int J Older People Nurs | 2020 |
acute care |
Delirium accompanies kidney dysfunction in hospitalized elderly patients | Coppolino, G. Castagna, A. Provenzano, M. Ruberto, C. Leonardi, G. Greco, L. Battaglia, G. G. Cerra, R. P. Andreucci, M. Bolignano, D. Ruotolo, G. | Journal of Gerontology and Geriatrics | 2020 |
low density lipoprotein cholesterol |
An observational study of older patient specialling in acute hospital settings | Cook, J. Palesy, D. Lapkin, S. Chenoweth, L. | Int J Older People Nurs | 2020 |
acute hospital |
Fundamental care for people with cognitive impairment in the hospital setting: A study combining positive organisational scholarship and video-reflexive ethnography | Collier, A. De Bellis, A. Hosie, A. Dadich, A. Symonds, T. Prendergast, J. Rodrigues, J. Bevan, A. | J Clin Nurs | 2020 |
Gait speed |
Comparison of multidimensional frailty score, grip strength, and gait speed in older surgical patients | Choi, J. Y. Kim, K. I. Choi, Y. Ahn, S. H. Kang, E. Oh, H. K. Kim, D. W. Kim, E. K. Yoon, Y. S. Kang, S. B. Kim, H. H. Han, H. S. Kim, C. H. | J Cachexia Sarcopenia Muscle | 2020 |
Gait speed |
Sleep Disturbance Strongly Related to the Development of Postoperative Delirium in Proximal Femoral Fracture Patients Aged 60 or Older | Cho, M. R. Song, S. K. Ryu, C. H. | Hip Pelvis | 2020 |
Delirium |
Variation in the Management of Pain, Agitation, and Delirium in Intensive Care Units in British Columbia | Chiu, J. A. Shergill, M. Dhingra, V. Ronco, J. J. LeBlanc, A. Pamplin, C. McKeown, S. Dodek, P. M. | Am J Crit Care | 2020 | |
Is hospitalisation a risk factor for cognitive decline in the elderly? | Chinnappa-Quinn, L. Bennett, M. Makkar, S. R. Kochan, N. A. Crawford, J. D. Sachdev, P. S. | Curr Opin Psychiatry | 2020 | |
Clinical studies on the relationship of the short duration of use of midazolam with the occurrence of delirium in icu patients with mechanical ventilation | Chen, Z. F. | Farmacia | 2020 |
midazolam |
Preoperative Circulating MiR-210, a Risk Factor for Postoperative Delirium among Elderly Patients with Gastric Cancer Undergoing Curative Resection | Chen, Y. Zheng, J. Chen, J. | Curr Pharm Des | 2020 |
Gastric cancer |
The Incidence and Predictors of Postoperative Delirium After Brain Tumor Resection in Adults: A Cross-Sectional Survey | Chen, H. Jiang, H. Chen, B. Fan, L. Shi, W. Jin, Y. Ren, X. Lang, L. Zhu, F. | World Neurosurg | 2020 |
Delirium |
Baclofen has a risk of encephalopathy in older adults receiving dialysis | Chauvin, K. J. Blake, P. G. Garg, A. X. Weir, M. A. Bathini, L. Dixon, S. N. McArthur, E. Sontrop, J. M. Moist, L. Kim, R. B. Muanda, F. T. | Kidney Int | 2020 |
baclofen |
Delirium Among Hospitalized Older Adults in Thailand: An Integrative Review | Chang, H. C. R. Neal, K. Traynor, V. Ho, M. H. Kankom, W. | J Gerontol Nurs | 2020 | |
American Society for Enhanced Recovery and Perioperative quality initiative joint consensus statement on the role of neuromonitoring in perioperative outcomes: Electroencephalography | Chan, M. T. V. Hedrick, T. L. Egan, T. D. García, P. S. Koch, S. Purdon, P. L. Ramsay, M. A. Miller, T. E. McEvoy, M. D. Gan, T. J. Hughes, C. G. Boncyk, C. S. Culley, D. J. Fleisher, L. A. Leung, J. M. McDonagh, D. L. Thiele, R. H. Shaw, A. Bartels, K. | Anesthesia and Analgesia | 2020 |
