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 | |
---|---|---|---|---|---|
Melatonin and the Prevention and Management of Delirium: A Scoping Study. | Choy, S. W. Yeoh, A. C. Lee, Z. Z. Srikanth, V. Moran, C. | Front Med | 2017 |
delirium |
|
The impact of sepsis, delirium, and psychological distress on self-rated cognitive function in ICU survivors-a prospective cohort study. | Bruck, E. Schandl, A. Bottai, M. Sackey, P. | J Intensive Care | 2018 |
Anxiety |
|
Falls and Delirium in an Acute Care Setting: A Retrospective Chart Review Before and After an Organization Wide Interprofessional Education. | Babine, R. L. Hyrkas, K. E. Hallen, S. Wierman, H. R. Bachand, D. A. Chapman, J. L. Fuller, V. J. | J Clin Nurs | 2018 |
delirium |
|
Prognostic effects of delirium motor subtypes in hospitalized older adults: A prospective cohort study. | Avelino-Silva, T. J. Campora, F. Curiati, J. A. E. Jacob-Filho, W. | PLoS One | 2018 | ||
Recognition of Delirium Features in Clinical Practice: Data from the "Delirium Day 2015" National Survey. | Mossello, E. Tesi, F. Di Santo, S. G. Mazzone, A. Torrini, M. Cherubini, A. Bo, M. Musicco, M. Bianchetti, A. Ferrari, A. Ferrara, N. Trabucchi, M. Morandi, A. Bellelli, G. | J Am Geriatr Soc | 2017 |
arousal |
|
A Pilot Analysis of the Association Between Types of Monitored Anesthesia Care Drugs and Outcomes in Transfemoral Aortic Valve Replacement Performed Without General Anesthesia. | Chen, E. Y. Sukumar, N. Dai, F. Akhtar, S. Schonberger, R. B. | Journal of Cardiothoracic and Vascular Anesthesia | 2017 |
age |
|
Dexmedetomidine Based Sedation for Post-surgery Critically Ill Adults: A Meta-analysis of Randomized Controlled Trials. | Fan, H. Zhao, Y. Sun, M. Ye, J. H. Chen, G. D. Zhu, J. H. | Iran J Public Health | 2017 |
Delirium |
|
Delirium and mental health history as predictors of aggression in individuals with dementia in inpatient settings. | Wharton T, Paulson D, Macri L, Dubin L | Aging & mental health | 2016 |
Mental Health |
|
Development and Validation of an Abbreviated Questionnaire to Easily Measure Cognitive Failure in ICU Survivors: A Multicenter Study. | Wassenaar, Annelies De Reus, Jorn Donders, A. Rogier T. Schoonhoven, Lisette Cremer, Olaf L. De Lange, Dylan W. Van Dijk, Diederik Slooter, Arjen J. C. Pickkers, Peter Van Den Boogaard, Mark | Crit Care Med | 2018 |
Psychometrics — Statistics and Numerical Data |
|
Practice Patterns and Outcomes Associated With Early Sedation Depth in Mechanically Ventilated Patients: A Systematic Review and Meta-Analysis. | Stephens, R. J. Dettmer, M. R. Roberts, B. W. Ablordeppey, E. Fowler, S. A. Kollef, M. H. Fuller, B. M. | Crit Care Med | 2017 | ||
Nursing assessment as an effective tool for the identification of delirium risk in older in-patients: a case-control study. | Solà-Miravete E, López C, Martínez-Segura E, Adell-Lleixà M, Juvé-Udina ME, Lleixà-Fortuño M | Journal of clinical nursing | 2017 |
delirium |
|
Implementing ACOVE quality indicators as an intervention checklist to improve care for hospitalized older adults. | Sinvani, L. Kozikowski, A. Smilios, C. Patel, V. Qiu, G. Akerman, M. Lesser, M. Rosenberg, D. Wolf-Klein, G. Pekmezaris, R. | Journal of Hospital Medicine | 2017 |
indwelling catheter |
|
