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
- A review of recent clinical trials and guidelines on the prevention and management of delirium in hospitalized older patients.
- Authors
- Rathier MO, Baker WL
- Year
- 2011
- Journal
- Hospital practice (1995)
- Abstract
Treatment of acute illness in older adults is frequently complicated by the presence of delirium. Delirium is characterized by the development of an altered mental status over the course of hours to days, and can have a fluctuating course. Patients with delirium have difficulty paying attention to their environment, have disorganized thinking, and usually have an altered level of consciousness. While scientists continue to elucidate the pathophysiologic mechanisms associated with delirium, clinicians can identify patients at risk for delirium and diagnose it using valid instruments, such as the Confusion Assessment Method and Confusion Assessment Method for the Intensive Care Unit. Delirium is an independent risk factor for death, institutionalization, and dementia, and resolves in many patients by the time of hospital discharge. For patients admitted to medical units, optimal management of delirium includes reassessment of medications, pain, sleep, nutrition, mobility, need for physical restraints, and bowel and bladder function. The use of antipsychotic medication to sedate delirious patients should be restricted to patients in danger of harming themselves or others and should be used when nonpharmacologic means fail. Multicomponent interventions performed by the hospital care team that address risk factors can prevent delirium in patients in medical units and those undergoing hip fracture repair. This includes attention to the depth of sedation during spinal anesthesia and the addition of regional nerve blocks to patient-controlled analgesia in orthopedic patients, both of which may reduce postoperative delirium. Perioperative use of antipsychotics may further reduce the incidence of delirium, although hospital length of stay has not been routinely reduced. Appropriate management of analgesia, sedation, and delirium in the intensive care unit is also associated with reduced duration of mechanical ventilation, as well as intensive care unit and hospital length of stay. The use of dexmedetomidine, an α-adrenergic receptor agonist, for sedation may reduce intensive care unit length of stay when compared with use of benzodiazepines.
- PMID
22056829
- Keywords
Aged, Aged, 80 and over, Analgesics, therapeutic use, Antipsychotic Agents, therapeutic use, Cholinesterase Inhibitors, therapeutic use, Clinical Trials as Topic, Delirium, diagnosis, Diagnosis, Differential, Geriatric Assessment, Humans, Hypnotics and Sedatives, therapeutic use, Inpatients, Intensive Care Units, Practice Guidelines as Topic, Risk Factors
- Page(s)
- 96-106
- Volume
- 39
- Issue
- 4
| Title | Authors | Journal | Year | Keywords |
|---|---|---|---|---|
| The effect of dexmedetomidine on delirium and agitation in patients in intensive care: systematic review and meta-analysis with trial sequential analysis. | Ng, K. T. Shubash, C. J. Chong, J. S. | Anaesthesia | 2018 |
adult |
| A Point Prevalence Study of Delirium in Italian Nursing Homes. | Morichi, V. Fedecostante, M. Morandi, A. Di Santo, S. G. Mazzone, A. Mossello, E. Bo, M. Bianchetti, A. Rozzini, R. Zanetti, E. Musicco, M. Ferrari, A. Ferrara, N. Trabucchi, M. Cherubini, A. Bellelli, G. | Dementia and Geriatric Cognitive Disorders | 2018 |
neuroleptic agent |
| Increased Readmission Risk and Healthcare Cost for Delirium Patients without Immediate Hospitalization in the Emergency Department. | Ma, I. C. Chen, K. C. Chen, W. T. Tsai, H. C. Su, C. C. Lu, R. B. Chen, P. S. Chang, W. H. Yang, Y. K. | Clin Psychopharmacol Neurosci | 2018 |
