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 |
---|---|---|---|---|
Implementing a Multicomponent Intervention to Prevent Delirium Among Critically Ill Patients. | Martinez, F. Donoso, A. M. Marquez, C. Labarca, E. | Crit Care Nurse | 2017 | |
Health-Care Workers' Judgments About Pain in Older Palliative Care Patients With and Without Delirium. | Mah, K. Rodin, R. A. Chan, V. W. S. Stevens, B. J. Zimmermann, C. Gagliese, L. | Am J Hosp Palliat Care | 2017 |
cancer pain |
Incidence and Risk Factors of Delirium in Patients After Type-A Aortic Dissection Surgery. | Liu, Z. Pang, X. Zhang, X. Cao, G. Fang, C. Wu, S. | J Cardiothorac Vasc Anesth | 2017 |
delirium |
Comparison of regional with general anaesthesia on postoperative delirium (RAGA-delirium) in the older patients undergoing hip fracture surgery: Study protocol for a multicentre randomised controlled trial. | Li, T. Yeung, J. Li, J. Zhang, Y. Melody, T. Gao, Y. Wang, Y. Lian, Q. Gao, F. | BMJ Open | 2017 |
NCT02213380 |
Factors Related to the Severity of Delirium in the Elderly Patients With Infection. | Kuswardhani, R. A. T. Sugi, Y. S. | Gerontol Geriatr Med | 2017 |
delirium |
Decreasing Delirium through Music (DDM) in critically ill, mechanically ventilated patients in the intensive care unit: study protocol for a pilot randomized controlled trial. | Khan, S. H. Wang, S. Harrawood, A. Martinez, S. Heiderscheit, A. Chlan, L. Perkins, A. J. Tu, W. Boustani, M. Khan, B. | Trials | 2017 |
Critical care |
Sinai Abbreviated Geriatric Evaluation: Development and Validation of a Practical Test. | Katlic, M. R. Coleman, J. Khan, K. Wozniak, S. E. Abraham, J. H. | Ann Surg | 2017 | |
Structured interdisciplinary bedside rounds do not reduce length of hospital stay and 28-day re-admission rate among older people hospitalised with acute illness: an Australian study. | Huynh, E. Basic, D. Gonzales, R. Shanley, C. | Aust Health Rev | 2017 | |
Cerebrospinal Fluid S100B and Alzheimer’s Disease Biomarkers in Hip Fracture Patients with Delirium. | Hov, K. R. Bolstad, N. Idland, A. V. Zetterberg, H. Blennow, K. Chaudhry, F. A. Frihagen, F. Ræder, J. Wyller, T. B. Watne, L. O. | Dementia and Geriatric Cognitive Disorders Extra | 2017 |
adult |
Effect of various antipsychotic regimens on incidence of delirium in critically ill adults. | Hawkins, W. A. Phan, S. V. Campbell, S. L. | J Crit Care | 2017 |
Antipsychotic agents |
2-(18)F-fluoro-2-deoxyglucose positron emission tomography in delirium. | Haggstrom, L. R. Nelson, J. A. Wegner, E. A. Caplan, G. A. | J Cereb Blood Flow Metab | 2017 |
Aged |
Preoperative Serum Metabolites Are Associated With Postoperative Delirium in Elderly Hip-Fracture Patients. | Guo, Y. Zhang, Y. Jia, P. Wang, W. Zhou, Q. Sun, L. Zhao, A. Zhang, X. Wang, X. Li, Y. Zhang, J. Jiang, W. | J Gerontol A Biol Sci Med Sci | 2017 |
Aged |
Delirium and effect of circadian light in the intensive care unit: a retrospective cohort study. | Estrup, S. Kjer, C. K. W. Poulsen, L. M. Gogenur, I. Mathiesen, O. | Acta Anaesthesiol Scand | 2017 | |
Advance Directives, Hospitalization, and Survival Among Advanced Cancer Patients with Delirium Presenting to the Emergency Department: A Prospective Study. | Elsayem, A. F. Bruera, E. Valentine, A. Warneke, C. L. Wood, G. L. Yeung, S. J. Page, V. D. Silvestre, J. Brock, P. A. Todd, K. H. | Oncologist | 2017 |
