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 |
---|---|---|---|---|
Optimal goal of management of delirium in end-of-life cancer care | Akechi, T. | Lancet Oncol | 2020 | |
Multiple Peri-Operative Complications are Associated with Reduced Long Term Amputation Free Survival Following Revascularisation for Lower Limb Peripheral Artery Disease: A Population Based Linked Data Study | Aitken, S. J. Randall, D. A. Noguchi, N. Blyth, F. M. Naganathan, V. | Eur J Vasc Endovasc Surg | 2020 |
Aged |
Neurological manifestations and complications of COVID-19: A literature review | Ahmad, I. Rathore, F. A | J Clin Neurosci | 2020 |
Clinical features |
The role of suvorexant in the prevention of delirium during acute hospitalization: A systematic review | Adams, A. D. Pepin, M. J. Brown, J. N. | J Crit Care | 2020 |
Belsomra |
Quetiapine for delirium prophylaxis in high-risk critically ill patients | Abraham, M. P. Hinds, M. Tayidi, I. Jeffcoach, D. R. Corder, J. M. Hamilton, L. A. Lawson, C. M. Bollig, R. W. Heidel, R. E. Daley, B. J. Taylor, J. E. McMillen, J. C. | Surgeon | 2020 |
Delirium |
Comparing outcomes after peripheral nerve block versus general anesthesia for lower extremity amputation: a nationwide exploratory retrospective cohort study in Japan | Abe, H. Sumitani, M. Matsui, H. Aso, S. Inoue, R. Fushimi, K. Uchida, K. Yasunaga, H. Yamada, Y. | Reg Anesth Pain Med | 2020 |
lower extremity |
Development of delirium: Association with old age, severe burns, and intensive care | Abdelrahman, I. Vieweg, R. Irschik, S. Steinvall, I. Sjöberg, F. Elmasry, M. | Burns | 2020 |
Burns |
Factors Associated With Postoperative Confusion and Prolonged Hospital Stay Following Deep Brain Stimulation Surgery for Parkinson Disease | Abboud, H. Genc, G. Saad, S. Thompson, N. Oravivattanakul, S. Alsallom, F. Yu, X. X. Floden, D. Gostkowski, M. Ahmed, A. Ezzeldin, A. Marouf, H. M. Mansour, O. Y. Fernandez, H. H. | Neurosurgery | 2020 |
Dbs |
Mortality and complications after emergency laparotomy in patients above 80 years | Aakre, E. K. Ulvik, A. Hufthammer, K. O. Jammer, I. | Acta Anaesthesiol Scand | 2020 |
elderly |
Evaluation of an emergency department falls pathway for older people: A patient chart review | O' Keeffe A O' Grady S Cronin, F. Dolan, C. O' Hea A O' Shea KL Naughton, C. | Int Emerg Nurs | 2020 | |
Rapid in-person cognitive screening in the preoperative setting: Test considerations and recommendations from the Society for Perioperative Assessment and Quality Improvement (SPAQI) | Arias, F. Wiggins, M. Urman, R. D. Armstrong, R. Pfeifer, K. Bader, A. M. Libon, D. J. Chopra, A. Price, C. C. | Journal of Clinical Anesthesia | 2020 |
anesthesiology |
Updated nomenclature of delirium and acute encephalopathy: statement of ten Societies | Slooter, A. J. C. Otte, W. M. Devlin, J. W. Arora, R. C. Bleck, T. P. Claassen, J. Duprey, M. S. Ely, E. W. Kaplan, P. W. Latronico, N. Morandi, A. Neufeld, K. J. Sharshar, T. MacLullich, A. M. J. Stevens, R. D. | Intensive Care Medicine | 2020 |
acute brain disease |
Nonsedation or Light Sedation in Critically Ill, Mechanically Ventilated Patients | Olsen, H. T. Nedergaard, H. K. Strøm, T. Oxlund, J. Wian, K. A. Ytrebø, L. M. Kroken, B. A. Chew, M. Korkmaz, S. Lauridsen, J. T. Toft, P. | The New England journal of medicine | 2020 |
NCT01967680 |
Ketamine Safety and Use in the Emergency Department for Pain and Agitation/Delirium: A Health System Experience | Mo, H. Campbell, M. J. Fertel, B. S. Lam, S. W. Wells, E. J. Casserly, E. Meldon, S. W. | The western journal of emergency medicine | 2020 |