Delirium |
| The effect of chronotherapy on delirium in critical care - a systematic review. | Luther R, McLeod A | Nursing in critical care | 2017 |
Adult intensive care |
| Intraoperative use of dexmedetomidine for the prevention of emergence agitation and postoperative delirium in thoracic surgery: a randomized-controlled trial. | Kim, J. A. Ahn, H. J. Yang, M. Lee, S. H. Jeong, H. Seong, B. G. | Canadian Journal of Anesthesia | 2019 |
adult |
| Delirium following total joint replacement surgery. | Huang, J. Sprung, J. Weingarten, T. N. | Bosn J Basic Med Sci | 2019 | |
| Delirium management: Let's get physical? A systematic review and meta-analysis. | Haley, M. N. Casey, P. Kane, R. Y. Darzins, P. Lawler, K. | Australas J Ageing | 2019 |
delirium |
| Increasing Light Exposure for the Prevention of Delirium: A Systematic Review. | Groves, R. L. | Dimensions of Critical Care Nursing | 2019 |
adult |
| Perioperative Risk Factors for Postoperative Delirium in Patients Undergoing Esophagectomy. | Fuchita, M. Khan, S. H. Perkins, A. J. Gao, S. Wang, S. Kesler, K. A. Khan, B. A. | Ann Thorac Surg | 2019 | |
| Delirium and Alzheimer's Disease: A Proposed Model for Shared Pathophysiology. | Fong, T. G. Vasunilashorn, S. M. Libermann, T. Marcantonio, E. R. Inouye, S. K. | Int J Geriatr Psychiatry | 2019 |
biomarkers |
| Diagnostic Performance and Utility of Quantitative EEG Analyses in Delirium: Confirmatory Results From a Large Retrospective Case-Control Study. | Fleischmann, R. Tränkner, S. Bathe-Peters, R. Rönnefarth, M. Schmidt, S. Schreiber, S. J. Brandt, S. A. | Clinical EEG and Neuroscience | 2019 |
electroencephalograph |
| Differences in potential biomarkers of delirium between acutely ill medical and elective cardiac surgery patients. | Egberts, A. Osse, R. J. Fekkes, D. Tulen, J. H. M. van der Cammen, T. J. M. Mattace-Raso, F. U. S. | Clin Interv Aging | 2019 |
delirium |
| Translation and validation of the tibetan confusion assessment method for the intensive care unit (CAM-ICU). | Danzeng, Q. Z. Cui, N. Wang, H. Pan, W. J. Long, Y. Deji, Y. Z. Ze, C. Ren, Z. | Chin Med J (Engl) | 2019 | |
| Intra-operative Blood Transfusion Predicts Post-Operative Delirium among Older Patients Undergoing Elective Orthopedic Surgery: a Prospective Cohort Study. | Chou, M. Y. Wang, Y. C. Peng, L. N. Liang, C. K. Chu, C. S. Liao, M. C. Lin, Y. T. Hsu, C. J. Chen, L. K. | Int J Geriatr Psychiatry | 2019 |
a |
| Vitamin D levels and risk of delirium: A mendelian randomization study in the UK Biobank | Bowman, K. Jones, L. Pilling, L. C. Delgado, J. Kuchel, G. A. Ferrucci, L. Fortinsky, R. H. Melzer, D. | Neurology | 2019 | |
| Pharmacological interventions for prevention and management of delirium in intensive care patients: A systematic overview of reviews and meta-analyses. | Barbateskovic, M. Krauss, S. R. Collet, M. O. Larsen, L. K. Jakobsen, J. C. Perner, A. Wetterslev, J. | BMJ Open | 2019 |
CRD42016046628 |
| Pre-operative biomarkers and imaging tests as predictors of post-operative delirium in non-cardiac surgical patients: a systematic review. | Ayob, F. Lam, E. Ho, G. Chung, F. El-Beheiry, H. Wong, J. | BMC Anesthesiology | 2019 |
Post-operative delirium |
| Training interventions to improve general hospital care for older people with cognitive impairment: systematic review. | Abley, C. Dickinson, C. Andrews, Z. Prato, L. Lindley, L. Robinson, L. | Br J Psychiatry | 2019 |
Dementia |
| Cognitive impairment and postoperative outcomes in patients undergoing primary total hip arthroplasty: A systematic review. | Viramontes, O. Luan Erfe, B. M. Erfe, J. M. Brovman, E. Y. Boehme, J. Bader, A. M. Urman, R. D. | J Clin Anesth | 2019 |
Anesthesia |
