Delirium: a guide for the general physician

Todd, Oliver; Teale, Elizabeth

doi:10.7861/clinmedicine.17-1-48

Cited by 11 publications

(12 citation statements)

References 28 publications

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“…No screening of ongoing research protocols was performed and although the method used was based on a systematic review process, some studies could have been missed. The multifactorial model of delirium already documented, identifying predisposing and precipitating triggers, 2,79 has been used to categorise factors associated with delirium, thus using mainly a conservative-deductive approach. Moreover, according to the nature of scoping reviews, which are substantially used to map the research available, the studies included were not evaluated for their methodological quality, as suggested by Moja et al 80…”

Section: Limitationsmentioning

confidence: 99%

Delirium in patients with ischaemic and haemorrhagic stroke: findings from a scoping review

Mansutti

Saiani

Palese

2019

European Journal of Cardiovascular Nursing

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Background: Delirium is a complex syndrome characterised by disturbances in attention and awareness, associated with alterations in cognitive functions, which can emerge in a time frame of hours or days and tend to fluctuate in severity over time. Delirium is a clinical manifestation of the brain’s vulnerability and diminished resilience to insult. Stroke patients are particularly vulnerable to delirium episodes. Aims: The aim of this study was to map: (a) studies focused on ischaemic or haemorrhagic post-stroke delirium; (b) factors that have been investigated as being possibly associated with post-stroke delirium; and (c) outcomes that have been studied to date. Methods: A scoping review was performed. Medline, CINAHL, Cochrane Database of Systematic Reviews, PsycINFO and Scopus databases were searched. Eligible studies were those: (a) exploring any variable regarding delirium in patients with stroke; (b) involving adults; (c) as primary studies; (d) written in English; and (e) published before April 2017. Results: To date 25 studies have been published, mainly prospective or cohort studies. The most commonly studied predisposing factors have been the older age, gender, aetiology of the stroke and its location, and the presence of previous cognitive decline/dementia. The most studied precipitating factors to date have been pneumonia, urinary tract infections and symptoms of neglect. Functional dependence, length of inhospital stays, post-stroke cognitive impairments or dementia, short and long-term mortality have been the most studied post-stroke delirium outcomes. Conclusions: Studies across different clinical settings, also at the international level, including more female patients and a wider range of ages should be designed in order to improve the evidence available to develop specific clinical guidelines. Standardised frameworks of research addressing the great variability of methods and measures used in the field should be established at the international level by clinicians and researchers’ experts in the field.

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Section: Limitationsmentioning

confidence: 99%

Delirium in patients with ischaemic and haemorrhagic stroke: findings from a scoping review

Mansutti

Saiani

Palese

2019

European Journal of Cardiovascular Nursing

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“…Over the age of 80 years, more than one third of those in hospital will experience delirium. 2 The cause of delirium is typically multifactorial. In fact, the development of delirium involves the complex interrelationship between a vulnerable patient (with a predisposing factor) and exposure to precipitating factors or noxious insults.…”

Section: Introductionmentioning

confidence: 99%

“…And precipitating factors such as: Drugs, primary neurologic diseases, infections, severe acute illness, dehydratation, surgery, use of physical restraints, use of catheters. [1][2][3]…”

Section: Introductionmentioning

confidence: 99%

Non-pharmacological management for delirium

Páramo¹

2018

MOJGG

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Delirium is an acute attention and cognitive disorder, frequently presented in the elderly by multifactorial causes, which has a serious impact on mortality, health costs and quality of life.1 Non-pharmacological measures are the standard of prevention and treatment of delirium. This approaches such as HELP (Hospital Elder Life Program) include cognitive stimulation techniques, however, we have observed in our Hospital, that the "Day Room", based on Snoezelen sensory stimulation theory, improves delirium severity. This article describes a clinical case of a female geariatric patient with delirium, whom receives both programs (HELP and Snoezelen), where we observed a decrease on delirium severity scales. For the above, we can conclude that "Day Room" might be a very useful non-pharmacological instrument on patients with delirium, so we should do comparative research that sustains clinical efficacy.

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“…1 It would seem at long last there is a plan to simplify the greatly criticised 'tick-box approach' to medical training. This is hardly a new idea and this progress has been greatly hampered and delayed by the Joint Royal Colleges of Physicians Training Board (JRCPTB) themselves.…”

Section: The New Uk Internal Medicine Curriculummentioning

confidence: 99%