adult |
Impact of skeletal muscle mass on postoperative delirium in patients undergoing free flap repair after oral cancer resection | Makiguchi, T. Yamaguchi, T. Nakamura, H. Ogawa, M. Harimoto, N. Shirabe, K. Yokoo, S. | Journal of plastic surgery and hand surgery | 2020 |
adult |
Identifying delirium in Parkinson disease: A pilot study | Lawson, R. A. Richardson, S. J. Yarnall, A. J. Burn, D. J. Allan, L. M. | International Journal of Geriatric Psychiatry | 2020 |
aged |
Presurgical cognitive impairment is associated with postoperative delirium and postoperative cognitive dysfunction | Knaak, C. Brockhaus, W. R. Spies, C. Borchers, F. Piper, S. K. Radtke, F. M. Lachmann, G. | Minerva anestesiologica | 2020 |
aged |
The effects of elective aortic repair, colorectal cancer surgery and subsequent postoperative delirium on long-term quality of life, cognitive functioning and depressive symptoms in older patients | Janssen, T. L. de Vries, J. Lodder, P. Faes, M. C. Ho, G. H. Gobardhan, P. D. van der Laan, L. | Aging & mental health | 2020 |
abdominal aortic aneurysm |
American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Delirium Prevention | Hughes, C. G. Boncyk, C. S. Culley, D. J. Fleisher, L. A. Leung, J. M. McDonagh, D. L. Gan, T. J. McEvoy, M. D. Miller, T. E. | Anesthesia and analgesia | 2020 |
adult |
Healthcare professionals' reports of cancer pain cues among older people with delirium: a qualitative-quantitative content analysis | Graham, C. A. Chaves, G. Harrison, R. Gauthier, L. R. Nissim, R. Zimmermann, C. Chan, V. Rodin, G. Stevens, B. Gagliese, L. | Journal of pain and symptom management | 2020 |
adult |
Preoperative Cognitive Abnormality, Intraoperative Electroencephalogram Suppression, and Postoperative Delirium: A Mediation Analysis | Fritz, B. A. King, C. R. Ben Abdallah, A. Lin, N. Mickle, A. M. Budelier, T. P. Oberhaus, J. Park, D. Maybrier, H. R. Wildes, T. S. Avidan, M. S. Apakama, G. Aranake-Chrisinger, A. Bolzenius, J. Burton, J. Cui, V. Emmert, D. A. Goswami, S. Graetz, T. J. G | Anesthesiology | 2020 |
adult |
Delirium screening and mortality in patients with dementia admitted to acute hospitals | Codling, D. Hood, C. Bassett, P. Smithard, D. Crawford, M. J. | Aging & mental health | 2020 |
aged |
Do Neuroleptics Still Have a Role in Patients With Delirium? | Nikooie, R. Oh, E. S. Zhang, A. Robinson, K. A. Needham, D. M. | Annals of internal medicine | 2020 |
adult |
Randomized clinical trial of intraoperative dexmedetomidine to prevent delirium in the elderly undergoing major non-cardiac surgery | Li, C. J. Wang, B. J. Mu, D. L. Hu, J. Guo, C. Li, X. Y. Ma, D. Wang, D. X. | British Journal of Surgery | 2020 |
ChiCTRIPR15007654 |
Risk factors for adverse drug reactions in older inpatients of geriatric wards at admission: Multicenter study | Kojima, T. Matsui, T. Suzuki, Y. Takeya, Y. Tomita, N. Kozaki, K. Kuzuya, M. Rakugi, H. Arai, H. Akishita, M. | Geriatrics and Gerontology International | 2020 |
albumin |
Real-world effectiveness of ramelteon and suvorexant for delirium prevention in 948 patients with delirium risk factors | Hatta, K. Kishi, Y. Wada, K. Takeuchi, T. Hashimoto, N. Suda, K. Taira, T. Tsuchida, K. Ohmori, T. Akizuki, N. Nishio, Y. Nakanishi, Y. Usui, C. Kurata, A. Horikawa, N. Eguchi, H. Ito, S. Muto, H. Nakamura, H. Uchimura, N. | Journal of Clinical Psychiatry | 2020 |
corticosteroid derivative |