Health and social factors associated with a delayed discharge amongst inpatients in acute geriatric wards: A retrospective observational study. | Moore, G. Hartley, P. Romero-Ortuno, R. | Geriatrics & Gerontology International | 2017 |
frail older adults |
|
Impact of restarting home neuropsychiatric medications on sedation outcomes in medical intensive care unit patients | La, M. K. Thompson Bastin, M. L. Gisewhite, J. T. Johnson, C. A. Flannery, A. H. | Journal of Critical Care | 2018 |
amfebutamone |
|
Exposure to anticholinergic and sedative medicines as indicators of high-risk prescriptions in the elderly. | Jean-Bart, E. Moutet, C. Dauphinot, V. Krolak-Salmon, P. Mouchoux, C. | International Journal of Clinical Pharmacy | 2017 |
NCT01483456 |
|
Delirium in hemodialysis predicts mortality: a single-center, long-term observational study. | Yasui-Furukori, N. Tarakita, N. Uematsu, W. Saito, H. Nakamura, K. Ohyama, C. Sugawara, N. | Neuropsychiatr Dis Treat | 2017 |
delirium |
|
The prevention of delirium in elderly with obstructive sleep apnea (PODESA) study: protocol for a multi-centre prospective randomized, controlled trial. | Wong, Jean Lam, David Choi, Stephen Singh, Mandeep Siddiqui, Naveed Sockalingam, Sanjeev Chung, Frances | BMC Anesthesiology | 2018 |
Delirium — Prevention and Control — In Old Age |
|
Using simulated family presence to decrease agitation in older hospitalized delirious patients: A randomized controlled trial. | Waszynski, Christine M. Milner, Kerry A. Staff, Ilene Molony, Sheila L. | International Journal of Nursing Studies | 2018 |
Dementia |
|
DemDel, a nursing-led practice-based delirium intervention, improves certain outcomes for older cognitively impaired inpatients. | Wand, A. P. Teodorczuk, A. | Evidence-based nursing | 2017 |
delirium |
|
Delirium Severity Post-Surgery and its Relationship with Long-Term Cognitive Decline in a Cohort of Patients without Dementia. | Vasunilashorn, S. M. Fong, T. G. Albuquerque, A. Marcantonio, E. R. Schmitt, E. M. Tommet, D. Gou, Y. Travison, T. G. Jones, R. N. Inouye, S. K. | Journal of Alzheimer's Disease | 2017 |
aged |
|
Turning education into action: Impact of a collective social education approach to improve nurses' ability to recognize and accurately assess delirium in hospitalized older patients. | Travers, C. Henderson, A. Graham, F. Beattie, E. | Nurse Educ Today | 2017 |
Delirium |
|
Reduced level of arousal and increased mortality in adult acute medical admissions: a systematic review and meta-analysis. | Todd, A. Blackley, S. Burton, J. K. Stott, D. J. Ely, E. W. Tieges, Z. MacLullich, A. M. J. Shenkin, S. D. | BMC Geriatr | 2017 |
Altered mental status |
|
Risk factors and outcomes of critically ill patients with acute brain failure: A novel end point. | Singh, T. D. O'Horo, J. C. Gajic, O. Sakusic, A. Day, C. N. Mandrekar, J. Kashyap, R. Reddy, D. R. S. Rabinstein, A. A. | Journal of Critical Care | 2018 |
acute brain failure |
|
Intraoperative oxygen concentration and neurocognition after cardiac surgery: study protocol for a randomized controlled trial. | Shaefi, S. Marcantonio, E. R. Mueller, A. Banner-Goodspeed, V. Robson, S. C. Spear, K. Otterbein, L. E. O'Gara, B. P. Talmor, D. S. Subramaniam, B. | Trials | 2017 |