anesthesiologist |
Evidence-based clinical practice guidelines for the management of sedoanalgesia and delirium in critically ill adult patients | Celis-Rodríguez, E. Díaz Cortés, J. C. Cárdenas Bolívar, Y. R. Carrizosa González, J. A. Pinilla, D. I. Ferrer Záccaro, L. E. Birchenall, C. Caballero López, J. Argüello, B. M. Castillo Abrego, G. Castorena Arellano, G. Dueñas Castell, C. Jáure | Med Intensiva | 2020 |
Agitación |
Patient care during the COVID-19 pandemic: do not leave delirium behind | Castro, R. E. V. Garcez, F. B. Avelino-Silva, T. J. | Braz J Psychiatry | 2020 | |
The financial and social costs of delirium | Caplan, G. A. Teodorczuk, A. Streatfeild, J. Agar, M. R. | European Geriatric Medicine | 2020 |
cost control |
Clinical impression for identification of vulnerable older patients in the emergency department | Calf, A. H. Lubbers, S. van den Berg, A. A. van den Berg, E. Jansen, C. J. van Munster, B. C. de Rooij, S. E. Ter Maaten, J. C. | Eur J Emerg Med | 2020 | |
Is Delirium Pediatric Confusion Assessment Method Tools Confiable? | Caino de Oliveira, F. R. Ribeiro de Araujo, O. Brunow de Carvalho, W. | Pediatr Crit Care Med | 2020 |
Brazil |
Research in brief: Inpatient hip fractures and nomenclature of delirium and acute encephalopathy | Cacciottolo, T. M. Ferrigan, L. | Clin Med (Lond) | 2020 | |
Prolonged Confusional state as first manifestation of COVID-19 | Butt, I. Sawlani, V. Geberhiwot, T. | Ann Clin Transl Neurol | 2020 |
Covid-19 |
Delirium After Withdrawal From Valerian Root: A Case Report | Burke, H. Jiang, S. Chatham, P. Stern, T. A. | Psychosomatics | 2020 | |
Deciphering delirium through semantics: a selective synopsis | Bugiani, O. | Neurol Sci | 2020 |
Ageing |
Predicting incident delirium diagnoses using data from primary-care electronic health records | Bowman, K. Jones, L. Masoli, J. Mujica-Mota, R. Strain, D. Butchart, J. Valderas, J. M. Fortinsky, R. H. Melzer, D. Delgado, J. | Age Ageing | 2020 |
at home |
Comparison of Self-Reported and Behavioral Pain Assessment Tools in Critically Ill Patients | Bouajram, R. H. Sebat, C. M. Love, D. Louie, E. L. Wilson, M. D. Duby, J. J. | J Intensive Care Med | 2020 |
Behavioral Pain Scale |
Practical Training of Anesthesia Clinicians in Electroencephalogram-Based Determination of Hypnotic Depth of General Anesthesia | Bombardieri, A. M. Wildes, T. S. Stevens, T. Wolfson, M. Steinhorn, R. Ben Abdallah, A. Sleigh, J. Avidan, M. S. | Anesth Analg | 2020 |
Anesthesia, Inhalation |
A multisite study of nurse-reported perceptions and practice of ABCDEF bundle components | Boehm, L. M. Pun, B. T. Stollings, J. L. Girard, T. D. Rock, P. Hough, C. L. Hsieh, S. J. Khan, B. A. Owens, R. L. Schmidt, G. A. Smith, S. Ely, E. W. | Intensive Crit Care Nurs | 2020 |
ABCDEF bundle |