Advance directives |
Post-operative delirium is an independent predictor of 30-day hospital readmission after spine surgery in the elderly (≥65 years old): A study of 453 consecutive elderly spine surgery patients. | Elsamadicy, A. A. Wang, T. Y. Back, A. G. Lydon, E. Reddy, G. B. Karikari, I. O. Gottfried, O. N. | Journal of Clinical Neuroscience | 2017 |
acute kidney failure |
The Abbreviated Mental Test 4 for cognitive screening of older adults presenting to the Emergency Department. | Dyer, A. H. Briggs, R. Nabeel, S. O'Neill, D. Kennelly, S. P. | Eur J Emerg Med | 2017 | |
A Proactive Approach to High Risk Delirium Patients Undergoing Total Joint Arthroplasty. | Duque, A. F. Post, Z. D. Orozco, F. R. Lutz, R. W. Ong, A. C. | J Arthroplasty | 2017 |
complications |
Poor Performance on a Preoperative Cognitive Screening Test Predicts Postoperative Complications in Older Orthopedic Surgical Patients. | Culley, D. J. Flaherty, D. Fahey, M. C. Rudolph, J. L. Javedan, H. Huang, C. C. Wright, J. Bader, A. M. Hyman, B. T. Blacker, D. Crosby, G. | Anesthesiology | 2017 |
Age Factors |
Early postoperative delirium after hemiarthroplasty in elderly patients aged over 70 years with displaced femoral neck fracture. | Choi, Y. H. Kim, D. H. Kim, T. Y. Lim, T. W. Kim, S. W. Yoo, J. H. | Clin Interv Aging | 2017 |
delirium |
Effect of short-term exposure to ambient air particulate matter on incidence of delirium in a surgical population. | Che, L. Li, Y. Gan, C. | Sci Rep | 2017 | |
Subsyndromal Delirium and Institutionalization Among Patients With Critical Illness. | Brummel, N. E. Boehm, L. M. Girard, T. D. Pandharipande, P. P. Jackson, J. C. Hughes, C. G. Patel, M. B. Han, J. H. Vasilevskis, E. E. Thompson, J. L. Chandrasekhar, R. Bernard, G. R. Dittus, R. S. Ely, E. W. | Am J Crit Care | 2017 | |
Delirium in the intensive care setting: A reevaluation of the validity of the CAM-ICU and ICDSC versus the DSM-IV-TR in determining a diagnosis of delirium as part of the daily clinical routine. | Boettger, S. Nunez, D. G. Meyer, R. Richter, A. Fernandez, S. F. Rudiger, A. Schubert, M. Jenewein, J. | Palliat Support Care | 2017 |
Concurrent validity |
Delirium in the intensive care setting and the Richmond Agitation and Sedation Scale (RASS): Drowsiness increases the risk and is subthreshold for delirium. | Boettger, S. Nunez, D. G. Meyer, R. Richter, A. Fernandez, S. F. Rudiger, A. Schubert, M. Jenewein, J. | J Psychosom Res | 2017 |
Alertness |
Is Delirium the Cognitive Harbinger of Frailty in Older Adults? A Review about the Existing Evidence. | Bellelli, G. Moresco, R. Panina-Bordignon, P. Arosio, B. Gelfi, C. Morandi, A. Cesari, M. | Front Med | 2017 |
delirium |
Recovery after critical illness: putting the puzzle together-a consensus of 29. | Azoulay, Elie Vincent, Jean-Louis Angus, Derek C. Arabi, Yaseen M. Brochard, Laurent Brett, Stephen J. Citerio, Giuseppe Cook, Deborah J. Curtis, Jared Randall dos Santos, Claudia C. Ely, E. Wesley Hall, Jesse Halpern, Scott D. Hart, Nicholas Hopkins, Ram | Crit Care | 2017 | |