| Autonomic cardiovascular control in older patients with acute infection and delirium: a pilot study of orthostatic stress responses. | Neerland, B. E. Wyller, T. B. Wyller, V. B. B. | BMC Geriatr | 2019 |
Autonomic function |
| The prognostic value of neurofilament levels in patients with sepsis-associated encephalopathy - A prospective, pilot observational study. | Ehler, J. Petzold, A. Wittstock, M. Kolbaske, S. Gloger, M. Henschel, J. Heslegrave, A. Zetterberg, H. Lunn, M. P. Rommer, P. S. Grossmann, A. Sharshar, T. Richter, G. Noldge-Schomburg, G. Sauer, M. | PLoS One | 2019 | |
| A systematic review of interventions to facilitate extubation in patients difficult-to-wean due to delirium, agitation, or anxiety and a meta-analysis of the effect of dexmedetomidine. | Dupuis, S. Brindamour, D. Karzon, S. Frenette, A. J. Charbonney, E. Perreault, M. M. Bellemare, P. Burry, L. Williamson, D. R. | Can J Anaesth | 2019 | |
| Haloperidol for the management of delirium in adult intensive care unit patients: A systematic review and meta-analysis of randomized controlled trials. | Zayed, Y. Barbarawi, M. Kheiri, B. Banifadel, M. Haykal, T. Chahine, A. Rashdan, L. Aburahma, A. Bachuwa, G. Seedahmed, E. | J Crit Care | 2019 |
Critically ill patients |
| Genome-wide association study of myocardial infarction, atrial fibrillation, acute stroke, acute kidney injury and delirium after cardiac surgery - a sub-analysis of the RIPHeart-Study. | Westphal, S. Stoppe, C. Gruenewald, M. Bein, B. Renner, J. Cremer, J. Coburn, M. Schaelte, G. Boening, A. Niemann, B. Kletzin, F. Roesner, J. Strouhal, U. Reyher, C. Laufenberg-Feldmann, R. Ferner, M. Brandes, I. F. Bauer, M. Kortgen, A. Stehr, S. N. Witt | BMC Cardiovasc Disord | 2019 |
Acute kidney injury |
| Preoperative Anxiety as a Predictor of Delirium in Cancer Patients: A Prospective Observational Cohort Study. | Wada, S. Inoguchi, H. Sadahiro, R. Matsuoka, Y. J. Uchitomi, Y. Sato, T. Shimada, K. Yoshimoto, S. Daiko, H. Shimizu, K. | World J Surg | 2019 | |
| Development of a Dynamic Multi-Protein Signature of Postoperative Delirium. | Vasunilashorn, S. M. Ngo, L. H. Chan, N. Y. Zhou, W. Dillon, S. T. Otu, H. H. Inouye, S. K. Wyrobnik, I. Kuchel, G. A. McElhaney, J. E. Xie, Z. Alsop, D. C. Jones, R. N. Libermann, T. A. Marcantonio, E. R. | J Gerontol A Biol Sci Med Sci | 2019 | |
| Improved Guideline Adherence and Reduced Brain Dysfunction After a Multicenter Multifaceted Implementation of ICU Delirium Guidelines in 3,930 Patients. | Trogrlic, Z. van der Jagt, M. Lingsma, H. Gommers, D. Ponssen, H. H. Schoonderbeek, J. F. J. Schreiner, F. Verbrugge, S. J. Duran, S. Bakker, J. Ista, E. | Crit Care Med | 2019 | |
| Trajectory of severity of postoperative delirium symptoms and its prospective association with cognitive function in patients with gastric cancer: results from a prospective observational study. | Shim, E. J. Noh, H. L. Lee, K. M. Hwang, H. Son, K. L. Jung, D. Kim, W. H. Kong, S. H. Suh, Y. S. Lee, H. J. Yang, H. K. Hahm, B. J. | Support Care Cancer | 2019 |
Anesthesia |
| Sedation Variability Increases Incidence of Delirium in Adult Medical Intensive Care Unit Patients at a Tertiary Academic Medical Center. | Ritchie, B. M. Torbic, H. DeGrado, J. R. Reardon, D. P. | Am J Ther | 2019 | |
| Current Pharmacotherapy Does Not Improve Severity of Hypoactive Delirium in Patients with Advanced Cancer: Pharmacological Audit Study of Safety and Efficacy in Real World (Phase-R). | Okuyama, T. Yoshiuchi, K. Ogawa, A. Iwase, S. Yokomichi, N. Sakashita, A. Tagami, K. Uemura, K. Nakahara, R. Akechi, T. | Oncologist | 2019 |
Antipsychotic agents |
| Quality of care in hospitalized cancer patients before and after implementation of a systematic prevention program for delirium: the DELTA exploratory trial. | Ogawa, A. Okumura, Y. Fujisawa, D. Takei, H. Sasaki, C. Hirai, K. Kanno, Y. Higa, K. Ichida, Y. Sekimoto, A. Asanuma, C. | Supportive Care in Cancer | 2019 |