Cardiac surgery |
|
A novel scoring system to predict delirium and its relationship with the clinical course in patients with acute decompensated heart failure. | Sakaguchi, T. Watanabe, M. Kawasaki, C. Kuroda, I. Abe, H. Date, M. Ueda, Y. Yasumura, Y. Koretsune, Y. | J Cardiol | 2017 |
Acute heart failure |
|
Feasibility of a Nurse-Managed Pain, Agitation, and Delirium Protocol in the Surgical Intensive Care Unit. | Rozycki, A. Jarrell, A. S. Kruer, R. M. Young, S. Mendez-Tellez, P. A. | Crit Care Nurse | 2017 | ||
Development of core outcome sets for effectiveness trials of interventions to prevent and/or treat delirium (Del-COrS): Study protocol. | Rose, L. Agar, M. Burry, L. D. Campbell, N. Clarke, M. Lee, J. Siddiqi, N. Page, V. J. | BMJ Open | 2017 |
article |
|
The association of geriatric syndromes with hospital outcomes. | Romero-Ortuno, R. Forsyth, D. R. Wilson, K. J. Cameron, E. Wallis, S. Biram, R. Keevil, V. | Journal of Hospital Medicine | 2017 |
acute confusion |
|
Bright light and oxygen therapies decrease delirium risk in critically ill surgical patients by targeting sleep and acid-base disturbances. | Potharajaroen, S. Tangwongchai, S. Tayjasanant, T. Thawitsri, T. Anderson, G. Maes, M. | Psychiatry Res | 2017 |
Bicarbonate |
|
Impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery. | Ogawa, M. Izawa, K. P. Satomi-Kobayashi, S. Tsuboi, Y. Komaki, K. Gotake, Y. Sakai, Y. Tanaka, H. Okita, Y. | PLoS One | 2017 |
|
|
The correlation of the depth of anesthesia and postoperative cognitive impairment: A meta-analysis based on randomized controlled trials. | Lu, X. Jin, X. Yang, S. Xia, Y. | J Clin Anesth | 2017 |
Anesthesia |
|
Geriatric Delirium Care: Using Chart Audits to Target Improvement Strategies. | Loftus, C. A. Wiesenfeld, L. A. | American Journal of Therapeutics | 2017 |
acute care |
|
Preoperative medication use and postoperative delirium: a systematic review. | Kassie, G. M. Nguyen, T. A. Kalisch Ellett, L. M. Pratt, N. L. Roughead, E. E. | BMC Geriatr | 2017 |
Adverse drug event |
|
Noise and light pollution in the hospital: A call for action. | Kamdar, B. B. Martin, J. L. Needham, D. M. | Journal of Hospital Medicine | 2017 |
circadian rhythm |
|
Hydroxyethyl starch is associated with early postoperative delirium in patients undergoing esophagectomy. | Jung, D. M. Ahn, H. J. Yang, M. Kim, J. A. Kim, D. K. Lee, S. M. Park, J. H. | J Thorac Cardiovasc Surg | 2017 |
delirium |
|
Earplugs could be an effective sleep hygiene strategy to reduce delirium in the ICU. | Hill, L. | Evidence-based nursing | 2017 |
delirium |
|
Screening and detection of delirium in older ED patients: performance of the modified Confusion Assessment Method for the Emergency Department (mCAM-ED). A two-step tool. | Hasemann, W. Grossmann, F. F. Stadler, R. Bingisser, R. Breil, D. Hafner, M. Kressig, R. W. Nickel, C. H. | Intern Emerg Med | 2017 |
Algorithms |
|
PERFECTED enhanced recovery (PERFECT-ER) care versus standard acute care for patients admitted to acute settings with hip fracture identified as experiencing confusion: study protocol for a feasibility cluster randomized controlled trial. | Hammond, S. P. Cross, J. L. Shepstone, L. Backhouse, T. Henderson, C. Poland, F. Sims, E. MacLullich, A. Penhale, B. Howard, R. Lambert, N. Varley, A. Smith, T. O. Sahota, O. Donell, S. Patel, M. Ballard, C. Young, J. Knapp, M. Jackson, S. Waring, J. Leav | Trials | 2017 |