The efficacy of antipsychotics for prolonged delirium with renal dysfunction. | Asano, S. Kunii, Y. Hoshino, H. Osakabe, Y. Shiga, T. Itagaki, S. Miura, I. Yabe, H. | Neuropsychiatr Dis Treat | 2017 |
antipsychotic |
Comparison of the effect of high versus low mean arterial pressure levels on clinical outcomes and complications in elderly patients during non-cardiothoracic surgery under general anesthesia: study protocol for a randomized controlled trial. | Anmin, Hu Yan, Qiu Peng, Zhang Bailong, Hu Yali, Yang Shutao, Li Rui, Zhao Zhongjun, Zhang Yaoxian, Zhang Zihao, Zheng Chen, Qiu Furong, Li Xiaolei, Gong Hu, Anmin Qiu, Yan Zhang, Peng Hu, Bailong Yang, Yali Li, Shutao Zhao, Rui | Trials | 2017 | |
Association between baseline cognitive impairment and postoperative delirium in elderly patients undergoing surgery for adult spinal deformity. | Adogwa, O. Elsamadicy, A. A. Vuong, V. D. Fialkoff, J. Cheng, J. Karikari, I. O. Bagley, C. A. | J Neurosurg Spine | 2017 |
CAM = Confusion Assessment Method |
Effect of the Hospital Elder Life Program on Risk of 30-Day Readmission. | Rubin, F. H. Bellon, J. Bilderback, A. Urda, K. Inouye, S. K. | Journal of the American Geriatrics Society | 2017 |
aged |
Clinical outcomes in older surgical patients with mild cognitive impairment. | Racine, A. M. Fong, T. G. Gou, Y. Travison, T. G. Tommet, D. Erickson, K. Jones, R. N. Dickerson, B. C. Metzger, E. Marcantonio, E. R. Schmitt, E. M. Inouye, S. K. | Alzheimers Dement | 2017 |
Mild cognitive impairment |
Prediction of Long-term Cognitive Decline Following Postoperative Delirium in Older Adults. | Devore EE, Fong TG, Marcantonio ER, Schmitt EM, Travison TG, Jones RN, Inouye SK | The journals of gerontology. Series A, Biological sciences and medical sciences | 2017 |
Aged |
The Cognitive Reserve Model in the Development of Delirium: The Successful Aging After Elective Surgery Study. | Cizginer, S. Marcantonio, E. Vasunilashorn, S. Pascual-Leone, A. Shafi, M. Schmitt, E. M. Inouye, S. K. Jones, R. N. | J Geriatr Psychiatry Neurol | 2017 |
delirium |
Incidence of Delirium Among Patients Having Cancer Injected With Different Opioids for the First Time. | Tanaka R, Ishikawa H, Sato T, Shino M, Matsumoto T, Mori K, Omae K, Osaka I | The American journal of hospice & palliative care | 2016 |
delirium |
Complications after hip fracture surgery: are they preventable? | Flikweert, E. R. Wendt, K. W. Diercks, R. L. Izaks, G. J. Landsheer, D. Stevens, M. Reininga, I. H. F. | Eur J Trauma Emerg Surg | 2017 |
Complications |
Pilot prospective study of post-surgery sleep and EEG predictors of post-operative delirium. | Evans, J. L. Nadler, J. W. Preud'homme, X. A. Fang, E. Daughtry, R. L. Chapman, J. B. Attarian, D. Wellman, S. Krystal, A. D. | Clin Neurophysiol | 2017 |
Aged |
Development of an international undergraduate curriculum for delirium using a modified delphi process. | Copeland, C. Fisher, J. Teodorczuk, A. | Age Ageing | 2017 |
curriculum |
Serum galectin-3 levels and delirium among postpartum intensive care unit women. | Zhu, Y. Hu, W. Zhu, M. L. Yin, T. Su, J. Wang, J. R. | Brain Behav | 2017 |
delirium |
Characteristics of patients with an unplanned admission to an acute palliative care unit. | Mercadante, S. Adile, C. Ferrera, P. Casuccio, A. | Intern Emerg Med | 2017 |