Independent Association Between Type of Intraoperative Blood Transfusion and Postoperative Delirium After Complex Spinal Fusion for Adult Deformity Correction | Elsamadicy, A. A. Adil, S. M. Charalambous, L. Drysdale, N. Koo, A. B. Lee, M. Kundishora, A. J. Camara-Quintana, J. Kolb, L. Laurans, M. Abbed, K. Karikari, I. O. | Spine | 2020 |
adult |
Practices related to assessment of sedation, analgesia and delirium among critical care pediatricians in Brazil | Colleti Junior, J. Araujo, O. R. Andrade, A. B. Carvalho, W. B. | Einstein (Sao Paulo, Brazil) | 2020 |
analgesia |
Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study | Chen, N. Zhou, M. Dong, X. Qu, J. Gong, F. Han, Y. Qiu, Y. Wang, J. Liu, Y. Wei, Y. Xia, J. Yu, T. Zhang, X. Zhang, L. | The Lancet | 2020 |
adult |
Association between postoperative delirium and mortality in elderly patients undergoing hip fractures surgery: a meta-analysis | Bai, J. Liang, Y. Zhang, P. Liang, X. He, J. Wang, J. Wang, Y. | Osteoporosis International | 2020 |
article |
Impact of frailty on short-term outcomes in patients undergoing transsphenoidal pituitary surgery | Asemota, A. O. Gallia, G. L. | Journal of Neurosurgery | 2020 |
acute heart infarction |
Randomised controlled trial to investigate the relationship between mild hypercapnia and cerebral oxygen saturation in patients undergoing major surgery | Wong, C. Churilov, L. Cowie, D. Tan, C. O. Hu, R. Tremewen, D. Pearce, B. Pillai, P. Karalapillai, D. Bellomo, R. Weinberg, L. | BMJ Open | 2020 |
delirium |
Establishment and validation of a delirium prediction model for neurosurgery patients in intensive care | Wang, J. Ji, Y. Wang, N. Chen, W. Bao, Y. Qin, Q. Ma, C. Xiao, Q. Li, S. | Int J Nurs Pract | 2020 |
delirium |
Early mobilisation after transfemoral transcatheter aortic valve implantation: results of the MobiTAVI trial | Vendrik, J. Vlastra, W. van Mourik, M. S. Delewi, R. Beijk, M. A. Lemkes, J. Wykrzykowska, J. J. de Winter, R. J. Henriques, J. S. Piek, J. J. Vis, M. M. Koch, K. T. Baan, J., Jr. | Neth Heart J | 2020 |
Ambulation |
Influence of sedation on delirium recognition in critically ill patients: A multinational cohort study | van den Boogaard, M. Wassenaar, A. van Haren, F. M. P. Slooter, A. J. C. Jorens, P. G. van der Jagt, M. Simons, K. S. Egerod, I. Burry, L. D. Beishuizen, A. Pickkers, P. Devlin, J. W. | Aust Crit Care | 2020 |
Assessment |
Intraoperative reduction of vasopressors using processed electroencephalographic monitoring in patients undergoing elective cardiac surgery: a randomized clinical trial | Sponholz, C. Schuwirth, C. Koenig, L. Hoyer, H. Coldewey, S. M. Schelenz, C. Doenst, T. Kortgen, A. Bauer, M. | J Clin Monit Comput | 2020 |
Adverse events |
Enhanced rehabilitation and care models for adults with dementia following hip fracture surgery | Smith, T. O. Gilbert, A. W. Sreekanta, A. Sahota, O. Griffin, X. L. Cross, J. L. Fox, C. Lamb, S. E. | Cochrane Database Syst Rev | 2020 | |
Prospective Evaluation of Delirium in Geriatric Patients Undergoing Emergency General Surgery | Saljuqi, A. T. Hanna, K. Asmar, S. Tang, A. Zeeshan, M. Gries, L. Ditillo, M. Kulvatunyou, N. Castanon, L. Joseph, B. | J Am Coll Surg | 2020 | |
Predisposing and Precipitating Factors Associated With Postoperative Delirium in Patients Undergoing Cardiac Surgery at a Veterans Affairs Medical Center: A Pilot Retrospective Analysis | Russell, M. D. Pinkerton, C. Sherman, K. A. Ebert, T. J. Pagel, P. S. | J Cardiothorac Vasc Anesth | 2020 |
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition |
Dopaminergic Hyperactivity in Neurological Patients with Delirium | Ramirez-Bermudez, J. Perez-Neri, I. Montes, S. Nente, F. Ramirez-Abascal, M. Carrillo-Mezo, R. Perez-Esparza, R. Soto-Hernandez, J. L. Espinola-Nadurille, M. Bayliss, L. De Jesus Flores Rivera, J. Rios, C. | Arch Med Res | 2020 |
Autoimmune limbic encephalitis |
Effects of intravenous and mask induction on post-operative emergence delirium in pediatric patients undergoing tonsillectomy with or without adenoidectomy | Peker, K. Polat, R. | Ir J Med Sci | 2020 |
Intravenous induction |
Safety and Tolerability of Rapid Administration Undiluted Levetiracetam | Morgan, O. Medenwald, B. | Neurocrit Care | 2020 |
Anticonvulsants |
New use of psychotropic medication after hospitalization among people with dementia | Mollers, T. Perna, L. Stocker, H. Ihle, P. Schubert, I. Schottker, B. Frolich, L. Brenner, H. | Int J Geriatr Psychiatry | 2020 |
claims data |
A logistic regression analysis comparing minimalistic approach and intubation anaesthesia in patients undergoing transfemoral transcatheter aortic valve replacement | Maier, A. Hammerich, B. Humburger, F. Brieschal, T. Heidt, T. Bothe, W. Schrofel, H. Kaier, K. Zehender, M. Reinohl, J. Bode, C. von Zur Muhlen, C. Stachon, P. | PLoS One | 2020 | |
Anticipating Postoperative Delirium During Burst Suppression Using Electroencephalography | Ma, O. Crepeau, A. Z. Dutta, A. Bliss, D. | IEEE Trans Biomed Eng | 2020 |
adult |
Can haloperidol prophylaxis reduce the incidence of delirium in critically ill patients in intensive care units? A systematic review and meta-analysis | Lin, P. Zhang, J. Shi, F. Liang, Z. A. | Heart Lung | 2020 |
Delirium |
Benzodiazepines for treatment of patients with delirium excluding those who are cared for in an intensive care unit | Li, Y. Ma, J. Jin, Y. Li, N. Zheng, R. Mu, W. Wang, J. Si, J. H. Chen, J. Shang, H. C. | Cochrane Database Syst Rev | 2020 | |
Delirium prevalence and prevention in patients with acute brain injury: A prospective before-and-after intervention study | Larsen, L. K. Moller, K. Petersen, M. Egerod, I. | Intensive Crit Care Nurs | 2020 |
Brain injuries |
Postoperative anaemia might be a risk factor for postoperative delirium and prolonged hospital stay: A secondary analysis of a prospective cohort study | Kunz, J. V. Spies, C. D. Bichmann, A. Sieg, M. Mueller, A. | PLoS One | 2020 | |
Development of a Simple and Practical Delirium Screening Tool for Use in Surgical Wards | Kubota, K. Suzuki, A. Ohde, S. Yamada, U. Fujitani, I. Koitabashi, A. | J Nurs Res | 2020 |
adult |
Psychometric evaluation of the family caregiver ICU delirium knowledge questionnaire | Krewulak, K. D. Bull, M. J. Ely, E. W. Stelfox, H. T. Fiest, K. M. | BMC Health Serv Res | 2020 |
Critical care |
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. Slozowska, J. Listewnik, M. Szylinska, A. Rotter, I. | Int J Environ Res Public Health | 2020 |
Aki |
Delirium point prevalence studies in inpatient settings: A systematic review and meta-analysis | Koirala, B. Hansen, B. R. Hosie, A. Budhathoki, C. Seal, S. Beaman, A. Davidson, P. M. | J Clin Nurs | 2020 |
delirium |
Validity and Reliability of the Memorial Delirium Assessment Scale-Thai Version (MDAS-T) for Assessment of Delirium in Palliative Care Patients | Klankluang, W. Pukrittayakamee, P. Atsariyasing, W. Siriussawakul, A. Chanthong, P. Tongsai, S. Tayjasanant, S. | Oncologist | 2020 |
Delirium |
The Impact of an Attending Intensivist on the Clinical Outcomes of Patients Admitted to the Cardiac Surgical Intensive Care Unit after Coronary Artery Bypass Grafting | Kim, D. J. Sohn, B. Kim, H. Chang, H. W. Lee, J. H. Kim, J. S. Lim, C. Park, K. H. | Korean J Thorac Cardiovasc Surg | 2020 |
