Contributed by Michele Cavallari, MD, PhD, Center for Neurological Imaging, Brigham and Women’s Hospital; Harvard Medical School; and Marcus Institute for Aging Research, Hebrew SeniorLife; Boston, MA. Rationale and Objective Postoperative delirium is a common acute confusional state, affecting up to half of older surgical patients [1] and is an established independent risk factor for […]
Category Archives: Delirium Research
Performance and Validation of Two ICU Delirium Assessment and Severity Tools: A Prospective Observational Study
Contributed by Mark van den Boogaard, RN, PhD, Radboud University Medical Center, Nijmegen, the Netherlands Background Delirium is common in intensive care unit (ICU) and medium care unit (MCU) settings 1, 2 and associated with number of deleterious short and long-term outcomes, including long-term cognitive impairment. Current guidelines recommend that ICU/MCU patients should be routinely […]
Prevention of postoperative delirium using an overnight infusion of dexmedetomidine in patients undergoing cardiac surgery: A pragmatic, randomized, double blind, placebo-controlled trial
Contributed by Olivier Huet, MD, PhD, Université de Bretagne Occidentale, Brest, France. Background Postoperative delirium is acknowledged to have a significant negative impact on patient outcome after cardiac surgery including long-term cognitive decline. To date, there is no specific treatment for postoperative delirium 1. Prevention of postoperative delirium primarily relies on patient re-orientation, mobility and […]
Do Language Disparities Exist in Preoperative Cognitive Screening and Does Language Preference Influence the Association Between Preoperative Cognition and Postoperative Delirium?
Contributed by Angela Chen, BA1, 2; Robert Whittington, MD1; Cecilia Canales, MD, MPH1. 1. Department of Anesthesiology and Perioperative Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA. 2. Chicago Medical School, Rosalind Franklin University of Medicine & Science, North Chicago, IL, USA Background Older adults are highly vulnerable to postoperative delirium, particularly […]
Prevalence of clinical electroencephalography findings in stroke patients with delirium
Contributed by Noa Mintz, ScB, Brown University, Providence, RI and Michael Reznik, MD, Department of Critical Care Medicine & Neurology, University of Pittsburgh, Pittsburgh, PA Background Patients with acute stroke are at a high risk for delirium, which may occur in up to half of cases depending on the type of stroke.1–4 However, post-stroke delirium […]
Anesthesia Choice for Cognitively Impaired Patients Undergoing Hip Fracture Surgery
Contributed by Kyra O’Brien MD and Mark Neuman MD MSc, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA Background The impact of general anesthesia on postoperative outcomes in patients with cognitive impairment is often debated. Some have posited that general anesthesia may have neurotoxic effects and therefore increase the risk of postoperative delirium and […]
Comparison of the frailty index and frailty phenotype and their associations with postoperative delirium incidence and severity
Stacie Deiner MS MD, LeRoy Garth Professor and Vice Chair for Research, Department of Anesthesiology, Dartmouth University Medical School, Hanover, NH Studies show that preoperative frailty is associated with up to six times the odds of postoperative delirium, depending on which frailty measurement tool is used.1,2 There are two distinct paradigms of frailty measurement, Frailty […]
Perioperative Neurocognitive Disorders and Putative Biomarkers
Contributed by Phillipe E. Vlisides, MD, Department of Anesthesiology, University of Michigan Medicine, Ann Arbor, MI Background Perioperative neurocognitive disorders represent a major public health issue, particularly among aging surgical populations. In fact, the American Society of Anesthesiologists has launched a Brain Health Initiative with the aim of protecting and preserving brain health in older […]
The Delirium Interview: a new reference standard for large studies evaluating delirium assessment tools
Contributed by Fienke L. Ditzel, MD; Arjen J. C. Slooter MD, PhD; and Suzanne C.A. Hut, PhD, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands Rationale The gold standard for diagnosing delirium is the classification by a delirium expert based on the DSM-5(TR) criteria.1,2 When validating a new delirium assessment tool, ideally, a panel […]
Sleep Fragmentation, EEG Slowing and Circadian Disarray in a Mouse Model for Intensive Care Unit Delirium
Contributed by Nadia Lunardi, M.D., Ph.D., Associate Professor of Anesthesiology and Critical Care, University of Virginia and Michal Jedrusiak, M.D., Visiting Graduate Student, Anesthesiology Department, University of Virginia Introduction In 2020, our research group introduced a novel mouse model designed to investigate postoperative delirium.1 This model aimed to emulate the combination of surgical stress, anesthetic […]