Cancer |
FRAIL Questionnaire Screening Tool and Short-Term Outcomes in Geriatric Fracture Patients. | Gleason, L. J. Benton, E. A. Alvarez-Nebreda, M. L. Weaver, M. J. Harris, M. B. Javedan, H. | J Am Med Dir Assoc | 2017 |
Frailty |
Disruption of the ascending arousal system and cortical attention networks in post-stroke delirium and spatial neglect. | Boukrina, O. Barrett, A. M. | Neurosci Biobehav Rev | 2017 |
Aras |
Incidence of delirium after cardiac surgery: protocol for the DELIRIUM-CS Canada cross-sectional cohort study. | DELIRIUM-CS Investigators, Canadian Cardiovascular Critical Care Society Investigator Group and the Canadian Critical Care Trials Group | CMAJ Open | 2017 | |
Preoperative C-Reactive Protein as a Risk Factor for Postoperative Delirium in Elderly Patients Undergoing Laparoscopic Surgery for Colon Carcinoma. | Xiang, Dong Xing, Hailin Tai, Huiyu Xie, Guozhu | BioMed Research International | 2017 | |
Responding to Ten Common Delirium Misconceptions With Best Evidence: An Educational Review for Clinicians. | Oldham, M. A. Flanagan, N. M. Khan, A. Boukrina, O. Marcantonio, E. R. | J Neuropsychiatry Clin Neurosci | 2017 |
Cognitive Disorders |
The network model of delirium. | Young JWS | Medical hypotheses | 2017 |
Default-mode network |
Aging and Post-Intensive Care Syndrome: A Critical Need for Geriatric Psychiatry. | Wang, S. Allen, D. Kheir, Y. N. Campbell, N. Khan, B. | Am J Geriatr Psychiatry | 2017 |
Aging |
Intensive care discharge delay is associated with increased hospital length of stay: A multicentre prospective observational study. | Tiruvoipati, R. Botha, J. Fletcher, J. Gangopadhyay, H. Majumdar, M. Vij, S. Paul, E. Pilcher, D. | PLoS One | 2017 |
Adolescent |
How can we identify patients with delirium in the emergency department?: A review of available screening and diagnostic tools. | Tamune H, Yasugi D | The American journal of emergency medicine | 2017 |
Aged |
Symptom profile as assessed on delirium rating scale-revised-98 of delirium in respiratory intensive care unit: A study from India. | Sharma, A. Malhotra, S. Grover, S. Jindal, S. K. | Lung India | 2017 | |
Burst-suppression ratio underestimates absolute duration of electroencephalogram suppression compared with visual analysis of intraoperative electroencephalogram. | Muhlhofer, W. G. Zak, R. Kamal, T. Rizvi, B. Sands, L. P. Yuan, M. Zhang, X. Leung, J. M. | Br J Anaesth | 2017 | |
Post-anaesthesia care unit delirium: incidence, risk factors and associated adverse outcomes. | Hernandez, B. A. Lindroth, H. Rowley, P. Boncyk, C. Raz, A. Gaskell, A. Garcia, P. S. Sleigh, J. Sanders, R. D. | Br J Anaesth | 2017 | |
Validation of the 4AT questionnaire in the emergency department | Gagné, A. Voyer, P. Boucher, V. Pelletier, M. Gouin, E. Berthelot, S. Daoust, R. Laguë, A. Bédard, C. Émond, M. | Canadian Journal of Emergency Medicine | 2017 |
aged |
Incidence, prognostic factors and impact of postoperative delirium after major vascular surgery: A meta-analysis and systematic review. | Aitken, S. J. Blyth, F. M. Naganathan, V. | Vasc Med | 2017 |
aging |
