Delirium in hospitalized older adults

Rieck, Katie M.; Pagali, Sandeep R.; Miller, Donna

doi:10.1080/21548331.2019.1709359

Cited by 60 publications

(59 citation statements)

References 106 publications

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“…The progress of basic research and clinical research in recent years has shown that interventions for such patients are extremely important. Dynamic observation and accurate and effective treatment must be adopted to reduce the mortality rate (15,16). The S100B protein is an acidic calcium-binding protein, which is mainly found in astrocytes and oligodendrocytes of the central nervous system, and Schwann cells of the peripheral nervous system.…”

Section: Discussionmentioning

confidence: 99%

Levels of S100 calcium binding protein B (S100B), neuron-specific enolase (NSE), and cyclophilin A (CypA) in the serum of patients with severe craniocerebral injury and multiple injuries combined with delirium transferred from the ICU and their prognostic value

Gao¹,

Duan²,

Ji³

et al. 2021

Ann Palliat Med

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Background:To analyze the levels of S100 calcium binding protein B (S100B), neuron-specific enolase (NSE), and cyclophilin A (CypA) in the serum of patients with severe craniocerebral injury combined with delirium and multiple injuries transferred from the intensive care unit (ICU), and their prognostic value. Methods:The data of 98 patients with severe craniocerebral injury combined with delirium and multiple injuries admitted to our hospital from January 2018 to May 2019 were retrospectively analyzed as the study group. The differences in serum S100B, NSE, and CypA levels in each group were compared, and the deaths of the study group during follow-up were counted.Results: The levels of S100B, NSE, and CypA in the study group were higher than those in the control group (P<0.05). The mortality rate of the 98 patients with severe craniocerebral injury combined with delirium and multiple injuries transferred from the ICU was 37.76%. Furthermore, the levels of S100B, NSE, and CypA in the death group were higher than those in the survival group (P<0.05). Glasgow Coma Score (GCS) score ≤5 points, Injury Severity Score (ISS) score >25 points, multiple organ dysfunction syndrome, and increased levels of S100B, NSE, and CypA were independent risk factors that affected the prognosis of patients with severe craniocerebral injury combined with delirium and multiple injuries transferred from the ICU (P<0.05). The average survival times of the high S100B level group, the high NSE level group, and the high CypA level group were shorter than those of the low-level groups (P<0.05). Conclusions:The levels of S100B, NSE, and CypA in serum were closely related to the prognosis of patients with severe craniocerebral injury combined with delirium and multiple injuries transferred from the ICU. They can be used as molecular markers for predicting the prognosis of patients, and may serve as potential targets for treatment.

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Section: Discussionmentioning

confidence: 99%

Levels of S100 calcium binding protein B (S100B), neuron-specific enolase (NSE), and cyclophilin A (CypA) in the serum of patients with severe craniocerebral injury and multiple injuries combined with delirium transferred from the ICU and their prognostic value

Gao¹,

Duan²,

Ji³

et al. 2021

Ann Palliat Med

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“…The studies included in this review show that patients with COVID-19 presented neurological manifestations that include the central and peripheral nervous system, since it causes hypogeusia, anosmia, cerebrovascular disease, headache, altered state of consciousness, and neuropathy (Mimenza-Alvarado et al, 2020). It is considered that delirium could be an early manifestation in OA with this disease, so it is important to identify it routinely, since inadequate or delayed diagnosis is associated with greater morbidity and mortality (Rieck et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Regarding dosage, antipsychotics should be started at low doses on a daytime basis, as needed and according to the severity of the patient's symptoms. Conversely, if frequent doses are required, they should be gradually increased and modified according to the clinical evolution of the patient, reserving the daytime dose for use as required (Rieck, Pagali, & Miller, 2020). Benzodiazepines are generally considered a poor option for delirium treatment.…”