Coronary artery bypass grafting |
Working Collaboratively: Outcomes of Geriatrician Input in Older Patients Undergoing Emergency Laparotomy in a District General Hospital | Khan, K. A. Subramanian, T. Richters, M. Mubarik, A. Saad Abdalla Al-Zawi, A. Thorn, C. C. Chalstrey, S. Gunasekera, S. | Cureus | 2020 |
ageing & frailty |
Postoperative delirium: the findings from a multidisciplinary survey | Jin, Z. Rahman, A. Pattnaik, S. Smith, M. | Psychogeriatrics | 2020 |
education |
Postoperative delirium after reconstructive surgery for oral tumor: a retrospective clinical study | Ishibashi-Kanno, N. Takaoka, S. Nagai, H. Okubo-Sato, M. Fukuzawa, S. Uchida, F. Yamagata, K. Yanagawa, T. Bukawa, H. | Int J Oral Maxillofac Surg | 2020 |
Delirium |
Joining Forces against Delirium - From Organ-System Care to Whole-Human Care | Inouye, S. K. | N Engl J Med | 2020 |
Aged |
Incidence of and risk factors for postoperative delirium in older adult patients undergoing noncardiac surgery: a prospective study | Iamaroon, A. Wongviriyawong, T. Sura-Arunsumrit, P. Wiwatnodom, N. Rewuri, N. Chaiwat, O. | BMC Geriatr | 2020 |
Collaborative approach |
Delirium misdiagnosis risk in psychiatry: a machine learning-logistic regression predictive algorithm | Hercus, C. Hudaib, A. R. | BMC Health Serv Res | 2020 |
Delirium |
Patterns of Potentially Inappropriate Bladder Antimuscarinic Use in People with Dementia: A Retrospective Cohort Study | Green, A. R. Segal, J. Boyd, C. M. Huang, J. Roth, D. L. | Drugs Real World Outcomes | 2020 | |
Incidence, determinants and consequences of delirium in older patients after transcatheter aortic valve implantation | Goudzwaard, J. A. de Ronde-Tillmans, Mjag de Jager, T. A. J. Lenzen, M. J. Nuis, R. J. van Mieghem, N. M. Daemen, J. de Jaegere, P. P. T. Mattace-Raso, F. U. S. | Age Ageing | 2020 |
aortic stenosis |
Neuromonitoring of delirium with quantitative pupillometry in sedated mechanically ventilated critically ill patients | Favre, E. Bernini, A. Morelli, P. Pasquier, J. Miroz, J. P. Abed-Maillard, S. Ben-Hamouda, N. Oddo, M. | Crit Care | 2020 |
Cholinergic |
Cognitive Outcomes of Long-term Benzodiazepine and Related Drug (BDZR) Use in People Living With Mild to Moderate Alzheimer's Disease: Results From NILVAD | Dyer, A. H. Murphy, C. Lawlor, B. Kennelly, S. P. | J Am Med Dir Assoc | 2020 |
Dementia |
'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. | Arch Osteoporos | 2020 |
Frail elderly |
Comparison of single minimum dose administration of dexmedetomidine and midazolam for prevention of emergence delirium in children: a randomized controlled trial | Cho, E. A. Cha, Y. B. Shim, J. G. Ahn, J. H. Lee, S. H. Ryu, K. H. | J Anesth | 2020 |
Dexmedetomidine |
Innovative care models across settings: Providing nursing care to older adults | Cacchione, P. Z. | Geriatr Nurs | 2020 |
Evercare/Optum |
Is the bispectral index monitoring protective against postoperative cognitive decline? A systematic review with meta-analysis | Bocskai, T. Kovacs, M. Szakacs, Z. Gede, N. Hegyi, P. Varga, G. Pap, I. Toth, I. Revesz, P. Szanyi, I. Nemeth, A. Gerlinger, I. Karadi, K. Lujber, L. | PLoS One | 2020 |
Anesthesia |
Postanesthesia care unit delirium following robot-assisted vs open retropubic radical prostatectomy: A prospective observational study | Beck, S. Hoop, D. Ragab, H. Rademacher, C. Messner-Schmitt, A. von Breunig, F. Haese, A. Graefen, M. Zollner, C. Fischer, M. | Int J Med Robot | 2020 |
