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
- Withdrawal versus continuation of long-term antipsychotic drug use for behavioural and psychological symptoms in older people with dementia.
- Authors
- Van Leeuwen, E. Petrovic, M. van Driel, M. L. De Sutter, A. I. M. Vander Stichele, R. Declercq, T. Christiaens, T.
- Year
- 2018
- Journal
- Cochrane Database of Systematic Reviews
- Abstract
Background: Antipsychotic agents are often used to treat neuropsychiatric symptoms (NPS) in people with dementia although there is uncertainty about the effectiveness of their long-term use for this indication and concern that they may cause harm, including higher mortality. When behavioural strategies have failed and treatment with antipsychotic drugs is instituted, regular attempts to withdraw them have been recommended in guidelines. Physicians, nurses and families of older people with dementia may be reluctant to stop antipsychotics, fearing deterioration of NPS. This is an update of a Cochrane Review published in 2013. Objectives: To evaluate whether withdrawal of antipsychotic agents is successful in older people with dementia and NPS in primary care or nursing home settings, to list the different strategies for withdrawal of antipsychotic agents in older participants with dementia and NPS, and to measure the effects of withdrawal of antipsychotic agents on participants’ behaviour and assess safety. Search methods: We searched the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (ALOIS), theCochrane Library, MEDLINE, Embase, PsycINFO, CINAHL, LILACS, clinical trials registries and grey literature sources up to 11 January 2018. Selection criteria: We included all randomised, controlled trials comparing an antipsychotic withdrawal strategy to continuation of antipsychotics in people with dementia who had been treated with an antipsychotic drug for at least three months. Data collection and analysis: We used standard methodological procedures according to the Cochrane Handbook for Systematic Reviews of Interventions. We rated the quality of evidence for each outcome using the GRADE approach. Main results: We included 10 studies involving 632 participants. One new trial (19 participants) was added for this update. One trial was conducted in a community setting, eight in nursing homes and one in both settings. Different types of antipsychotics at varying doses were discontinued in the studies. Both abrupt and gradual withdrawal schedules were used. Reported data were predominantly from studies at low or unclear risk of bias. We included nine trials with 575 randomised participants that used a proxy outcome for overall success of antipsychotic withdrawal. Pooling data was not possible due to heterogeneity of outcome measures used. Based on assessment of seven studies, discontinuation may make little or no difference to whether or not participants complete the study (low-quality evidence). Two trials included only participants with psychosis, agitation or aggression who had responded to antipsychotic treatment. In these two trials, stopping antipsychotics was associated with a higher risk of leaving the study early due to symptomatic relapse or a shorter time to symptomatic relapse. We found low-quality evidence that discontinuation may make little or no difference to overall NPS, measured using various scales (7 trials, 519 participants). There was some evidence from subgroup analyses in two trials that discontinuation may reduce agitation for participants with less severe NPS at baseline, but may be associated with a worsening of NPS in participants with more severe NPS at baseline. None of the studies assessed withdrawal symptoms. Adverse effects of antipsychotics (such as falls) were not systematically assessed. Low-quality evidence showed that discontinuation may have little or no effect on adverse events (5 trials, 381 participants), quality of life (2 trials, 119 participants), or cognitive function (5 trials, 365 participants). There were insufficient data to determine whether discontinuation of antipsychotics has any effect on mortality (very low-quality evidence). Authors’ conclusions: There is low-quality evidence that antipsychotics may be successfully discontinued in older people with dementia and NPS who have been taking antipsychotics for at least three months, and that discontinuation may have little or no important effect on behavioural and psychological symptoms. This i consistent with the observation that most behavioural complications of dementia are intermittent and often do not persist for longer than three months. Discontinuation may have little or no effect on overall cognitive function. Discontinuation may make no difference to adverse events and quality of life. Based on the trials in this review, we are uncertain whether discontinuation of antipsychotics leads to a decrease in mortality. People with psychosis, aggression or agitation who responded well to long-term antipsychotic drug use, or those with more severe NPS at baseline, may benefit behaviourally from continuation of antipsychotics. Discontinuation may reduce agitation for people with mild NPS at baseline. However, these conclusions are based on few studies or small subgroups and further evidence of benefits and harms associated with withdrawal of antipsychotic is required in people with dementia and mild and severe NPS. The overall conclusions of the review have not changed since 2013 and the number of available trials remains low.