benzodiazepine derivative |
| Relevance of peripheral cholinesterase activity on postoperative delirium in adult surgical patients (CESARO): A prospective observational cohort study. | Müller, A. Olbert, M. Heymann, A. Zahn, P. K. Plaschke, K. von Dossow, V. Bitzinger, D. Barth, E. Meister, M. Kranke, P. Herrmann, C. Wernecke, K. D. Spies, C. D. | European Journal of Anaesthesiology | 2019 |
NCT01964274 |
| Predicting postoperative delirium and postoperative cognitive decline with combined intraoperative electroencephalogram monitoring and cerebral near-infrared spectroscopy in patients undergoing cardiac interventions. | Momeni, M. Meyer, S. Docquier, M. A. Lemaire, G. Kahn, D. Khalifa, C. Rosal Martins, M. Van Dyck, M. Jacquet, L. M. Peeters, A. Watremez, C. | J Clin Monit Comput | 2019 |
Burst suppression |
| Early Postoperative Actigraphy Poorly Predicts Hypoactive Delirium. | Maybrier, H. R. King, C. R. Crawford, A. E. Mickle, A. M. Emmert, D. A. Wildes, T. S. Avidan, M. S. Palanca, B. J. A. | J Clin Sleep Med | 2019 |
actigraphy |
| Subsyndromal delirium is associated with poor functional outcome after ischemic stroke. | Klimiec, E. Lis, A. Pera, J. Slowik, A. Dziedzic, T. | Eur J Neurol | 2019 |
confusion |
| Pharmacological Management of Delirium in the Intensive Care Unit: A Randomized Pragmatic Clinical Trial. | Khan, B. A. Perkins, A. J. Campbell, N. L. Gao, S. Farber, M. O. Wang, S. Khan, S. H. Zarzaur, B. L. Boustani, M. A. | J Am Geriatr Soc | 2019 |
benzodiazepine |
| Use of medicines that may precipitate delirium prior to hospitalisation in older Australians with delirium: An observational study. | Kassie, G. M. Kalisch Ellett, L. M. Nguyen, T. A. Roughead, E. E. | Australas J Ageing | 2019 |
delirium |
| Comprehensive risk factor evaluation of postoperative delirium following major surgery: clinical data warehouse analysis. | Kang, S. Y. Seo, S. W. Kim, J. Y. | Neurol Sci | 2019 |
Clinical data warehouse |
| Lower risk of postoperative delirium using laparoscopic approach for major abdominal surgery. | Ito, K. Suka, Y. Nagai, M. Kawasaki, K. Yamamoto, M. Koike, D. Nomura, Y. Tanaka, N. Kawaguchi, Y. | Surg Endosc | 2019 |
Laparoscopic approach |
| Delirium is associated with frequency band specific dysconnectivity in intrinsic connectivity networks: preliminary evidence from a large retrospective pilot case-control study. | Fleischmann, R. Traenkner, S. Kraft, A. Schmidt, S. Schreiber, S. J. Brandt, S. A. | Pilot Feasibility Stud | 2019 |
Biomarker |
| Risk Factors Associated With Postoperative Delirium in Patients Undergoing Head and Neck Free Flap Reconstruction. | Densky, J. Eskander, A. Kang, S. Chan, J. Tweel, B. Sitapara, J. Ozer, E. Agrawal, A. Carrau, R. Rocco, J. Teknos, T. N. Old, M. | JAMA Otolaryngol Head Neck Surg | 2019 | |
| Deprescribing in the Pharmacologic Management of Delirium: A Randomized Trial in the Intensive Care Unit. | Campbell, N. L. Perkins, A. J. Khan, B. A. Gao, S. Farber, M. O. Khan, S. Wang, S. Boustani, M. A. | J Am Geriatr Soc | 2019 |
anticholinergic |
| Reliability of mobility measures in older medical patients with cognitive impairment. | Braun, T. Thiel, C. Schulz, R. J. Gruneberg, C. | BMC Geriatr | 2019 |
Cognitive impairment |
| Effectiveness of Melatonin for the Prevention of Intensive Care Unit Delirium. | Baumgartner, L. Lam, K. Lai, J. Barnett, M. Thompson, A. Gross, K. Morris, A. | Pharmacotherapy | 2019 |
Delirium |
| Validation of the Prediction of Delirium for Intensive Care model to predict subsyndromal delirium. | Azuma, K. Mishima, S. Shimoyama, K. Ishii, Y. Ueda, Y. Sakurai, M. Morinaga, K. Fujikawa, T. Oda, J. | Acute Med Surg | 2019 |
Critical care |