Trendelenburg position |
The impact of Hospital Elder Life Program interventions, on 30-day readmission Rates of older hospitalized patients | Zachary, W. Kirupananthan, A. Cotter, S. Barbara, G. H. Cooke, R. C., 3rd Sipho, M. | Arch Gerontol Geriatr | 2020 |
Cost savings |
Prevalence and risk factors for postoperative delirium in patients with colorectal carcinoma: a systematic review and meta-analysis | Yang, Z. Wang, X. F. Yang, L. F. Fang, C. Gu, X. K. Guo, H. W. | Int J Colorectal Dis | 2020 |
Coloretal cancer |
Incidence, risk factors, and outcomes for sepsis-associated delirium in patients with mechanical ventilation: A sub-analysis of a multicenter randomized controlled trial | Yamamoto, T. Mizobata, Y. Kawazoe, Y. Miyamoto, K. Ohta, Y. Morimoto, T. Yamamura, H. | Journal of Critical Care | 2020 |
fentanyl |
Effects of different BP management strategies on postoperative delirium in elderly patients undergoing hip replacement: A single center randomized controlled trial | Xu, X. Hu, X. Wu, Y. Li, Y. Zhang, Y. Zhang, M. Yang, Q. | J Clin Anesth | 2020 |
Blood pressure |
Preoperative prognostic nutritional index predicts postoperative delirium in elderly patients after hip fracture surgery | Xing, H. Xiang, D. Li, Y. Ji, X. Xie, G. | Psychogeriatrics | 2020 |
elderly |
The effects of early femoral nerve block intervention on preoperative pain management and incidence of postoperative delirium geriatric patients undergoing trochanteric femur fracture surgery: A randomized controlled trial | Uysal, A. I. Altiparmak, B. Yasar, E. Turan, M. Canbek, U. Yilmaz, N. Gumus Demirbilek, S. | Ulus Travma Acil Cerrahi Derg | 2020 | |
A smartphone-based test for the assessment of attention deficits in delirium: A case-control diagnostic test accuracy study in older hospitalised patients | Tieges, Z. Stott, D. J. Shaw, R. Tang, E. Rutter, L. M. Nouzova, E. Duncan, N. Clarke, C. Weir, C. J. Assi, V. Ensor, H. Barnett, J. H. Evans, J. Green, S. Hendry, K. Thomson, M. McKeever, J. Middleton, D. G. Parks, S. Walsh, T. Weir, A. J. Wilson, E. Qua | PLoS One | 2020 | |
A 'real-world' analysis of risk factors for post liver transplant delirium and the effect on length of stay | Tavabie, O. D. Colwill, M. Adamson, R. McPhail, M. J. W. Bernal, W. Jassem, W. Prachialias, A. Heneghan, M. Aluvihare, V. R. Agarwal, K. | Eur J Gastroenterol Hepatol | 2020 | |
Intraoperative hypotension and delirium in patients with hip fracture | Tantardini, V. Roca, F. Bahri, O. Compere, V. Dujardin, F. Chassagne, P. | Geriatr Psychol Neuropsychiatr Vieil | 2020 |
anaesthesia |
Evaluation of emergence agitation after general anaesthesia in rhinoplasty patients: Inhalation anaesthesia versus total intravenous anaesthesia | Talih, G. Yüksek, A. Şahin, E. | American Journal of Otolaryngology - Head and Neck Medicine and Surgery | 2020 |
adult |
Implementation of a multiprofessional, multicomponent delirium management guideline in two intensive care units, and its effect on patient outcomes and nurse workload: a pre-post design retrospective cohort study | Schubert, M. Bettex, D. Steiger, P. Schurch, R. Haller, A. Bogdanovic, J. Garcia Nunez, D. Schwarz, U. Siegemund, M. | Swiss Med Wkly | 2020 | |
Cerebrospinal Fluid Levels of Interleukin-8 in Delirium, Dementia, and Cognitively Healthy Patients | Sajjad, M. U. Blennow, K. Knapskog, A. B. Idland, A. V. Chaudhry, F. A. Wyller, T. B. Zetterberg, H. Watne, L. O. | J Alzheimers Dis | 2020 |
Alzheimer’s disease |
