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 or Ramelteon for Delirium Prevention in the Intensive Care Unit: A Systematic Review and Meta-Analysis of Randomized Controlled Trials | Aiello, G. Cuocina, M. La Via, L. Messina, S. Attaguile, G. A. Cantarella, G. Sanfilippo, F. Bernardini, R. | J Clin Med | 2023 |
agonist |
The Role of Insulin-Like Growth Factor 1 in Delirium: A Systematic Review and Meta-Analysis | Adamis, D. Eikelenboom, P. | Dement Geriatr Cogn Disord | 2023 |
Biomarkers |
Influence of dosing pattern of antipsychotics on treatment outcome of delirium in patients with advanced cancer | Abe, A. Fujisawa, D. Miyajima, K. Takeuchi, E. Takeuchi, M. Mimura, M. Imai, K. Uemura, K. Watanabe, H. Matsuo, N. Matsuda, Y. Maeda, I. Ogawa, A. Yoshiuchi, K. Iwase, S. | Jpn J Clin Oncol | 2023 |
antipsychotics |
Prone positioning reduces frontal and hippocampal neuronal dysfunction in a murine model of ventilator-induced lung injury | Sparrow, N. A. Guidry, G. Anwar, F. Darwish, S. Kelly, S. A. Karumanchi, S. A. Lahiri, S. | Front Med (Lausanne) | 2022 |
delirium |
Association between the reactivity of local cerebral oxygen saturation after hypo-to-hypercapnic tests and delirium after abdominal surgery in older adults: A prospective study | Song, J. Cheng, C. Sheng, K. Jiang, L. L. Li, Y. Xia, X. Q. Hu, X. W. | Front Psychiatry | 2022 |
abdominal surgery |
Cardiac surgery, ICU sedation, and delirium: is dexmedetomidine the silver bullet | Smith, W. Whitlock, E. L. | Curr Opin Anaesthesiol | 2022 | |
In pursuit of inter-specialty consensus on excited delirium syndrome: a scoping literature review | Slocum, S. Fiorillo, M. Harding, E. Owen, J. Long, R. Dunn, T. Martin, I. | Forensic Sci Med Pathol | 2022 |
Agitation |
Magnitude and associated factors of delirium among patients attending emergency department at Jimma medical center, Jimma, southwest Ethiopia, 2022 | Sileshy, B. Hailesilasiie, H. Tesfaye, Y. Ababu, H. | BMC Psychiatry | 2022 |
Humans |
Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay | Serafim, R. B. Dal-Pizzol, F. Souza-Dantas, V. Soares, M. Bozza, F. A. Póvoa, P. Luiz, R. R. Lapa, E. Silva J. R. Salluh, J. I. F. | J Clin Med | 2022 |
Icu |
Association between frailty, delirium, and mortality in older critically ill patients: a binational registry study | Sahle, B. W. Pilcher, D. Litton, E. Ofori-Asenso, R. Peter, K. McFadyen, J. Bucknall, T. | Ann Intensive Care | 2022 |
Clinical decision-making |
Pharmacologic treatment of delirium symptoms: A systematic review | Sadlonova, M. Duque, L. Smith, D. Madva, E. N. Amonoo, H. L. Vogelsang, J. Staton, S. C. von Arnim, C. A. F. Huffman, J. C. Celano, C. M. | Gen Hosp Psychiatry | 2022 |
Adult |
Haloperidol Versus Atypical Antipsychotics for Treating Delirium in Intensive Care Unit Patients: A Systematic Review | Sadhu, A. Valencia, C. Fatima, H. Nwankwo, I. Anam, M. Maharjan, S. Amjad, Z. Abaza, A. Vasavada, A. M. Khan, S. | Cureus | 2022 |
atypicalantipsychotics |
Reporting of outcomes and measures in studies of interventions to prevent and/or treat delirium in older adults resident in long-term care: a systematic review | Russell, G. Rana, N. Watts, R. Roshny, S. Siddiqi, N. Rose, L. | Age Ageing | 2022 |
Humans |
Research progress on risk factors of delirium in burn patients: A narrative review | Ren, Y. Zhang, Y. Luo, J. Liao, W. Cheng, X. Zhan, J. | Front Psychiatry | 2022 |
burn injury |
Association of delirium and spatial neglect in right-hemisphere stroke patients | Ott, J. Oh-Park, M. Boukrina, O. | Pm r | 2022 | |