Acute care |
|
Improving the Accuracy of Delirium Assessments in Neuroscience Patients: Scaling a Quality Improvement Program to Improve Nurses' Skill, Compliance, and Accuracy in the Use of the Confusion Assessment Method in the Intensive Care Unit Tool. | DiLibero, Justin | Dimensions of Critical Care Nursing | 2018 |
Delirium — Evaluation |
|
Attention, vigilance, and visuospatial function in hospitalized elderly medical patients: relationship to delirium syndromal status and motor subtype profile. | Daly, C. Leonard, M. O'Connell, H. Williams, O. Awan, F. Exton, C. O'Connor, M. Adamis, D. Dunne, C. P. Cullen, W. Meagher, D. J. | Int Psychogeriatr | 2017 |
assessment |
|
Caring for a patient with delirium in an acute hospital: The lived experience of cardiology, elderly care, renal, and respiratory nurses. | Brooke, J. Manneh, C. | Int J Nurs Pract | 2018 |
aggression |
|
Association between Delirium and Prehospitalization Medication in Poststroke Patients. | Hosoya, R. Sato, Y. Ishida, E. Shibamoto, H. Hino, S. Yokote, H. Kamata, T. | J Stroke Cerebrovasc Dis | 2018 |
Derilium |
|
Acute Brain Dysfunction: Development and Validation of a Daily Prediction Model. | Marra, A. Pandharipande, P. P. Shotwell, M. S. Chandrasekhar, R. Girard, T. D. Shintani, A. K. Peelen, L. M. Moons, K. Dittus, R. S. Ely, E. W. Vasilevskis, E. E. | Chest | 2018 |
Coma |
|
Delirium in the Elderly. | Hshieh, T. T. Inouye, S. K. Oh, E. S. | Psychiatr Clin North Am | 2018 |
Cognitive decline |
|
Barriers to delirium assessment in the intensive care unit: A literature review. | Rowley-Conwy, G. | Intensive Crit Care Nurs | 2018 |
Critical Care Nursing/*methods |
|
Exploratory and Confirmatory Factor Analyses of Delirium Symptoms in a Sample of Nursing Home Residents. | Moyo P, Huang TY, Simoni-Wastila L, Harrington D | Journal of applied gerontology : the official journal of the Southern Gerontological Society | 2016 |
confirmatory factor analysis |
|
Neurosurgery in Octogenarians: A Prospective Study of Perioperative Morbidity, Mortality, and Complications in Elderly Patients. | Maldaner, N. Sarnthein, J. Bozinov, O. Regli, L. Neidert, M. C. | World Neurosurgery | 2018 |
glucocorticoid |
|
Delirium in the Cardiac Intensive Care Unit. | Ibrahim, K. McCarthy, C. P. McCarthy, K. J. Brown, C. H. Needham, D. M. Januzzi, J. L., Jr. McEvoy, J. W. | J Am Heart Assoc | 2018 |
critical care |
|
The Diagnostic Sensitivity of the Memorial Delirium Assessment Scale—Spanish Version | Barahona, E. Pinhao, R. Galindo, V. Noguera, A. | Journal of Pain and Symptom Management | 2018 |
adult |
|
First- and second-line pharmacological treatment for delirium in general hospital setting-Retrospective analysis. | Wada, K. Morita, Y. Iwamoto, T. Mifune, Y. Nojima, S. | Asian J Psychiatr | 2018 |
Consultation liaison service |
|
Increasing use of cognitive measures in the operational definition of frailty-A systematic review | Vella Azzopardi, R. Beyer, I. Vermeiren, S. Petrovic, M. Van Den Noortgate, N. Bautmans, I. Gorus, E. | Ageing Res Rev | 2018 |
Aged |
|