Altered cortical brain activity in end stage liver disease assessed by multi-channel near-infrared spectroscopy: Associations with delirium. | Yoshimura, A. Goodson, C. Johns, J. T. Towe, M. M. Irvine, E. S. Rendradjaja, N. A. Max, L. K. LaFlam, A. Ledford, E. C. Probert, J. Tieges, Z. Edwin, D. H. MacLullich, A. M. J. Hogue, C. W. Lindquist, M. A. Gurakar, A. Neufeld, K. J. Kamiya, A. | Sci Rep | 2017 | |
Comprehensive geriatric care reduces acute perioperative delirium in elderly patients with hip fractures: A meta-analysis. | Wang, Y. Tang, J. Zhou, F. Yang, L. Wu, J. | Medicine | 2017 |
Aged |
Effect of nocturnal sound reduction on the incidence of delirium in intensive care unit patients: An interrupted time series analysis. | van de Pol, I. van Iterson, M. Maaskant, J. | Intensive Crit Care Nurs | 2017 |
Aged |
Poorer outcomes and greater healthcare costs for hospitalised older people with dementia and delirium: a retrospective cohort study. | Tropea J, LoGiudice D, Liew D, Gorelik A, Brand C | International journal of geriatric psychiatry | 2017 |
dementia |
Attitudes, knowledge and practices concerning delirium: a survey among intensive care unit professionals. | Trogrlić, Zoran Ista, Erwin Ponssen, Huibert H. Schoonderbeek, Jeannette F. Schreiner, Frodo Verbrugge, Serge J. Dijkstra, Annemieke Bakker, Jan Jagt, Mathieu | Nursing in Critical Care | 2017 |
Attitude of Health Personnel |
Can we predict a delirium after cardiac surgery? A validation study of a delirium risk checklist. | Ten Broeke, M. Koster, S. Konings, T. Hensens, A. G. van der Palen, J. | Eur J Cardiovasc Nurs | 2017 |
Delirium |
Suvorexant is associated with a low incidence of delirium in critically ill patients: a retrospective cohort study. | Masuyama, T. Sanui, M. Yoshida, N. Iizuka, Y. Ogi, K. Yagihashi, S. Nagatomo, K. Sasabuchi, Y. Lefor, A. K. | Psychogeriatrics | 2018 |
critically ill |
Do Risk Prediction Models for Postoperative Delirium Consider Patients' Preoperative Medication Use? | Kassie, G. M. Nguyen, T. A. Kalisch Ellett, L. M. Pratt, N. L. Roughead, E. E. | Drugs Aging | 2018 | |
Predictors and Outcomes of Cardiac Surgery-Associated Delirium. A Single Centre Retrospective Cohort Study. | Jones, D. Matalanis, G. Martensson, J. Robbins, R. Shaw, M. Seevanayagam, S. Cowie, D. Bellomo, R. | Heart Lung Circ | 2018 |
Cardiac surgery |
Delirium in older hospitalized patients-signs and actions: a retrospective patient record review. | Johansson, Y. A. Bergh, I. Ericsson, I. Sarenmalm, E. K. | BMC Geriatr | 2018 |
*Action by healthcare professionals |
Delirium-A Framework to Improve Acute Care for Older Persons. | Inouye, S. K. | J Am Geriatr Soc | 2018 |
Acute care for elders |
The minimal clinically important difference of the Richmond Agitation-Sedation Scale in patients with cancer with agitated delirium. | Hui, D. Hess, K. Dibaj, S. S. Arthur, J. Dev, R. Dalal, S. Reddy, S. Bruera, E. | Cancer | 2018 |
delirium |
The use of cerebral imaging for investigating delirium aetiology. | Hijazi, Z. Lange, P. Watson, R. Maier, A. B. | Eur J Intern Med | 2018 |
Delirium |
Medication Profiles of Patients with Cognitive Impairment and High Anticholinergic Burden. | Green, A. R. Reifler, L. M. Boyd, C. M. Weffald, L. A. Bayliss, E. A. | Drugs Aging | 2018 | |