A quality improvement project addressing the underreporting of delirium in hip fracture patients | Onizuka, N. Huyke-Hernández, F. A. Roby, M. A. Martell, T. F. Scislow, R. M. Jones, S. C. Olson, A. James, N. Switzer, J. A. | Int J Orthop Trauma Nurs | 2022 | |
Anesthesia and Postoperative Cognitive Impairment: Types of Knowing | Mutch, W. A. C. | Anesth Analg | 2022 |
Humans |
Delirium detection using GAMMA wave and machine learning: A pilot study | Mulkey, M. Albanese, T. Kim, S. Huang, H. Yang, B. | Res Nurs Health | 2022 |
Humans |
Cohort profile: the Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog) - a national research and quality registry with a biomaterial collection | Medbøen, I. T. Persson, K. Nåvik, M. Totland, T. H. Bergh, S. Treviño, C. S. Ulstein, I. Engedal, K. Knapskog, A. B. Brækhus, A. Øksengård, A. R. Horndalsveen, P. O. Saltvedt, I. Lyngroth, A. L. Ranhoff, A. H. Skrettingland, D. B. Naik, M. Soares, J | BMJ Open | 2022 |
Humans |
Evaluation of Suvorexant and Lemborexant for the Prevention of Delirium in Adult Critically Ill Patients at an Advanced Critical Care Center: A Single-Center, Retrospective, Observational Study | Matsuoka, A. Tobita, S. Sogawa, R. Shinada, K. Murakawa-Hirachi, T. Shimanoe, C. Monji, A. Mizoguchi, Y. Miike, T. Sakamoto, Y. | J Clin Psychiatry | 2022 |
Adult |
Managing delirium in acute inpatient units: A cross-sectional study of nursing teams' knowledge and perceived limitations | Martínez-García, M. Sánchez-López, E. Fernández-Trinidad, M. | Nurs Open | 2022 |
delirium |
Delirium prevalence, risk factors and outcomes among patients with acute stroke: A multi-centre observational study | Mansutti, I. Saiani, L. Cargnelutti, D. Petrucco, S. Giannina, V. Di Domenico, C. Passadore, P. Palese, A. | J Vasc Nurs | 2022 |
United States |
DEX, Delirium and Dilemma | Magoon, R. Mahajan, S. Jose, J. | Braz J Cardiovasc Surg | 2022 |
Cardiac Surgery |
Three key areas in progressing delirium practice and knowledge: recognition and relief of distress, new directions in delirium epidemiology and developing better research assessments | MacLullich, A. M. J. Hosie, A. Tieges, Z. Davis, D. H. J. | Age Ageing | 2022 |
Humans |
Postoperative delirium after transcatheter aortic valve replacement: An updated systematic review and meta-analysis | Ma, X. Chu, H. Han, K. Shao, Q. Yu, Y. Jia, S. Wang, D. Wang, Z. Zhou, Y. | J Am Geriatr Soc | 2022 |
incidence |
Effect of Anaesthesia Depth on Postoperative Delirium and Postoperative Cognitive Dysfunction in High-Risk Patients: A Systematic Review and Meta-Analysis | Ling, L. Yang, T. X. Lee, S. W. K. | Cureus | 2022 |
bispectral index monitoring |
Potential value of cerebrospinal fluid α-synuclein in the identification of postoperative delirium undergoing knee/hip arthroplasty: The perioperative neurocognitive disorder and biomarker lifestyle study | Lin, X. Guo, Y. Dong, R. Wang, B. Bi, Y. | Front Neurosci | 2022 |
biomarker |
Association between preoperative dementia and hospital mortality in old old patients undergoing elective gastrointestinal surgery | Li, M. Liu, M. Li, C. Zhang, G. Wei, Y. Xu, Y. Li, T. | Aging Clin Exp Res | 2022 |
Humans |
Effect of remimazolam on the incidence of delirium after transcatheter aortic valve implantation under general anesthesia: a retrospective exploratory study | Kaneko, S. Morimoto, T. Ichinomiya, T. Murata, H. Yoshitomi, O. Hara, T. | J Anesth | 2022 |
Aortic stenosis |