Preoperative Hemoglobin Level is Associated with Increased Health Care Use After Elective Spinal Fusion (≥3 Levels) in Elderly Male Patients with Spine Deformity. | Elsamadicy, A. A. Adogwa, O. Ongele, M. Sergesketter, A. R. Tarnasky, A. Lubkin, D. E. T. Drysdale, N. Cheng, J. Bagley, C. A. Karikari, I. O. | World Neurosurg | 2018 |
aged |
|
Comprehensive geriatric assessment for older people admitted to a surgical service. | Eamer, G. Taheri, A. Chen, S. S. Daviduck, Q. Chambers, T. Shi, X. Khadaroo, R. G. | Cochrane Database of Systematic Reviews | 2018 |
clinical assessment |
|
Effects of a Medication Review on Delirium in Older Hospitalised Patients: A Comparative Retrospective Cohort Study. | van Velthuijsen, E. L. Zwakhalen, S. M. G. Pijpers, E. van de Ven, L. I. Ambergen, T. Mulder, W. J. Verhey, F. R. J. Kempen, Gijm | Drugs Aging | 2018 | ||
Effect of haloperidol on survival among critically ill adults with a high risk of delirium the REDUCE randomized clinical trial | Van Den Boogaard, M. Slooter, A. J. C. Brüggemann, R. J. M. Schoonhoven, L. Beishuizen, A. Vermeijden, J. W. Pretorius, D. De Koning, J. Simons, K. S. Dennesen, P. J. W. Van Der Voort, P. H. J. Houterman, S. Van Der Hoeven, J. G. Pickkers, P. | JAMA | 2018 |
adult |
|
Individualized Acute Medical Care for Cognitively Impaired Individuals: A Call Always to Pause Before Hospitalization. | Sheckter, C. C. Bott, N. T. Milstein, A. Leff, B. | J Am Geriatr Soc | 2018 |
cognitive defect |
|
Baden Prevention and Reduction of Incidence of Postoperative Delirium Trial (PRIDe): a phase IV multicenter, randomized, placebo-controlled, double-blind clinical trial of ketamine versus haloperidol for prevention of postoperative delirium. | Riegger, H. Hollinger, A. Seifert, B. Toft, K. Blum, A. Zehnder, T. Siegemund, M. | Trials | 2018 |
Dos |
|
Frequency and predictors of post-stroke delirium in PRospective Observational POLIsh Study (PROPOLIS) | Pasinska, P. Kowalska, K. Klimiec, E. Szyper-Maciejowska, A. Wilk, A. Klimkowicz-Mrowiec, A. | J Neurol | 2018 |
Delirium |
|
Hypertension, mitral valve disease, atrial fibrillation and low education level predict delirium and worst outcome after cardiac surgery in older adults. | Oliveira, F. R. Oliveira, V. H. Oliveira, I. M. Lima, J. W. Calderaro, D. Gualandro, D. M. Caramelli, B. | BMC Anesthesiology | 2018 |
*Cardiac surgery |
|
Delirium, Frailty, and Fast-Track Surgery in Oncogeriatrics: Is There a Link? | Monacelli, F. Signori, A. Prefumo, M. Giannotti, C. Nencioni, A. Romairone, E. Scabini, S. Odetti, P. | Dementia and Geriatric Cognitive Disorders Extra | 2018 |
aged |
|
Confusion Strongly Associated with Antibiotic Prescribing Due to Suspected Urinary Tract Infections in Nursing Homes. | Mayne, S. Sundvall, P. D. Gunnarsson, R. | J Am Geriatr Soc | 2018 |
urinary catheter |
|
Training students to detect delirium: An interprofessional pilot study | Chambers, B. Meyer, M. Peterson, M. | Nurse Educ Today | 2018 |
Attitude of Health Personnel |
|
Antipsychotics for treatment of delirium in hospitalised non-ICU patients | Burry, L. Mehta, S. Perreault, M. M. Luxenberg, J. S. Siddiqi, N. Hutton, B. Fergusson, D. A. Bell, C. Rose, L. | Cochrane Database of Systematic Reviews | 2018 | ||