Cognitive impairment, clinical symptoms and functional disability in patients emerging from the minimally conscious state | Bodien, Y. G. Martens, G. Ostrow, J. Sheau, K. Giacino, J. T. | NeuroRehabilitation | 2020 |
adult |
Effect of intravenous iron on functional outcomes in hip fracture: a randomised controlled trial | Bielza, R. Llorente, J. Thuissard, I. J. Andreu-Vázquez, C. Blanco, D. Sanjurjo, J. López, N. Herráez, M. R. Molano, C. Morales, A. Arias, E. Neira, M. Lung, A. Escalera, J. Portillo, L. Larrubia, Y. García, C. Zambrana, F. Gómez Cerezo, J. | Age Ageing | 2020 |
anaemia |
Tapering with Pharmaceutical GHB or Benzodiazepines for Detoxification in GHB-Dependent Patients: A Matched-Subject Observational Study of Treatment-as-Usual in Belgium and The Netherlands | Beurmanjer, H. Luykx, J. J. De Wilde, B. van Rompaey, K. Buwalda, V. J. A. De Jong, C. A. J. Dijkstra, B. A. G. Schellekens, A. F. A. | CNS Drugs | 2020 | |
Clinical characteristics and outcomes of inpatients with neurologic disease and COVID-19 in Brescia, Lombardy, Italy | Benussi, A. Pilotto, A. Premi, E. Libri, I. Giunta, M. Agosti, C. Alberici, A. Baldelli, E. Benini, M. Bonacina, S. Brambilla, L. Caratozzolo, S. Cortinovis, M. Costa, A. Piccinelli, S. C. Cottini, E. Cristillo, V. Delrio, I. Filosto, M. Gamba, M. Gazzina | Neurology | 2020 | |
Palliative sedation: beliefs and decision-making among Spanish palliative care physicians | Benítez-Rosario, M. A. Ascanio-León, B. | Support Care Cancer | 2020 |
Cancer patients |
A Tunisian version of the confusion assessment method for the intensive care unit (CAM-ICU): translation and validation | Ben Saida, I. Kortli, S. Amamou, B. Kacem, N. Ghardallou, M. Ely, E. W. Ben Saad, H. Boussarsar, M. | BMC Psychiatry | 2020 |
Critical illness |
'Socialised care futility' in the care of older people in hospital who call out repetitively: An ethnographic study | Beaver, J. Goldberg, S. E. Edgley, A. Harwood, R. H. | Int J Nurs Stud | 2020 |
Acute hospitals |
Delirium in COVID-19: A case series and exploration of potential mechanisms for central nervous system involvement | Beach, S. R. Praschan, N. C. Hogan, C. Dotson, S. Merideth, F. Kontos, N. Fricchione, G. L. Smith, F. A. | Gen Hosp Psychiatry | 2020 |
Akinetic mutism |
Prevalence of delirium in intensive care patients and association with sedoanalgesia, severity and mortality | Bastos, A. S. Beccaria, L. M. Silva, D. C. D. Barbosa, T. P. | Revista gaucha de enfermagem | 2020 |
adult |
Antipsychotics and the Risk of Mortality or Cardiopulmonary Arrest in Hospitalized Adults | Basciotta, M. Zhou, W. Ngo, L. Donnino, M. Marcantonio, E. R. Herzig, S. J. | J Am Geriatr Soc | 2020 |
antipsychotics |
Comprehensive analysis of in-hospital delirium after major surgical oncology procedures: A population-based study | Bandini, M. Marchioni, M. Preisser, F. Nazzani, S. Tian, Z. Graefen, M. Montorsi, F. Saad, F. Shariat, S. F. Schips, L. Briganti, A. Karakiewicz, P. I. | Can Urol Assoc J | 2020 |
adult |
Sepsis Associated Delirium | Atterton, B. Paulino, M. C. Povoa, P. Martin-Loeches, I. | Medicina (Kaunas) | 2020 |
adult |
