Delir bei Demenz

Kratz, Torsten

doi:10.1007/s00391-007-0435-5

Cited by 15 publications

(5 citation statements)

References 23 publications

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“…Eine neuere placebokontrollierte Pilot-Studie [87] [92]. Der Einsatz einer "Delirschwester" als besonders geschultes Personal wird als günstig beschrieben [93]. Umfassende Übersichtsarbeiten präsentieren und vergleichen zahlreiche Skalen miteinander [94,95].…”

Section: Cholinesterase-inhibitorenunclassified

Delir bei Demenz

Siafarikas

Preuß²

2014

Fortschr Neurol Psychiatr

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Delirium and dementia as organically caused mental disorders exhibit similarities in the clinical and neurological sense and often occur together. The existence of one appears to increase the risk for the development of the other. Although delirium is a very common disorder especially among the elderly, it is often not recognized. For the diagnosis of delirium, an exact family and case history including medication, clinical examination and determination of routine laboratory values are not infrequently necessary. Causal treatment of delirium is possible and not necessarily complicated. Both non-medicative and medicative measures are available for the symptomatic treatment. The non-medicative measures are to a large extent applied by nursing staff and comprise, among others, orientation guidance and attaining a balance between perceptual overload and deprivation. A good knowledge of symptomatology is decisive, also from the prevention point of view (nurses specialized in delirium). For symptomatic medicative treatment neuroleptic agents appear to be favorable. With regard to extrapyramidal side effects atypical neuroleptics are better than the typical ones. The use of cholinesterase inhibitors is not robustly supported by the literature. The use of benzodiazepines is rather discouraged except for the treatment of withdrawal delirium. Preparations with short half-lives and absence of active metabolites can be used as accompanying measures for a short time. Prevention appears to be extremely important for which the treating personnel require a good knowledge of risk factors and their management. The occurrence of delirium among cases of alpha-synucleinopathies represents a special case. Both international and German guidelines on the management of delirium are available.

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Section: Cholinesterase-inhibitorenunclassified

Delir bei Demenz

Siafarikas

Preuß²

2014

Fortschr Neurol Psychiatr

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“…Es sollteb edacht werden, dassD elirienn icht nur in der oben beschriebenen Weise als unruhige, produktiv-psychotische Syndrome imponieren können, sondern auch alshypoaktive Delirienmit Apathie, Sprachverarmung auftreten können, die leiderhäufig als "gehemmt depressive Verstimmungszustände" fehldiagnostiziert werden. Auch diese Delirienmüssen erkanntund psychiatrisch behandeltwerden, da es sich um psychiatrische Notfällehandelt (14).…”

Section: Hirnorganischestörungen -Das Delir Allgemeinesunclassified

Konsiliar- und Liaisonpsychiatrie im Allgemeinkrankenhaus

Bartels¹,

Burian²,

Diefenbacher³

et al. 2009

Die Psychiatrie

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ZusammenfassungSomatische Erkrankungen werden häufig von psychischen Symptomen und Verhaltensauffälligkeiten begleitet. Andererseits weisen viele körperliche Beschwerden auch auf das Vorliegen einer larvierten psychischen Erkrankung hin. Aus diesem Grund hat in den letzten Jahren die Bedeutung der Konsiliarpsychiatrie und Psychotherapie am Allgemeinkrankenhaus deutlich zugenommen. Der vorliegende Artikel gibt einen Überblick über die Aufgaben und die Organisation der Konsiliarpsychiatrie am Allgemeinkrankenhaus. Besonderer Aspekt wird auf die Bedeutung der Konsiliarpsychiatrie für die Arbeit des somatisch tätigen Arztes gelegt. Es sollten Probleme, Arbeitsfelder und Chancen der Konsiliarpsychiatrie am Allgemeinkrankenhaus aufgezeigt werden.

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“…This represents a dangerous gap in the treatment concept for patients who are at high risk of developing POD. 24 25 When applied thoroughly, the antidelirium bundle measures can improve the short-term and long-term outcome of elderly patients. An optimised treatment pathway for POD is shown in figure 1 .…”

Section: Introductionmentioning

confidence: 99%

Quality contract ‘prevention of postoperative delirium in the care of elderly patients’ study protocol: a non-randomised, pre–post, monocentric, prospective trial

Yürek

Zimmermann²,

Weidner

et al. 2023

BMJ Open

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IntroductionPostoperative delirium (POD) is seen in approximately 15% of elderly patients and is related to poorer outcomes. In 2017, the Federal Joint Committee (Gemeinsamer Bundesausschuss) introduced a ‘quality contract’ (QC) as a new instrument to improve healthcare in Germany. One of the four areas for improvement of in-patient care is the ‘Prevention of POD in the care of elderly patients’ (QC-POD), as a means to reduce the risk of developing POD and its complications.The Institute for Quality Assurance and Transparency in Health Care identified gaps in the in-patient care of elderly patients related to the prevention, screening and treatment of POD, as required by consensus-based and evidence-based delirium guidelines. This paper introduces the QC-POD protocol, which aims to implement these guidelines into the clinical routine. There is an urgent need for well-structured, standardised and interdisciplinary pathways that enable the reliable screening and treatment of POD. Along with effective preventive measures, these concepts have a considerable potential to improve the care of elderly patients.Methods and analysisThe QC-POD study is a non-randomised, pre–post, monocentric, prospective trial with an interventional concept following a baseline control period. The QC-POD trial was initiated on 1 April 2020 between Charité-Universitätsmedizin Berlin and the German health insurance company BARMER and will end on 30 June 2023. Inclusion criteria: patients 70 years of age or older that are scheduled for a surgical procedure requiring anaesthesia and insurance with the QC partner (BARMER). Exclusion criteria included patients with a language barrier, moribund patients and those unwilling or unable to provide informed consent. The QC-POD protocol provides perioperative intervention at least two times per day, with delirium screening and non-pharmacological preventive measures.Ethics and disseminationThis protocol was approved by the ethics committee of the Charité-Universitätsmedizin, Berlin, Germany (EA1/054/20). The results will be published in a peer-reviewed scientific journal and presented at national and international conferences.Trial registration numberNCT04355195.

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Delir bei Demenz

Cited by 15 publications

References 23 publications

Delir bei Demenz

Delir bei Demenz

Konsiliar- und Liaisonpsychiatrie im Allgemeinkrankenhaus

Quality contract ‘prevention of postoperative delirium in the care of elderly patients’ study protocol: a non-randomised, pre–post, monocentric, prospective trial

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