- PMID
- Keywords
chlorpromazine
haloperidol
levomepromazine
lorazepam
loxapine
mesoridazine
neuroleptic agent
olanzapine
perphenazine
placebo
risperidone
thioridazine
tiotixene
trifluoperazine
aggression
agitation
akathisia
behavior disorder
blood pressure
body equilibrium
cardiovascular disease
cognition
confusion
dementia
drug fatality
drug megadose
drug response
drug safety
drug withdrawal
extrapyramidal symptom
falling
fracture
heart rate
human
insomnia
long term care
low drug dose
lung disease
mental disease
motor dysfunction
nausea
neurologic disease
nursing home
parkinsonism
physical mobility
primary medical care
priority journal
psychosis
quality of life
relapse
restlessness
review
sedation
side effect
systematic review
tardive dyskinesia
treatment outcome
vomiting
- Page(s)
- Volume
- Issue
- 3
| Title | Authors | Journal | Year | Keywords |
|---|---|---|---|---|
| Early delirium after cardiac surgery: An analysis of incidence and risk factors in elderly (≥65 years) and very elderly (≥80 years) patients. | Kotfis, K. Szylińska, A. Listewnik, M. Strzelbicka, M. Brykczyński, M. Rotter, I. Żukowski, M. | Clinical Interventions in Aging | 2018 |
creatinine |
| ICU delirium - a diagnostic and therapeutic challenge in the intensive care unit. | Kotfis, K. Marra, A. Ely, E. W. | Anaesthesiol Intensive Ther | 2018 |
Cam-icu |
| Melatonin and sleep in preventing hospitalized delirium: A randomized clinical trial. | Jaiswal, S. J. McCarthy, T. J. Wineinger, N. E. Kang, D. Y. Song, J. Garcia, S. van Niekerk, C. J. Lu, C. Y. Loeks, M. Owens, R. L. | Am J Med | 2018 |
Delirium |
| Intraoperative ketamine administration to prevent delirium or postoperative cognitive dysfunction: A systematic review and meta-analysis. | Hovaguimian, F. Tschopp, C. Beck-Schimmer, B. Puhan, M. | Acta Anaesthesiol Scand | 2018 |
cognitive dysfunction |
| The use of clonidine in elderly patients with delirium; pharmacokinetics and hemodynamic responses. | Hov, K. R. Neerland, B. E. Andersen, A. M. Undseth, O. Wyller, V. B. MacLullich, A. M. J. Skovlund, E. Qvigstad, E. Wyller, T. B. | BMC Pharmacol Toxicol | 2018 |
Clonidine |
| Delirium's Arousal Subtypes and Their Relationship with 6-Month Functional Status and Cognition. | Han, J. H. Hayhurst, C. J. Chandrasekhar, R. Hughes, C. G. Vasilevskis, E. E. Wilson, J. E. Schnelle, J. F. Dittus, R. S. Ely, E. W. | Psychosomatics | 2018 |
aged |
| Intraoperative electroencephalogram suppression at lower volatile anaesthetic concentrations predicts postoperative delirium occurring in the intensive care unit. | Fritz, B. A. Maybrier, H. R. Avidan, M. S. | British Journal of Anaesthesia | 2018 |
NCT02032030 |
| Efficacy of perioperative dexmedetomidine on postoperative delirium: systematic review and meta-analysis with trial sequential analysis of randomised controlled trials. | Duan, X. Coburn, M. Rossaint, R. Sanders, R. D. Waesberghe, J. V. Kowark, A. | British Journal of Anaesthesia | 2018 |
adult |
| Long-term sequelae of acute respiratory distress syndrome caused by severe community-acquired pneumonia: Delirium-associated cognitive impairment and post-traumatic stress disorder. | Denke, C. Balzer, F. Menk, M. Szur, S. Brosinsky, G. Tafelski, S. Wernecke, K. D. Deja, M. | J Int Med Res | 2018 |
Community-acquired pneumonia |
| A Performing Arts Intervention Improves Cognitive Dysfunction in 50 Hospitalized Older Adults. | Danila, M. I. Melnick, J. A. Mudano, A. Flood, K. Booth, K. Kirklin, K. Saag, K. G. | Innov Aging | 2018 |
Alternative and complementary medicine/care/therapy |
| 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 |