Delirium Assessment Tools for Use in Critically Ill Adults: A Psychometric Analysis and Systematic Review. | Gelinas, C. Berube, M. Chevrier, A. Pun, B. T. Ely, E. W. Skrobik, Y. Barr, J. | Crit Care Nurse | 2018 | |
Postoperative Delirium in Glioblastoma Patients: Risk Factors and Prognostic Implications. | Flanigan, P. M. Jahangiri, A. Weinstein, D. Dayani, F. Chandra, A. Kanungo, I. Choi, S. Sankaran, S. Molinaro, A. M. McDermott, M. W. Berger, M. S. Aghi, M. K. | Neurosurgery | 2018 | |
The delirium and population health informatics cohort study protocol: ascertaining the determinants and outcomes from delirium in a whole population. | Davis, D. Richardson, S. Hornby, J. Bowden, H. Hoffmann, K. Weston-Clarke, M. Green, F. Chaturvedi, N. Hughes, A. Kuh, D. Sampson, E. Mizoguchi, R. Cheah, K. L. Romain, M. Sinha, A. Jenkin, R. Brayne, C. MacLullich, A. | BMC Geriatr | 2018 |
*Delirium |
Cerebral oximetry during preoperative resuscitation in elderly patients with hip fracture: a prospective observational study. | Clemmesen, C. G. Pedersen, L. M. Hougaard, S. Andersson, M. L. Rosenkvist, V. Nielsen, H. B. Palm, H. Foss, N. B. | J Clin Monit Comput | 2018 |
Delirium |
Clinical characteristics associated with the onset of delirium among long-term nursing home residents. | Cheung, E. N. M. Benjamin, S. Heckman, G. Ho, J. M. Lee, L. Sinha, S. K. Costa, A. P. | BMC Geriatr | 2018 |
*Delirium |
Evaluation of a multicomponent pathway to address inpatient delirium on a neurosciences ward. | Brown, E. G. Josephson, S. A. Anderson, N. Reid, M. Lee, M. Douglas, V. C. | BMC Health Serv Res | 2018 |
*Cognitive aging |
Subsyndromal delirium in the intensive care setting: Phenomenological characteristics and discrimination of subsyndromal delirium versus no and full-syndromal delirium. | Boettger S, Nuñez DG, Meyer R, Richter A, Schubert M, Jenewein J | Palliative & supportive care | 2017 |
Diagnostic and Statistical Manual of Mental Disorders |
Incidence, risk factors, and clinical implications of post-operative delirium in lung transplant recipients. | Anderson, B. J. Chesley, C. F. Theodore, M. Christie, C. Tino, R. Wysoczanski, A. Ramphal, K. Oyster, M. Kalman, L. Porteous, M. K. Bermudez, C. A. Cantu, E. Kolson, D. L. Christie, J. D. Diamond, J. M. | J Heart Lung Transplant | 2018 |
acidic protein |
Delirium and correlates of delirium among newly admitted elderly patients: A crosssectional study in a Saudi general hospital. | Alamri, S. H. Ashanqity, O. A. Alshomrani, A. B. Elmasri, A. H. Saeed, M. B. Yahya, S. A. Almasoud, A. I. Adam, Y. Alamoudi, H. M. Mukhtar, A. M. | Annals of Saudi Medicine | 2018 |
urinary catheter |
Preoperative Cognitive Impairment As a Predictor of Postoperative Outcomes in a Collaborative Care Model. | Zietlow, K. McDonald, S. R. Sloane, R. Browndyke, J. Lagoo-Deenadayalan, S. Heflin, M. T. | J Am Geriatr Soc | 2018 |
co-management |
Identifying Older Adults at Risk of Delirium Following Elective Surgery: A Systematic Review and Meta-Analysis. | Watt, J. Tricco, A. C. Talbot-Hamon, C. Pham, B. Rios, P. Grudniewicz, A. Wong, C. Sinclair, D. Straus, S. E. | J Gen Intern Med | 2018 |
delirium |