A survey study of delirium attitudes and knowledge among hospital medicine clinicians | Kaiksow, F. A. Gilmore-Bykovskyi, A. Golden, B. P. | J Am Geriatr Soc | 2022 | |
Mid- and Long-Term Surgical Outcomes Due to Infective Endocarditis in Elderly Patients: A Retrospective Cohort Study | Jussli-Melchers, J. Salem, M. A. Schoettler, J. Friedrich, C. Huenges, K. Elke, G. Puehler, T. Cremer, J. Haneya, A. | J Clin Med | 2022 |
cardiac surgery |
Effect of inpatient antibiotic treatment among older adults with delirium found with a positive urinalysis: a health record review | Joo, P. Grant, L. Ramsay, T. Nott, C. Zvonar, R. Jia, J. Yadav, K. Mollanji, E. He, W. Eagles, D. | BMC Geriatr | 2022 |
Humans |
Correlation Analysis of Inflammatory Markers CRP and IL-6 and Postoperative Delirium (POD) in Elderly Patients: A Meta-Analysis of Observational Studies | Huang, X. Li, L. Feng, Q. | J Environ Public Health | 2022 |
Aged |
One-year Medicare costs associated with delirium in older hospitalized patients with and without Alzheimer's disease dementia and related disorders | Hshieh, T. T. Gou, R. Y. Jones, R. N. Leslie, D. L. Marcantonio, E. R. Xu, G. Travison, T. G. Fong, T. G. Schmitt, E. M. Inouye, S. K. | Alzheimers Dement | 2022 |
Alzheimer’s dementia |
Nurses' competence in recognition and management of delirium in older patients: development and piloting of a self-assessment tool | Hoch, J. Bauer, J. M. Bizer, M. Arnold, C. Benzinger, P. | BMC Geriatr | 2022 |
Humans |
Scoping review of the use of virtual reality in intensive care units | Hill, J. E. Twamley, J. Breed, H. Kenyon, R. Casey, R. Zhang, J. Clegg, A. | Nurs Crit Care | 2022 |
Humans |
Real-time location systems technology in the care of older adults with cognitive impairment living in residential care: A scoping review | Haslam-Larmer, L. Shum, L. Chu, C. H. McGilton, K. McArthur, C. Flint, A. J. Khan, S. Iaboni, A. | Front Psychiatry | 2022 |
RTLS (Real-time location system) |
Exercise for acutely hospitalised older medical patients | Hartley, P. Keating, J. L. Jeffs, K. J. Raymond, M. J. Smith, T. O | Cochrane Database Syst Rev | 2022 |
Aged |
Predictors of hospital readmission for patients diagnosed with delirium: An electronic health record data analysis in South London | Friedrich, M. E. Perera, G. Leutgeb, L. Haardt, D. Frey, R. Stewart, R. Mueller, C. | Acta Psychiatr Scand | 2022 |
30-day readmission rates |
The impact of ABCDE bundle implementation on patient outcomes: A nationwide cohort study | Frade-Mera, M. J. Arias-Rivera, S. Zaragoza-García, I. Martí, J. D. Gallart, E. San José-Arribas, A. Velasco-Sanz, T. R. Blazquez-Martínez, E. Raurell-Torredà, M. | Nurs Crit Care | 2022 |
Adult |
Pre- and intraoperative cerebral near-infrared spectroscopy and postoperative delirium: Results of a prospective cross-sectional trial | Fischer-Kumbruch, M. Jung, C. Hinken, L. Trübenbach, D. Fielbrand, R. Schenk, I. Diegmann, O. Krauß, T. Scheinichen, D. Schultz, B. | Medicine (Baltimore) | 2022 |
Aged |
Filiatreault, S. Grimshaw, J. M. Kreindler, S. A. Chochinov, A. Linton, J. Doupe, M. B. | A critical appraisal of delirium clinical practice guidelines relevant to the care of older adults in the emergency department with a synthesis of recommendations: an umbrella review protocol | Syst Rev | 2022 |
Humans |
Delirium as late manifestation of infective endocarditis after transcatheter aortic valve implantation | Fantinati, J. Rossi, P. D. Conte, G. Cesari, M. Lucchi, T. Ciccone, S. | Age Ageing | 2022 |
Humans |