| Association Between Postoperative Delirium and Long-term Cognitive Function After Major Nonemergent Surgery. | Austin, C. A. O'Gorman, T. Stern, E. Emmett, D. Sturmer, T. Carson, S. Busby-Whitehead, J. | JAMA Surg | 2019 | |
| 'I hope you get normal again': an explorative study on how delirious octogenarian patients experience their interactions with healthcare professionals and relatives after aortic valve therapy. | Instenes, I. Fridlund, B. Amofah, H. A. Ranhoff, A. H. Eide, L. S. Norekval, T. M. | Eur J Cardiovasc Nurs | 2018 |
Delirium |
| Establishing a successful perioperative geriatric service in an Australian acute surgical unit. | Styan, L. Murphy, S. Fleury, A. McGowan, B. Wullschleger, M. | ANZ Journal of Surgery | 2018 |
aged |
| Delirium and Antipsychotic Medications at Hospital Intake: Screening to Decrease Likelihood of Aggression in Inpatient Settings Among Unknown Patients With Dementia. | Wharton, T. Paulson, D. Burcher, K. Lesch, H. | Am J Alzheimers Dis Other Demen | 2018 |
behavior |
| Preoperative assessment of frailty predicts age-related events after hepatic resection: a prospective multicenter study. | Tanaka, S. Ueno, M. Iida, H. Kaibori, M. Nomi, T. Hirokawa, F. Ikoma, H. Nakai, T. Eguchi, H. Kubo, S. | J Hepatobiliary Pancreat Sci | 2018 |
Age Factors |
| Efficacy and Tolerability of Atypical Antipsychotics in the Treatment of Delirium: A Systematic Review of the Literature. | Rivière, J. van der Mast, R. C. Vandenberghe, J. Van Den Eede, F. | Psychosomatics | 2018 |
aged |
| Outcomes of Prehospital Chemical Sedation With Ketamine Versus Haloperidol and Benzodiazepine or Physical Restraint Only. | O'Connor, L. Rebesco, M. Robinson, C. Gross, K. Castellana, A. O'Connor, M. J. Restuccia, M. | Preshosp Emerg Care | 2018 |
agitated delirium |
| Just another piece of paperwork": perceptions of clinicians on delirium screening following hip fracture repair elicited in focus groups. | Oberai, T. Killington, M. Laver, K. Crotty, M. Jaarsma, R. | Int Psychogeriatr | 2018 |
aging |
| Altered mental status predicts mortality in cardiogenic shock – results from the CardShock study. | Kataja, A. Tarvasmäki, T. Lassus, J. Køber, L. Sionis, A. Spinar, J. Parissis, J. Carubelli, V. Cardoso, J. Banaszewski, M. Marino, R. Nieminen, M. S. Mebazaa, A. Harjola, V. P. | European Heart Journal: Acute Cardiovascular Care | 2018 |
NCT01374867 |
| Nurses' and physicians' approaches to delirium management in the intensive care unit: A focus group investigation. | Collet, M. O. Thomsen, T. Egerod, I. | Aust Crit Care | 2018 |
Delirium |
| Low Plasma Cholinesterase Activity is Associated With Postoperative Delirium After Noncardiac Surgery in Elderly Patients: A Prospective Observational Study. | Zhao, B. Ni, Y. Tian, X. | Psychosomatics | 2018 |
aged |
| Propofol compared with sevoflurane general anaesthesia is associated with decreased delayed neurocognitive recovery in older adults. | Zhang, Y. Shan, G. J. Zhang, Y. X. Cao, S. J. Zhu, S. N. Li, H. J. Ma, D. Wang, D. X. | British Journal of Anaesthesia | 2018 |
ChiCTR-IPR-15006209 |
| Effect of dexmedetomidine on postoperative delirium in elderly patients undergoing hip fracture surgery. | Xie, S. Xie, M. | Pak J Pharm Sci | 2018 | |
| Development and Validation of an Electronic Health Record-Based Machine Learning Model to Estimate Delirium Risk in Newly Hospitalized Patients Without Known Cognitive Impairment. | Wong, A. Young, A. T. Liang, A. S. Gonzales, R. Douglas, V. C. Hadley, D. | JAMA Netw Open | 2018 | |
| Sedative drugs used for mechanically ventilated patients in intensive care units: a systematic review and network meta-analysis. | Wang, H. Wang, C. Wang, Y. Tong, H. Feng, Y. Li, M. Jia, L. Yu, K. | Curr Med Res Opin | 2018 |
Sedative drugs |