Sedative Plasma Concentrations and Delirium Risk in Critical Illness. | Stollings, J. L. Thompson, J. L. Ferrell, B. A. Scheinin, M. Wilkinson, G. R. Hughes, C. G. Shintani, A. K. Ely, E. W. Girard, T. D. Pandharipande, P. P. Patel, M. B. | Ann Pharmacother | 2018 |
analgesics |
A feasibility study of a randomised controlled trial to examine the impact of the ABCDE bundle on quality of life in ICU survivors. | Sosnowski, K. Mitchell, M. L. White, H. Morrison, L. Sutton, J. Sharratt, J. Lin, F. | Pilot Feasibility Stud | 2018 |
ABCDE bundle |
Potentially Modifiable Risk Factors for Long-Term Cognitive Impairment After Critical Illness: A Systematic Review. | Sakusic, A. O'Horo, J. C. Dziadzko, M. Volha, D. Ali, R. Singh, T. D. Kashyap, R. Farrell, A. M. Fryer, J. D. Petersen, R. Gajic, O. Rabinstein, A. A. | Mayo Clin Proc | 2018 | |
Prevalence of Potentially Inappropriate Medication Use in Older Inpatients with and without Cognitive Impairment: A Systematic Review. | Redston, M. R. Hilmer, S. N. McLachlan, A. J. Clough, A. J. Gnjidic, D. | J Alzheimers Dis | 2018 |
Cognitive impairment |
Identification of delirium and dementia in older medical inpatients in Tanzania: A comparison of screening and diagnostic methods. | Paddick, S. M. Lewis, E. G. Duinmaijer, A. Banks, J. Urasa, S. Tucker, L. Kisoli, A. Cletus, J. Lissu, C. Kissima, J. Dotchin, C. Gray, W. K. Muaketova-Ladinska, E. Cosker, G. Walker, R. W. | Journal of the Neurological Sciences | 2018 |
adult |
Interactions between drugs and geriatric syndromes in nursing home and home care: results from Shelter and IBenC projects. | Onder, G. Giovannini, S. Sganga, F. Manes-Gravina, E. Topinkova, E. Finne-Soveri, H. Garms-Homolova, V. Declercq, A. van der Roest, H. G. Jonsson, P. V. van Hout, H. Bernabei, R. | Aging Clinical and Experimental Research | 2018 |
Delirium |
Development of dementia in patients with femoral neck fracture who experience postoperative delirium-A three-year follow-up study. | Olofsson, B. Persson, M. Bellelli, G. Morandi, A. Gustafson, Y. Stenvall, M. | Int J Geriatr Psychiatry | 2018 |
cognitive impairment |
Prediction and early detection of delirium in the intensive care unit by using heart rate variability and machine learning. | Oh, J. Cho, D. Park, J. Na, S. H. Kim, J. Heo, J. Shin, C. S. Kim, J. J. Park, J. Y. Lee, B. | Physiol Meas | 2018 |
Autonomic nervous system |
Preoperative exercise capacity is associated with the prevalence of postoperative delirium in elective cardiac surgery. | Ogawa M, Izawa KP, Satomi-Kobayashi S, Kitamura A, Tsuboi Y, Komaki K, Ono R, Sakai Y, Tanaka H, Okita Y | Aging clinical and experimental research | 2017 |
Cardiac surgery |
Effectiveness of multicomponent interventions on incidence of delirium in hospitalized older patients with hip fracture: a systematic review. | Oberai, T. Laver, K. Crotty, M. Killington, M. Jaarsma, R. | Int Psychogeriatr | 2018 |
Delirium-elderly patients |
Controlled pre-post, mixed-methods study to determine the effectiveness of a national delirium clinical care standard to improve the diagnosis and care of patients with delirium in Australian hospitals: a protocol. | Mumford, V. Kulh, M. A. Hughes, C. Braithwaite, J. Westbrook, J. | BMJ Open | 2018 |
clinical governance |