Melatonin for delirium prevention in acute medically ill, and perioperative geriatric patients | Asleson, D. R. Chiu, A. W. | Aging Medicine | 2020 |
adult |
The short- And long-term outcomes of esophagectomy for esophageal cancer in patients older than 75 years | Aoyama, T. Hara, K. Kazama, K. Atsumi, Y. Tamagawa, H. Tamagawa, A. MacHida, D. Komori, K. Maezawa, Y. Kano, K. Hashimoto, I. Oshima, T. Murakawa, M. Numata, M. Yukawa, N. Masuda, M. Rino, Y. | Anticancer Research | 2020 |
antineoplastic agent |
National French survey of COVID-19 symptoms in people aged 70 and over | Annweiler, C. Sacco, G. Salles, N. Aquino, J. P. Gautier, J. Berrut, G. Guérin, O. Gavazzi, G. | Clin Infect Dis | 2020 | |
COVID-19: ICU delirium management during SARS-CoV-2 pandemic-pharmacological considerations | Andrews, L. J. Benken, S. T. | Crit Care | 2020 |
Betacoronavirus |
The Intersection of Architecture/Medicine/Quality and the Clinical Nurse Specialist: Designing for the Prevention of Delirium | Anderson, D. C. Jacoby, S. R. Scruth, E. A. | Clinical nurse specialist CNS | 2020 | |
The Agents Intervening against Delirium in the Intensive Care Unit-Trial (AID-ICU trial):- a detailed statistical analysis plan | Andersen-Ranberg, N. Poulsen, L. M. Perner, A. Wetterslev, J. Mathiesen, O. Mortensen, C. B. Estrup, S. Ebdrup, B. H. Hästbacka, J. Citerio, G. Caballero, J. Morgan, M. P. G. Oxenbøll-Collet, M. Weber, S. O. Andreasen, A. S. Bestle, M. H. Pedersen, H. B | Acta Anaesthesiol Scand | 2020 | |
A systematic review of the overlap of fluid biomarkers in delirium and advanced cancer-related syndromes | Amgarth-Duff, I. Hosie, A. Caplan, G. Agar, M. | BMC Psychiatry | 2020 |
Advanced cancer |
Toward best practice methods for delirium biomarker studies: An international modified Delphi study | Amgarth-Duff, I. Hosie, A. Caplan, G. Agar, M. | Int J Geriatr Psychiatry | 2020 |
consensus |
Preoperative cognitive dysfunction in older elective noncardiac surgical patients in South Africa | Amado, L. A. Perrie, H. Scribante, J. Ben-Israel, K. A. | Br J Anaesth | 2020 |
Mini-Cog |
The etiology and age-related properties of patients with delirium in coronary intensive care unit and its effects on inhospital and follow up prognosis | Altay, S. Gürdoğan, M. Kaya, Ç Kardaş, F. Zeybey, U. Çakir, B. Ebik, M. Demir, M. | Ideggyogy Sz | 2020 |
delirium in coronary intensive care unit |
A Unique Presentation of Delirium in a Patient with Otherwise Asymptomatic COVID-19 | Alkeridy, W. A. Almaghlouth, I. Alrashed, R. Alayed, K. Binkhamis, K. Alsharidi, A. Liu-Ambrose, T. | J Am Geriatr Soc | 2020 |
Covid-19 |
Postoperative delirium after abdominal aortic surgery: after ICU discharge surveillance should extend to the surgical ward | Alessandri, F. Bilotta, F. | Minerva Anestesiol | 2020 | |
The prevalence of emergence delirium and its associated factors among children at a postoperative unit: A retrospective cohort at a Middle Eastern hospital | Aldakhil, S. K. Salam, M. Albelali, A. A. Alkanhal, R. M. Alnemer, M. J. Alatassi, A. | Saudi J Anaesth | 2020 |
Anesthesia |