The association of indwelling urinary catheter with delirium in hospitalized patients and nursing home residents: an explorative analysis from the "Delirium Day 2015". | Bo, M. Porrino, P. Di Santo, S. G. Mazzone, A. Cherubini, A. Mossello, E. Bianchetti, A. Musicco, M. Ferrari, A. Ferrara, N. Filippini, C. Trabucchi, M. Morandi, A. Bellelli, G. | Aging Clin Exp Res | 2018 |
4AT test |
|
Impact of Dexmedetomidine on Long-term Outcomes After Noncardiac Surgery in Elderly: 3-Year Follow-up of a Randomized Controlled Trial. | Zhang, D. F. Su, X. Meng, Z. T. Li, H. L. Wang, D. X. Li, X. Y. Maze, M. Ma, D. | Ann Surg | 2018 | ||
Anticholinergic medications in patients admitted with cognitive impairment or falls (AMiCI). The impact of hospital admission on anticholinergic cognitive medication burden. Results of a multicentre observational study. | Weichert, I. Romero-Ortuno, R. Tolonen, J. Soe, T. Lebus, C. Choudhury, S. Nadarajah, C. V. Nanayakkara, P. Orru, M. Di Somma, S. | J Clin Pharm Ther | 2018 |
anticholinergic cognitive burden |
|
Delirium prediction in the intensive care unit: comparison of two delirium prediction models. | Wassenaar, A. Schoonhoven, L. Devlin, J. W. 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. Matos, J. Donders, A. R. T. Pickkers, P. van den Boogaard, M. | Crit Care | 2018 |
Adult |
|
Clinical Utility of a Structured Program to Reduce the Risk of Health-Related Quality of Life Impairment after Discharge from Intensive Care Unit: A Real-World Experience. | Venni, A. Ioia, F. Laviola, S. Frigieri, F. Pieri, A. Marilli, S. Balzi, D. Ballo, P. Gori, S. Guarducci, D. | Crit Care Res Pract | 2018 | ||
Perioperative predictors of delirium and incidence factors in adult patients post cardiac surgery. | Theologou, S. Giakoumidakis, K. Charitos, C. | Pragmat Obs Res | 2018 |
delirium biomarkers |
|
Evaluating the implementation of confusion assessment method-intensive care unit using a quality improvement approach. | Stewart, C. Bench, S. | Nurs Crit Care | 2018 |
Clinical audit |
|
Temporal biomarker profiles and their association with ICU acquired delirium: a cohort study. | Simons, K. S. van den Boogaard, M. Hendriksen, E. Gerretsen, J. van der Hoeven, J. G. Pickkers, P. de Jager, C. P. C. | Crit Care | 2018 |
Biomarkers |
|
Delirium after cardiac surgery. Incidence, phenotypes, predisposing and precipitating risk factors, and effects. | Sanson, G. Khlopenyuk, Y. Milocco, S. Sartori, M. Dreas, L. Fabiani, A. | Heart Lung | 2018 |
Cardiac surgery |
|
Educational Intervention on Delirium Assessment Using Confusion Assessment Method-ICU (CAM-ICU) in a General Intensive Care Unit. | Ramoo, V. Abu, H. Rai, V. Surat Singh, S. K. Baharudin, A. A. Danaee, M. Thinagaran, R. R. R. | J Clin Nurs | 2018 |
Cam-icu |
|
Delirium Burden in Patients and Family Caregivers: Development and Testing of New Instruments. | Racine, A. M. D'Aquila, M. Schmitt, E. M. Gallagher, J. Marcantonio, E. R. Jones, R. N. Inouye, S. K. Schulman-Green, D. | Gerontologist | 2018 | ||
Processed electroencephalogram and evoked potential techniques for amelioration of postoperative delirium and cognitive dysfunction following non-cardiac and non-neurosurgical procedures in adults. | Punjasawadwong, Y. Chau-In, W. Laopaiboon, M. Punjasawadwong, S. Pin-On, P. | Cochrane Database of Systematic Reviews | 2018 | ||