| Prediction of length of hospital stay and mortality in patients with delirium: A prospective cohort analysis of 200 ICU patients. | Tian, J. Chen, X. Liu, D. | Journal of Biological Regulators and Homeostatic Agents | 2018 |
adult |
| Ramelteon is Not Associated With Improved Outcomes Among Critically Ill Delirious Patients: A Single-Center Retrospective Cohort Study. | Thom, R. Bui, M. Rosner, B. Teslyar, P. Levy-Carrick, N. Wolfe, D. Klompas, M. | Psychosomatics | 2018 |
Delirium |
| A daily multidisciplinary assessment of older adults undergoing elective colorectal cancer surgery is associated with reduced delirium and geriatric syndromes. | Tarazona-Santabalbina, F. J. Llabata-Broseta, J. Belenguer-Varea, A. Alvarez-Martinez, D. Cuesta-Peredo, D. Avellana-Zaragoza, J. A. | J Geriatr Oncol | 2018 |
Colorectal surgery |
| Preventive Effect of Suvorexant for Postoperative Delirium after Coronary Artery Bypass Grafting. | Tamura, K. Maruyama, T. Sakurai, S. | Ann Thorac Cardiovasc Surg | 2018 |
Suvorexant |
| Aproach to the risk of delirium in an orthogeriatric unit. | Sopena Bert, E. Qanneta, R. Valenti Moreno, V. San Jose Laporte, A. | Med Clin | 2018 |
Delirium |
| A systematic review of the use of music interventions to improve outcomes for patients undergoing hip or knee surgery. | Sibanda, A. Carnes, D. Visentin, D. Cleary, M. | J Adv Nurs | 2018 |
anxiety |
| Use of "Months of the Year Backwards" (MOTYB) as a Screening Tool for Delirium in Palliative Care Patients in the Acute Hospital Setting. | Ryan, S. Hayes, D. Creedon, B. | Ir Med J | 2018 | |
| Impact of psychotic symptoms on clinical outcomes in delirium. | Paik, S. H. Ahn, J. S. Min, S. Park, K. C. Kim, M. H. | PLoS ONE | 2018 |
neuroleptic agent |
| Preoperative age and prognostic nutritional index are useful factors for evaluating postoperative delirium among patients with adult spinal deformity. | Oe, S. Togawa, D. Yamato, Y. Hasegawa, T. Yoshida, G. Kobayashi, S. Yasuda, T. Banno, T. Arima, H. Mihara, Y. Ushirozako, H. Yamada, T. Matsuyama, Y. | Spine | 2018 | |
| Decreased Risk of Delirium With Use of Regional Analgesia in Geriatric Trauma Patients With Multiple Rib Fractures. | O'Connell, K. M. Quistberg, D. A. Tessler, R. Robinson, B. R. H. Cuschieri, J. Maier, R. V. Rivara, F. P. Vavilala, M. S. Bhalla, P. I. Arbabi, S. | Ann Surg | 2018 |
OBJECTIVE: The aim of this study was to examine the risk of delirium in geriatric trauma patients with rib fractures treated with systemic opioids compared with those treated with regional analgesia (RA). SUMMARY OF BACKGROUND DATA: Delirium is a modifiable complication associated with increased morbidity and mortality. RA may reduce the need for opioid medications, which are associated with delirium in older adults. METHODS: Cohort study of patients >/=65 years admitted to a regional trauma center from 2011 to 2016. Inclusion factors were >/= 3 rib fractures, blunt trauma mechanism, and admission to intensive care unit (ICU). Exclusion criteria included head AIS >/=3, spine AIS >/=3, dementia, and death within 24 hours. The primary outcome was delirium positive ICU days, defined using the CAM-ICU assessment. Delirium incident rate ratios (IRRs) and 95% confidence intervals (95% CIs) were estimated using generalized linear mixed models with Poisson distribution and robust standard errors. RESULTS: Of the 144 patients included in the study, 27 (19%) received Acute Pain Service consultation and RA and 117 (81%) received opioid-based systemic analgesia. Patients with RA had more severe chest injury than those without. The risk of delirium decreased by 24% per day per patient with use of RA (IRR 0.76, 95% CI 0.61 to 0.96). Individual opioid use, as measured in daily morphine equivalents (MEDs), was significantly reduced after initiation of RA (mean difference -7.62, 95% CI -14.4 to -0.81). CONCLUSION: Although use of RA techniques in geriatric trauma patients with multiple rib fractures was associated with higher MED, opioid use decreased after RA initiation and Acute Pain Service consultation, and the risk of delirium was lower. |