Cognitive function and delirium following sevoflurane or propofol anesthesia for valve replacement surgery: A multicenter randomized controlled trial | Duan, G. Y. Duan, Z. X. Chen, H. Chen, F. Chen, F. Du, Z. Y. Chen, L. Y. Lu, K. Z. Zuo, Z. Y. Li, H. | Kaohsiung J Med Sci | 2022 |
multicenter randomized controlled trial |
Delirium in the intensive care unit: identifying difficulties in applying the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU | Dos Santos, F. C. M. Rêgo, A. S. Montenegro, W. S. de Carvalho, Strf Cutrim, R. C. Júnior, A. A. M. Pereira, F. H. F. Dibai-Filho, A. V. Bassi-Dibai, D. | BMC Nurs | 2022 |
Intensive care units |
Aren't you forgetting something? Cognitive screening beyond delirium in the emergency department | de Moraes, G. S. Curiati, P. K. Avelino-Silva, T. J. Morinaga, C. V. Apolinário, D. Suemoto, C. K. Aliberti, M. J. R. | J Am Geriatr Soc | 2022 | |
Postoperative delirium: An independent risk factor for poorer quality of life with long-term cognitive and functional decline after cardiac surgery | de la Varga-Martínez, O. Gutiérrez-Bustillo, R. Muñoz-Moreno, M. F. López-Herrero, R. Gómez-Sánchez, E. Tamayo, E. | J Clin Anesth | 2022 |
Cardiac surgery |
Brain-penetrant calcium channel blockers are associated with a reduced incidence of neuropsychiatric disorders | Colbourne, L. Harrison, P. J. | Mol Psychiatry | 2022 |
Humans |
Gender differences in the correlation between body mass index and cognitive impairment among the community-dwelling oldest-old in China: a cross-sectional study | Chen, N. Cao, J. Zhang, W. Chen, Y. Xu, L. | BMJ Open | 2022 |
Male |
Association between preoperative on-site CCU visits and postoperative delirium in patients undergoing cardiac surgery: A retrospective cohort study | Chen, B. Wu, L. Fang, Z. Zheng, J. Dong, W. Hong, X. Jin, P. | Nurs Crit Care | 2022 |
cardiac surgery |
Language discordance in emergency department delirium screening: Results from a qualitative interview-based study | Chary, A. N. Torres, B. Brickhouse, E. Santangelo, I. Godwin, K. M. Naik, A. D. Carpenter, C. R. Liu, S. W. Kennedy, M. | J Am Geriatr Soc | 2022 | |
Impact of early mobilization on the duration of delirium in elderly hospitalized patients: A retrospective cohort pilot study | Anada, S. Iigaya, M. Takahashi, M. Soda, K. Wada, N. | Medicine (Baltimore) | 2022 |
Male |
A Recipe for Delirium: Community-Acquired Pneumonia and Sickle Cell Anemia With Moyamoya Disease | Alier, F. Santana, L. Wasey, W. Grubb, L. Satti, A. | Cureus | 2022 |
and transient ischemic attack (tia) |
Does time to surgery for traumatic hip fracture impact the efficacy of fascia iliaca blocks? A brief report | Akinola, K. Salottolo, K. Meinig, R. Fine, L. Madayag, R. M. Ekengren, F. Tanner, A., 2nd Bar-Or, D. | Trauma Surg Acute Care Open | 2022 |
delirium |
Longitudinal Profiling of Plasma Cytokines and Its Association With Postoperative Delirium in Elderly Patients Undergoing Major Lower Limb Surgery: A Prospective Observational Study | Zhang, Y. Hu, J. Zuo, W. He, P. Xue, Q. Feng, X. Zhang, Y. Maze, M. | Anesth Analg | 2023 |
Humans |
The implementation of nUrsiNg DEliRium preventive INterventions in the Intensive Care Unit (UNDERPIN-ICU): A qualitative evaluation | Tilburgs, B. Rood, P. J. T. Zegers, M. van den Boogaard, M. | Int J Nurs Stud | 2023 |
Humans |
Cardiac surgery, ICU sedation, and delirium: is dexmedetomidine the silver bullet? | Smith, W. Whitlock, E. L. | Curr Opin Anaesthesiol | 2023 |
Humans |