Influence of physical restraint on delirium of adult patients in ICU: A nested case–control study. | Pan, Yanbin Jiang, Zhixia Yuan, Changrong Wang, Lianhong Zhang, Jingjing Zhou, Jing Tao, Ming Quan, Mingtao Wu, Qiong | Journal of Clinical Nursing | 2018 |
Restraint, Physical — Adverse Effects |
|
Development of a Novel Self-administered Cognitive Assessment Tool and Normative Data for Older Adults. | Monsch, R. J. Burckhardt, A. C. Berres, M. Thomann, A. E. Ehrensperger, M. M. Steiner, L. A. Goettel, N. | J Neurosurg Anesthesiol | 2018 | ||
Cooccurrence of Post-Intensive Care Syndrome Problems Among 406 Survivors of Critical Illness. | Marra, A. Pandharipande, P. P. Girard, T. D. Patel, M. B. Hughes, C. G. Jackson, J. C. Thompson, J. L. Chandrasekhar, R. Ely, E. W. Brummel, N. E. | Crit Care Med | 2018 | ||
Precipitants of Delirium in Older Inpatients Admitted in Surgery for Post-Fall Hip Fracture: An Observational Study. | Levinoff, E. Try, A. Chabot, J. Lee, L. Zukor, D. Beauchet, O. | The Journal of Frailty & Aging | 2018 |
aged |
|
Neural predisposing factors of postoperative delirium in elderly patients with femoral neck fracture. | Kyeong, S. Shin, J. E. Yang, K. H. Lee, W. S. Chung, T. S. Kim, J. J. | Sci Rep | 2018 | ||
Music intervention to prevent delirium among older patients admitted to a trauma intensive care unit and a trauma orthopaedic unit. | Johnson, K. Fleury, J. McClain, D. | Intensive Crit Care Nurs | 2018 |
Delirium |
|
Delirium as a predictor of mortality in US Medicare beneficiaries discharged from the emergency department: a national claims-level analysis up to 12 months. | Israni, J. Lesser, A. Kent, T. Ko, K. | BMJ Open | 2018 |
claims data |
|
An evaluation of patient-specific characteristics on attainment of target sedation in an intensive care unit. | Humphrey, M. Everhart, S. Kosmisky, D. Anderson, W. E. | Heart Lung | 2018 |
Agitation |
|
An assistant workforce to improve screening rates and quality of care for older patients in the emergency department: findings of a pre- post, mixed methods study. | Hullick, C. Conway, J. Higgins, I. Hewitt, J. Stewart, B. Dilworth, S. Attia, J. | BMC Geriatr | 2018 |
Assessment, nursing |
|
Cycling of Dexmedetomidine May Prevent Delirium After Liver Transplantation. | Hong, K. S. Kim, N. R. Song, S. H. Hong, G. | Transplant Proc | 2018 | ||
Risk Factors for Postoperative Delirium After Gastrectomy in Gastric Cancer Patients. | Honda, S. Furukawa, K. Nishiwaki, N. Fujiya, K. Omori, H. Kaji, S. Makuuchi, R. Irino, T. Tanizawa, Y. Bando, E. Kawamura, T. Terashima, M. | World J Surg | 2018 | ||
Factors Associated with the Effectiveness of Intravenous Administration of Chlorpromazine for Delirium in Patients with Terminal Cancer. | Hasuo, H. Kanbara, K. Fujii, R. Uchitani, K. Sakuma, H. Fukunaga, M. | J Palliat Med | 2018 |
delirium |
|
An evaluation of single question delirium screening tools in older emergency department patients. | Han, J. H. Wilson, A. Schnelle, J. F. Dittus, R. S. Wesley Ely, E. | American Journal of Emergency Medicine | 2018 |
adult |
|
A contemporary population-based analysis of the incidence, cost, and outcomes of postoperative delirium following major urologic cancer surgeries. | Ha, A. Krasnow, R. E. Mossanen, M. Nagle, R. Hshieh, T. T. Rudolph, J. L. Chang, S. L. | Urol Oncol | 2018 |