| Hypotension and a positive fluid balance are associated with delirium in patients with shock. | Nguyen, D. N. Huyghens, L. Parra, J. Schiettecatte, J. Smitz, J. Vincent, J. L. | PLoS One | 2018 | |
| End-Tidal Hypocapnia Under Anesthesia Predicts Postoperative Delirium. | Mutch, W. A. C. El-Gabalawy, R. Girling, L. Kilborn, K. Jacobsohn, E. | Front Neurol | 2018 |
*anesthetic agent |
| Risk Factors for Delirium after Spine Surgery: An Age-Matched Analysis. | Morino, T. Hino, M. Yamaoka, S. Misaki, H. Ogata, T. Imai, H. Miura, H. | Asian Spine J | 2018 |
Delirium |
| Outcomes of Patients With Delirium in Long-Term Care Facilities: A Prospective Cohort Study. | Moon, K. J. Park, H. | J Gerontol Nurs | 2018 |
Aged |
| Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non-cardiac surgery. | Miller, D. Lewis, S. R. Pritchard, M. W. Schofield-Robinson, O. J. Shelton, C. L. Alderson, P. Smith, A. F. | Cochrane Database of Systematic Reviews | 2018 |
Aged |
| Incidence, risk factors and clinical impact of postoperative delirium following open reduction and internal fixation (ORIF) for hip fractures: an analysis of 7859 patients from the ACS-NSQIP hip fracture procedure targeted database. | Malik, A. T. Quatman, C. E. Phieffer, L. S. Ly, T. V. Khan, S. N. | Eur J Orthop Surg Traumatol | 2018 |
Delirium |
| Delirium After Cardiac Surgery and Cumulative Fluid Balance: A Case-Control Cohort Study. | Mailhot, T. Cossette, S. Lambert, J. Beaubien-Souligny, W. Cournoyer, A. O'Meara, E. Maheu-Cadotte, M. A. Fontaine, G. Bouchard, J. Lamarche, Y. Benkreira, A. Rochon, A. Denault, A. | J Cardiothorac Vasc Anesth | 2019 |
cardiac surgery |
| The point-of-care EEG for delirium detection in the emergency department. | Lee, S. Yuki, K. Chan, A. Cromwell, J. Shinozaki, G. | Am J Emerg Med | 2018 |
Bispectral EEG |
| Intraoperative hypotension is not associated with postoperative cognitive dysfunction in elderly patients undergoing general anesthesia for surgery: results of a randomized controlled pilot trial. | Langer, T. Santini, A. Zadek, F. Chiodi, M. Pugni, P. Cordolcini, V. Bonanomi, B. Rosini, F. Marcucci, M. Valenza, F. Marenghi, C. Inglese, S. Pesenti, A. Gattinoni, L. | J Clin Anesth | 2019 |
Anesthesia, general |
| Differences in healthcare outcomes between teaching and non teaching hospitals for patients with delirium: a retrospective cohort study. | Kotwal, S. Abougergi, M. S. Wright, S. | Int J Qual Health Care | 2018 | |
| Gender differences in the use of atypical antipsychotic medications for ICU delirium. | Karamchandani, K. Schoaps, R. S. Printz, J. Kowaleski, J. M. Carr, Z. J. | Crit Care | 2018 | |
| Whole-Genome mRNA Gene Expression Differs Between Patients With and Without Delirium. | Kalantar, K. LaHue, S. C. DeRisi, J. L. Sample, H. A. Contag, C. A. Josephson, S. A. Wilson, M. R. Douglas, V. C. | Journal of Geriatric Psychiatry and Neurology | 2018 |
integrin |
| Incidence and risk factors of subsyndromal delirium after curative resection of gastric cancer. | Hwang, H. Lee, K. M. Son, K. L. Jung, D. Kim, W. H. Lee, J. Y. Kong, S. H. Suh, Y. S. Lee, H. J. Yang, H. K. Hahm, B. J. | BMC Cancer | 2018 |
adult |
| Performance of Electronic Prediction Rules for Prevalent Delirium at Hospital Admission. | Halladay, C. W. Sillner, A. Y. Rudolph, J. L. | JAMA Netw Open | 2018 | |
| Harmonization of delirium severity instruments: a comparison of the DRS-R-98, MDAS, and CAM-S using item response theory. | Gross, A. L. Tommet, D. D'Aquila, M. Schmitt, E. Marcantonio, E. R. Helfand, B. Inouye, S. K. Jones, R. N. | BMC Med Res Methodol | 2018 |