Inpatient GHB withdrawal management in an inner-city hospital in Sydney, Australia: a retrospective medical record review | Siefried, K. J. Freeman, G. Roberts, D. M. Lindsey, R. Rodgers, C. Ezard, N. Brett, J. | Psychopharmacology (Berl) | 2023 |
Humans |
Delirium-associated medication in people at risk: A systematic update review, meta-analyses, and GRADE-profiles | Reisinger, M. Reininghaus, E. Z. Biasi, J. Fellendorf, F. T. Schoberer, D. | Acta Psychiatr Scand | 2023 |
Adult |
Sleep quality and quantity determined by polysomnography in mechanically ventilated critically ill patients randomized to dexmedetomidine or placebo | Oxlund, J. Knudsen, T. Sörberg, M. Strøm, T. Toft, P. Jennum, P. J. | Acta Anaesthesiol Scand | 2023 |
Humans |
Falls Incidence Compared Between a Multibedded Ward Hospital and a 100% Single-Occupancy Room Hospital: An Uncontrolled Before-After Study | Hussain, F. van Dijk, M. Oudshoorn, C. Ista, E. | Herd | 2023 |
Humans |
Effectiveness of nursing intervention to reduce delirium in adult critically ill - A protocol for a randomized trial | Gómez Tovar, L. O. Henao-Castaño Á, M. | Contemp Clin Trials Commun | 2023 |
Delirium |
Variations in Clinical Practice: Assessing Clinical Care Processes According to Clinical Guidelines in a National Cohort of Hospice Patients | de Graaf, E. Grant, M. van de Baan, F. Ausems, M. Verboeket-Crul, C. Leget, C. Teunissen, S. | Am J Hosp Palliat Care | 2023 |
Humans |
Altered EEG, disrupted hippocampal long-term potentiation and neurobehavioral deficits implicate a delirium-like state in a mouse model of sepsis | Consoli, D. C. Spitznagel, B. D. Owen, B. M. Kang, H. Williams Roberson, S. Pandharipande, P. Wesley Ely, E. Nobis, W. P. Bastarache, J. A. Harrison, F. E. | Brain Behav Immun | 2023 |
Humans |
Malignant Catatonia: A Review for the Intensivist | Connell, J. Oldham, M. Pandharipande, P. Dittus, R. S. Wilson, A. Mart, M. Heckers, S. Ely, E. W. Wilson, J. E. | J Intensive Care Med | 2023 |
Humans |
Diagnostic yield of CT head in delirium and altered mental status-A systematic review and meta-analysis | Akhtar, H. Chaudhry, S. H. Bortolussi-Courval, É Hanula, R. Akhtar, A. Nauche, B. McDonald, E. G. | J Am Geriatr Soc | 2022 |
CT head |
Elevation of serum plasminogen activator inhibitor-1 predicts postoperative delirium independent of neural damage: a sequential analysis | Mietani, K. Hasegawa-Moriyama, M. Yagi, K. Inoue, R. Ogata, T. Shimojo, N. Seto, Y. Uchida, K. Sumitani, M. | Sci Rep | 2022 |
Aged |
Assessing prevalence and independent predictors of postoperative delirium in patients with head and neck cancer. Re: Crawford J E et al Postoperative delirium in patients with head and neck oral cancer in the West of Scotland. Br J Oral Maxillofac Surg 20 | McCaul, J. A. Young, D. McMahon, J. | Br J Oral Maxillofac Surg | 2022 |
*Delirium |
Preoperative homocysteine modifies the association between postoperative C-reactive protein and postoperative delirium | Ma, X. Mei, X. Tang, T. Wang, M. Wei, X. Zheng, H. Cao, J. Zheng, H. Cody, K. Xiong, L. Marcantonio, E. R. Xie, Z. Shen, Y. | Front Aging Neurosci | 2022 |
C-reactive protein |
Head Computed Tomography Findings in Geriatric Emergency Department Patients with Delirium, Altered Mental Status, and Confusion: A Systematic Review | Liu, S. W. Lee, S. Hayes, J. M. Khoujah, D. Lo, A. X. Doering, M. de Wit, K. Nickels, C. H. Kennedy, M. Eagles, D. Carpenter, C. Arendts, G. Ragsdale, L. | Acad Emerg Med | 2022 | |