Incidence and Risk Factors of Postoperative Delirium following Pancreatic Surgery: Does the Administration of TJ-54 Reduce the Incidence of Delirium. | Mizuno, S. Takeuchi, S. Kishiwada, M. Mizutani, N. Matsuda, M. Sekoguchi, N. Iizawa, Y. Azumi, Y. Kuriyama, N. Usui, M. Sakurai, H. Maruyama, K. Okuda, M. Okada, M. Isaji, S. | Dig Surg | 2018 |
Delirium rating scale – Japanese version |
Association of Integrated Care Coordination With Postsurgical Outcomes in High-Risk Older Adults: The Perioperative Optimization of Senior Health (POSH) Initiative. | McDonald, S. R. Heflin, M. T. Whitson, H. E. Dalton, T. O. Lidsky, M. E. Liu, P. Poer, C. M. Sloane, R. Thacker, J. K. White, H. K. Yanamadala, M. Lagoo-Deenadayalan, S. A. | JAMA Surg | 2018 | |
Effect of motor subtypes of delirium in the intensive care unit on fast-track failure after cardiac surgery | Lee, A. Mu, J. L. Chiu, C. H. Gin, T. Underwood, M. J. Joynt, G. M. | J Thorac Cardiovasc Surg | 2018 |
cardiac surgical procedures |
Preoperative medication use and its association with postoperative length of hospital stay in surgical oncology patients receiving comprehensive geriatric assessment. | Jeong, Y. M. Lee, K. E. Lee, E. S. Kim, K. I. Chung, J. E. Lee, B. K. Gwak, H. S. | Geriatrics & Gerontology International | 2018 |
comprehensive geriatric assessment |
Postoperative Delirium in Cardiac Surgery Patients. | Järvelä, K. Porkkala, H. Karlsson, S. Martikainen, T. Selander, T. Bendel, S. | Journal of Cardiothoracic and Vascular Anesthesia | 2018 |
aged |
“Eight Days of Nightmares … ” – Octogenarian Patients’ Experiences of Postoperative Delirium after Transcatheter or Surgical Aortic Valve Replacement. | Instenes, I. Gjengedal, E. Eide, L. S. P. Kuiper, K. K. J. Ranhoff, A. H. Norekvål, T. M. | Heart Lung and Circulation | 2018 |
aged |
General Anesthesia for Transcatheter Aortic Valve Replacement: Total Intravenous Anesthesia is Associated with Less Delirium as Compared to Volatile Agent Technique. | Goins, A. E. Smeltz, A. Ramm, C. Strassle, P. D. Teeter, E. G. Vavalle, J. P. Kolarczyk, L. | Journal of Cardiothoracic and Vascular Anesthesia | 2018 |
adult |
The use of point-of-care ultrasound to diagnose patent foramen ovale in elective hip and knee arthroplasty patients and its association with postoperative delirium. | Gai, N. Lavi, R. Jones, P. M. Lee, H. Naudie, D. Bainbridge, D. | Can J Anaesth | 2018 | |
Comparison of Lurasidone Versus Quetiapine for the Treatment of Delirium in Critically Ill Patients. | Fox, M. A. Elefritz, J. L. Huang, B. M. Hunley, C. | J Intensive Care Med | 2018 |
atypical antipsychotic |
Key components of the delirium syndrome and mortality: greater impact of acute change and disorganised thinking in a prospective cohort study. | Diwell, R. A. Davis, D. H. Vickerstaff, V. Sampson, E. L. | BMC Geriatr | 2018 |
*delirium |
Postoperative Delirium in Indian Patients Following Major Abdominal Surgery for Cancer: Risk Factors and Associations. | Dhakharia, V. Sinha, S. Bhaumik, J. | Indian J Surg Oncol | 2017 |
Cancer |
Effect of an interactive E-learning tool for delirium on patient and nursing outcomes in a geriatric hospital setting: findings of a before-after study. | Detroyer, E. Dobbels, F. Teodorczuk, A. Deschodt, M. Depaifve, Y. Joosten, E. Milisen, K. | BMC Geriatr | 2018 |
*Delirium |