Prehospital Anticholinergic Burden Is Associated With Delirium but Not With Mortality in a Population of Acutely Ill Medical Patients | Rigor, J. Rueff Rato, I. Ferreira, P. M. Pereira, R. Ribeiro, C. Teixeira, D. Mesquita Oliveira, P. Silva, A. M. Pereira, S. Costa, I. Ferreira, P. Sequeira, M. Monteiro-Soares, M. Martins-Mendes, D. | J Am Med Dir Assoc | 2020 |
Anticholinergic |
Impact of Vitamin C and Thiamine Administration on Delirium-Free Days in Patients with Septic Shock | Park, J. E. Shin, T. G. Jo, I. J. Jeon, K. Suh, G. Y. Park, M. Won, H. Chung, C. R. Hwang, S. Y. | J Clin Med | 2020 |
delirium |
Evaluation of an updated sedation protocol to reduce benzodiazepines in a pediatric intensive care unit | Michel, J. Hofbeck, M. Peper, A. K. Kumpf, M. Neunhoeffer, F. | Curr Med Res Opin | 2020 |
Cardiac surgery |
A qualitative exploration of the views of patients and their relatives regarding interventions to minimize the distress related to postoperative delirium | Meilak, C. Biswell, E. Willis, R. Partridge, J. Dhesi, J. | Int J Geriatr Psychiatry | 2020 |
aged |
Incidence and risk factors of postoperative delirium in elderly patients undergoing urological surgery: A multi-institutional prospective study | Matsuki, M. Tanaka, T. Takahashi, A. Inoue, R. Hotta, H. Itoh, N. Taguchi, K. Kato, R. Kobayashi, K. Masumori, N. | Int J Urol | 2020 |
elderly patients |
Still Predicting Delirium After All These Years | Marcantonio, ER | Anesth Analg | 2020 | |
Ketamine sedation in mechanically ventilated patients: A systematic review and meta-analysis | Manasco, A. T. Stephens, R. J. Yaeger, L. H. Roberts, B. W. Fuller, B. M. | Journal of Critical Care | 2020 |
fentanyl |
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 |
adult |
Risk factors for postoperative delirium after colorectal surgery: a systematic review and meta-analysis | Lee, S. H. Lim, S. W. | Int J Colorectal Dis | 2020 |
Colorectal surgery |
Results from a double blinded, randomized, 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 | 2020 |
Delirium |
Risk factors and outcomes among delirium subtypes in adult ICUs: A systematic review | Krewulak, K. D. Stelfox, H. T. Ely, E. W. Fiest, K. M. | J Crit Care | 2020 |
Critical care |
Survey of analgesia and sedation in pediatric intensive care units in Japan | Koizumi, T. Kurosawa, H. | Pediatr Int | 2020 |
analgesia |
Association of neuronal repair biomarkers with delirium among survivors of critical illness | Hayhurst, C. J. Patel, M. B. McNeil, J. B. Girard, T. D. Brummel, N. E. Thompson, J. L. Chandrasekhar, R. Ware, L. B. Pandharipande, P. P. Ely, E. W. Hughes, C. G. | Journal of Critical Care | 2020 |
NCT00392795 |
Dexmedetomidine's Relationship to Delirium in Patients Undergoing Cardiac Surgery: A Systematic Review | Halpin, E. Inch, H. O'Neill, M. | Crit Care Nurs Q | 2020 | |
Management of delirium at an academic medical center: Plans for antipsychotic prescribing upon discharge | Halavonich, L. Robert, S. McGraw, D. Weeda, E. Mullinax, K. Bass, B. | Ment Health Clin | 2020 |
antipsychotic |
Association Between Level of Arousal and 30-Day Survival in Acutely Ill Older Adults | Garcez, F. B. Jacob-Filho, W. Avelino-Silva, T. J. | J Am Med Dir Assoc | 2020 |
Delirium |
Drug therapy for delirium in terminally ill adults | Finucane, A. M. Jones, L. Leurent, B. Sampson, E. L. Stone, P. Tookman, A. Candy, B. | Cochrane Database Syst Rev | 2020 | |
Delirium in patients with hip fracture is associated with increased heart rate variability | Ernst, G. Watne, L. O. Rostrup, M. Neerland, B. E. | Aging Clin Exp Res | 2020 |
Autonomic nervous system |