Potential value of preoperative fasting blood glucose levels in the identification of postoperative delirium in non-diabetic older patients undergoing total hip replacement: The perioperative neurocognitive disorder and biomarker lifestyle study | Liu, S. Xv, L. Wu, X. Wang, F. Wang, J. Tang, X. Dong, R. Wang, B. Lin, X. Bi, Y. | Front Psychiatry | 2022 |
biomarkers |
New onset delirium prediction using machine learning and long short-term memory (LSTM) in electronic health record | Liu, S. Schlesinger, J. J. McCoy, A. B. Reese, T. J. Steitz, B. Russo, E. Koh, B. Wright, A. | J Am Med Inform Assoc | 2022 |
deep learning |
The hotspots and publication trends in postoperative delirium: A bibliometric analysis from 2000 to 2020 | Lin, X. Cao, Y. Liu, X. Yu, K. Miao, H. Li, T. | Front Aging Neurosci | 2022 |
Pod |
Donepezil treatment is associated with improved outcomes in critically ill dementia patients via a reduction in delirium | Lieberman, O. J. Lee, S. Zabinski, J. | Alzheimers Dement | 2022 |
acetylcholine |
Association of Incident Delirium With Short-term Mortality in Adults With Critical Illness Receiving Mechanical Ventilation | Li, H. C. Yeh, T. Y. Wei, Y. C. Ku, S. C. Xu, Y. J. Chen, C. C. Inouye, S. Boehm, L. M. | JAMA Netw Open | 2022 |
Adult |
A Nomogram to Predict Delirium after Hip Replacement in Elderly Patients with Femoral Neck Fractures | Li, B. Ju, J. Zhao, J. Qin, Y. Zhang, Y. | Orthop Surg | 2022 |
Femoral neck fracture |
Immunological risk factors for sepsis-associated delirium and mortality in ICU patients | Lei, W. Ren, Z. Su, J. Zheng, X. Gao, L. Xu, Y. Deng, J. Xiao, C. Sheng, S. Cheng, Y. Ma, T. Liu, Y. Wang, P. Luo, O. J. Chen, G. Wang, Z. | Front Immunol | 2022 |
Complement C3 |
Postoperative Delirium in Patients Receiving Hip Bipolar Hemiarthroplasty for Displaced Femoral Neck Fractures: The Risk Factors and Further Clinical Outcomes | Lee, D. H. Chang, C. H. Chang, C. W. Chen, Y. C. Tai, T. W. | J Arthroplasty | 2022 |
bipolar hemiarthroplasty |
Appraisal of Clinical Practice Guideline: Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU | Lang, J. | J Physiother | 2022 |
Adult |
Validation of the Korean Version of the Delirium Diagnostic Tool-Provisional (K-DDT-Pro) | Kim, K. M. Shim, M. S. Yi, D. Jeon, S. Y. Kim, J. L. | Psychiatry Investig | 2022 |
Delirium |
Trazodone and Mianserin for Delirium: A Retrospective Chart Review | Kawano, S. Ide, K. Kodama, K. Kikuchi, Y. Sugihara, H. Fujisawa, D. Uchida, H. Mimura, M. Takeuchi, H. | J Clin Psychopharmacol | 2022 | |
PAINT I: the effect of art therapy in preventing and managing delirium among hospitalized older adults in the PAINT I study-a proof-of-concept trial | Katrin, S. Masuch, J. Lim, S. Habboub, B. Gosch, M. | Eur Geriatr Med | 2022 |
Art therapy |
Building collaborative relationships with family caregivers of hospitalized older persons with delirium superimposed on dementia: A qualitative study | Julian, P. Ploeg, J. Kaasalainen, S. Markle-Reid, M. | J Adv Nurs | 2022 |
acute care |
Volatile Versus Total Intravenous Anesthesia on Postoperative Delirium in Adult Patients Undergoing Cardiac Valve Surgery: A Randomized Clinical Trial | Jiang, J. L. Zhang, L. He, L. L. Yu, H. Li, X. F. Dai, S. H. Yu, H. | Anesth Analg | 2022 | |
The Effect of Scenario-Based Learning on the Performance of Nurses Regarding Delirium in Cardiac Surgery Intensive Care Units: A Quasi-Experimental Study | Jahanbazi, A. Jokar, F. Kheirollahi, N. | Iran J Nurs Midwifery Res | 2022 |
Delirium |
Influence of cardioplegic solution on incidence of delirium after CABG surgery: Use of Calafiore blood cardioplegia versus HTK - Bretschneider - solution in a single-center retrospective analysis from 2017 to 2021 | Irqsusi, M. Loos, D. Dielmann, K. Ramzan, R. Wulf, H. Ghazy, T. Vogt, S. Rastan, A. J. | J Card Surg | 2022 |