Costs |
|
Risk Factors and Outcomes of Delirium in Older Patients Admitted to Postacute Care with and without Dementia. | Gual, N. Morandi, A. Perez, L. M. Britez, L. Burbano, P. Man, F. Inzitari, M. | Dement Geriatr Cogn Disord | 2018 |
Crisis management |
|
Frailty Assessment to Help Predict Patients at Risk of Delirium When Consulting the Emergency Department. | Giroux, M. Sirois, M. J. Boucher, V. Daoust, R. Gouin, E. Pelletier, M. Berthelot, S. Voyer, P. Emond, M. | J Emerg Med | 2018 |
delirium |
|
Performance of the French version of the 4AT for screening the elderly for delirium in the emergency department. | Gagne, A. J. Voyer, P. Boucher, V. Nadeau, A. Carmichael, P. H. Pelletier, M. Gouin, E. Berthelot, S. Daoust, R. Wilchesky, M. Richard, H. Pelletier, I. Ballard, S. Lague, A. Emond, M.` | CJEM | 2018 | ||
Early rehabilitation to prevent postintensive care syndrome in patients with critical illness: a systematic review and meta-analysis | Fuke, R. Hifumi, T. Kondo, Y. Hatakeyama, J. Takei, T. Yamakawa, K. Inoue, S. Nishida, O. | BMJ Open | 2018 |
early rehabilitation |
|
Effects of closed-loop intravenous anesthesia guided by Bispectral Index in adult patients on emergence delirium: A randomized controlled study. | Cotoia, A. Mirabella, L. Beck, R. Matrella, P. Assenzo, V. Hazot, T. C. Cinnella, G. Liu, N. Dambrosio, M. | Minerva Anestesiol | 2018 |
epidural catheter |
|
Prevalence and risk factors related to haloperidol use for delirium in adult intensive care patients: the multinational AID-ICU inception cohort study. | Collet, M. O. Caballero, J. Sonneville, R. Bozza, F. A. Nydahl, P. Schandl, A. Woien, H. Citerio, G. van den Boogaard, M. Hastbacka, J. Haenggi, M. Colpaert, K. Rose, L. Barbateskovic, M. Lange, T. Jensen, A. Krog, M. B. Egerod, I. Nibro, H. L. Wetterslev | Intensive Care Med | 2018 |
Cohort |
|
Latent class analysis of the multivariate Delirium Index in long-term care settings. | Ciampi, A. Bai, C. Dyachenko, A. McCusker, J. Cole, M. G. Belzile, E. | Int Psychogeriatr | 2018 |
Delirium Index |
|
Cognitive Decline after Delirium in Patients Undergoing Cardiac Surgery. | Brown, C. H. th Probert, J. Healy, R. Parish, M. Nomura, Y. Yamaguchi, A. Tian, J. Zehr, K. Mandal, K. Kamath, V. Neufeld, K. J. Hogue, C. W. | Anesthesiology | 2018 | ||
Screening for Delirium: Development and Validation of the Buffalo Delirium Scale for Use in a Home-Based Hospice Setting. | Breier, J. M. Meier, S. T. Kerr, C. W. Wright, S. T. Grant, P. C. Depner, R. M. | Am J Hosp Palliat Care | 2018 |
delirium |
|
Improving Geriatric Care Processes on Two Medical-Surgical Acute Care Units: A Pilot Study. | Booth, K. A. Simmons, E. E. Viles, A. F. Gray, W. A. Kennedy, K. R. Biswal, S. H. Lowe, J. A. Xhaja, A. Kennedy, R. E. Brown, C. J. Flood, K. L. | J Healthc Qual | 2018 | ||
Screening for delirium with the Intensive Care Delirium Screening Checklist (ICDSC): Symptom profile and utility of individual items in the identification of delirium dependent on the level of sedation. | Boettger, S. Meyer, R. Richter, A. Fernandez, S. F. Rudiger, A. Schubert, M. Jenewein, J. Nunez, D. G. | Palliat Support Care | 2018 |
4th edition |