Delirium |
| Prognostic factors of inhospital death in elderly patients: A time-to-event analysis of a cohort study in Martinique (French West Indies). | Godaert, L. Bartholet, S. Dorléans, F. Najioullah, F. Colas, S. Fanon, J. L. Cabié, A. Césaire, R. Dramé, M. | BMJ Open | 2018 |
aged |
| The Critical Vital Sign of Cognitive Health and Delirium: Whose Responsibility Is It? | Fick, D. M. | J Gerontol Nurs | 2018 | |
| Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. | Devlin, J. W. Skrobik, Y. Gelinas, C. Needham, D. M. Slooter, A. J. C. Pandharipande, P. P. Watson, P. L. Weinhouse, G. L. Nunnally, M. E. Rochwerg, B. Balas, M. C. van den Boogaard, M. Bosma, K. J. Brummel, N. E. Chanques, G. Denehy, L. Drouot, X. Fraser | Crit Care Med | 2018 | |
| Delirium etiology subtypes and their effect on six-month function and cognition in older emergency department patients. | Cirbus, J. MacLullich, A. M. J. Noel, C. Ely, E. W. Chandrasekhar, R. Han, J. H. | International Psychogeriatrics | 2018 |
aged |
| Perioperative Sedation in Mechanically Ventilated Cardiac Surgery Patients With Dexmedetomidine-Based Versus Propofol-Based Regimens. | Chuich, T. Cropsey, C. L. Shi, Y. Johnson, D. Shotwell, M. S. Henson, C. P. | Ann Pharmacother | 2019 |
anesthesia |
| Hospital discharge data under-reports delirium occurrence. Results from a point prevalence survey of delirium in a major Australian health service. | Casey, P. Cross, W. Webb-St Mart, M. Baldwin, C. Riddell, K. Darzins, P. | Intern Med J | 2018 |
Adult |
| TIME to think about delirium: improving detection and management on the acute medical unit. | Bauernfreund, Y. Butler, M. Ragavan, S. Sampson, E. L. | BMJ Open Qual | 2018 |
Pdsa |
| The Association of Delirium with Perioperative Complications in Primary Elective Total Hip Arthroplasty. | Aziz, K. T. Best, M. J. Naseer, Z. Skolasky, R. L. Ponnusamy, K. E. Sterling, R. S. Khanuja, H. S. | Clin Orthop Surg | 2018 |
Aged |
| Bispectral Index Monitoring During Anesthesia Promotes Early Postoperative Recovery of Cognitive Function and Reduces Acute Delirium in Elderly Patients with Colon Carcinoma: A Prospective Controlled Study using the Attention Network Test. | Zhou, Y. Li, Y. Wang, K. | Med Sci Monit | 2018 |
Aged |
| Military Service Members and Emergence Delirium Screening: An Evidence-Based Practice Project. | Wheat, L. L., 2nd Turner, B. S. Diaz, A. Maani, C. V. | J Perianesth Nurs | 2018 |
emergence delirium |
| Can delirium research activity impact on routine delirium recognition? A prospective cohort study. | Welch, C. Jackson, T. A. | BMJ Open | 2018 |
dementia |
| Preoperative STOP-BANG Scores and Postoperative Delirium and Coma in Thoracic Surgery Patients. | Wang, S. Sigua, N. L. Manchanda, S. Gradney, S. Khan, S. H. Perkins, A. Kesler, K. Khan, B. | Ann Thorac Surg | 2018 | |
| The Cost of ICU Delirium and Coma in the Intensive Care Unit Patient. | Vasilevskis, E. E. Chandrasekhar, R. Holtze, C. H. Graves, J. Speroff, T. Girard, T. D. Patel, M. B. Hughes, C. G. Cao, A. Pandharipande, P. P. Ely, E. W. | Med Care | 2018 | |
| Pharmacologic prevention of postoperative delirium after on-pump cardiac surgery: A meta-analysis of randomized trials. | Tao, R. Wang, X. W. Pang, L. J. Cheng, J. Wang, Y. M. Gao, G. Q. Liu, Y. Wang, C. | Medicine | 2018 |
Antipsychotic Agents/*therapeutic use |
| Epigenetics of Delirium and Aging: Potential Role of DNA Methylation Change on Cytokine Genes in Glia and Blood Along With Aging. | Shinozaki, G. Braun, P. R. Hing, B. W. Q. Ratanatharathorn, A. Klisares, M. J. Duncan, G. N. Jellison, S. S. Heinzman, J. T. Nagahama, Y. Close, L. Sabbagh, S. Dlouhy, B. J. Howard, M. A. Kawasaki, H. Cho, H. R. | Front Aging Neurosci | 2018 |
DNA methylation |