CABG procedure |
Should neuroleptics be used in patients with delirium seen by palliative care? | Hui, D. Agar, M. Maeda, I. | J Pain Symptom Manage | 2022 |
antipsychotic agents |
Risk factors for postoperative delirium in elderly urological patients: A meta-analysis | Hua, Y. Chen, S. Xiong, X. Lin, C. Li, D. Tu, P. | Medicine (Baltimore) | 2022 |
Aged |
Successful aging after elective surgery II: Study design and methods | Hshieh, T. T. Schmitt, E. M. Fong, T. G. Arnold, S. Cavallari, M. Dickerson, B. C. Dillon, S. T. Jones, R. N. Libermann, T. A. Marcantonio, E. R. Pascual-Leone, A. Shafi, M. M. Touroutoglou, A. Travison, T. G. Gou, R. Y. Tommet, D. Abdeen, A. Earp, B. Kun | J Am Geriatr Soc | 2022 |
biomarkers |
Overestimation of the Causal Effects of Medications on Delirium During Postoperative Hospital Days | Hindman, B. J. Dexter, F. | Anesth Analg | 2022 |
Humans |
A new medication-based prediction score for postoperative delirium in surgical patients: Development and proof of feasibility in a retrospective patient cohort | Hindelang, V. Dimitriadis, K. Saller, T. Golla, K. Mannell, H. Hug, M. J. Strobach, D. | Pharmazie | 2022 |
Humans |
Forecasting Postoperative Delirium in Older Adult Patients with Fast-and-Frugal Decision Trees | Heinrich, M. Woike, J. K. Spies, C. D. Wegwarth, O. | J Clin Med | 2022 |
clinical data prediction |
Association of Delirium Incidence with Visitation Restrictions due to COVID-19 Pandemic in Patients with Acute Cerebrovascular Disease in a Stroke-Unit Setting: A Retrospective Cohort Study | Hahn, M. Gröschel, S. Gröschel, K. Uphaus, T. | Gerontology | 2022 |
COVID-19 pandemic |
Nurses' assessment of subsyndromal delirium and barriers to assessment: A cross-sectional survey in the intensive care unit | Gao, Y. Zhang, C. Liao, C. Gan, X. | J Nurs Manag | 2022 |
barriers |
Anxiety as a Risk Factor for Postoperative Delirium in Elective Spine Deformity Surgeries: A National Database Study | Freedman, Z. Hudock, N. Hallan, D. R. Kelleher, J. | Cureus | 2022 |
anxiety |
Presurgical diffusion metrics of the thalamus and thalamic nuclei in postoperative delirium: A prospective two-centre cohort study in older patients | Fislage, M. Winzeck, S. Stamatakis, E. Correia, M. M. Preller, J. Feinkohl, I. Spies, C. D. Hendrikse, J. J. C. Slooter A Winterer, G. Pischon, T. Menon, D. K. Zacharias, N. | Neuroimage Clin | 2022 |
Diffusion kurtosis imaging |
Long-Term Intensive Care Unit (ICU) Stays Can Lead to Long-Term Cognitive Impairment (LTCI): Neurosurgery Nursing Strategies to Minimize Risk | Fiani, B. Figueras, R. A. Samones, P. Lee, C. Castillo, A. Sangalang, B. Garcia Perez, F. | Cureus | 2022 |
cognitive impairment |
Future without delirium: not quite there yet but we can start by prescribing touch | Fernandes, S. M. Adão-Serrano, M. Rodrigues, A. R. Belo, P. | Crit Care | 2022 |
Humans |
Using Music for the Prevention of Delirium in Patients After Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial | Esfahanian, F. Mirmohammadsadeghi, A. Gholami, H. Neshat, S. Mansouri, M. Sadeghi, M. Bathaie, S. R. Heidari, Z. Mirmohammadsadeghi, M. | J Cardiothorac Vasc Anesth | 2022 |
clinical trial |
The association of chronic pain and postoperative delirium: a prospective observational cohort study | Eckert, S. C. Spies, C. D. Mörgeli, R. Kruppa, J. Heinrich, M. | Minerva Anestesiol | 2022 |