Section: Interventions Non-pharmacological Managementmentioning

confidence: 99%

Prevention, diagnosis, and treatment of delirium in older adults with COVID-19. Literature review

et al. 2020

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Background. COVID-19 affects several systems in the body, including the central nervous system (CNS), expressed in the form of headaches, hyposmia, cerebrovascular disease, and neuropathy. Older Adults (OA) are vulnerable to this infection, and may also present delirium, which may be the result of the virus directly affecting the CNS or of systemic inflammation during infection. Objective. To determine the clinical characteristics, risk factors, pathophysiology, treatment measures, and prevention of delirium associated with COVID-19 from a review of the literature in times of the SARS-CoV-2 pandemic. Method. A search was conducted in PubMed, SciELO, UpToDate, and Medscape using keywords in English and Spanish. Results. Seventy-two articles were reviewed. We analyzed inclusion and exclusion criteria and 43 articles with relevant information for the narrative description of the review were selected. Twenty to thirty per cent of the COVID-19 patients will present or develop delirium, or changes in mental status during their hospitalization, with rates of 60% to 70% in severe illness. The exact mechanisms are likely to be multifactorial. There is a worrying lack of attention to the implications of identifying and managing delirium in the response to this pandemic. Discussion and conclusion. Delirium is a frequent neurological manifestation in OA with COVID-19 and requires early identification, as well as the implementation of non-pharmacological and pharmacological treatment strategies, which may reduce the associated morbidity and mortality in this age group.

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“…29 Smoking and atherosclerotic vascular disorders also play a role in the development of delirium. 30 Typical risk factors for delirium include dementia and infectious complications. 31 Dementia, for instance, increases the risk of developing delirium six times, while with benzodiazepine, the change of delirium occurring is just three times higher.…”

mentioning

confidence: 99%

Diagnosis and Risk Factors for Delirium in Elderly Patients in the Emergency Rooms and Intensive Care Unit of the National Geriatric Hospital Emergency Department: A Cross-Sectional Observational Study

Tran¹,

Hoang²,

Ho³

2021

IJGM

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Purpose: To diagnose delirium and identify risk factors for its development in elderly patients in the emergency department (ED) and intensive care units (ICU) at the National Geriatric Hospital (Vietnam). Patients and Methods: A cross-sectional observational study was conducted with a convenience sample of non-surgical patients admitted to ED and ICU at Hanoi National Geriatric Hospital in Vietnam. In total, 163 patients met the selection criteria and were included in the study. Screening involved using the Confusion Assessment Method (CAM) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). The diagnosis was established according to the DSM-5 and ICD-10 codes. Results: Delirium was found in a total of 106 (63.1%) patients. The factors significantly affecting its development were vision impairment (OR, 3.3; 95% CI, 1.5 to 7.4, P=0.003), hearing impairment (OR, 3.6; 95% CI, 1.77 to 7.36, P=0.0001), acute or chronic kidney failure (OR, 7.1; 95% CI, 2.05 to 6.39, P<0.001), respiratory disorders (OR, 2.7; 95% CI, 1.4 to 5.2, P=0.004), and malnutrition (OR, 9.17; 95% CI, 3.43-24.5, P=0.0001). The list also include the fall risk factors (OR, 12.2; 95% CI, 4.1-36.3, P=0.0001), frailty (OR, 8.35; 95% CI, P=0.0001), activities of daily living (OR, 8.35; 95% CI,, P=0.0001), hyponatremia (OR, 2.48; 95% CI, 1.07 to 5.75, P=0.001), hypernatremia (OR, 13.1; 95% CI, 1.67 to 2.5, P=0.001), and treatment interventions. In addition, delirium was linked to the duration of ICU admission (OR, 6.53; 95% CI, 4.5-25.5, P < 0.0001). Conclusion:The CAM/CAM-ICU diagnostic algorithm makes it possible to diagnose delirium successfully. The present study confirmed the role of several premorbid and triggering factors in the occurrence of delirium in elderly patients in ED and ICU. There is a need for further research into risk factors for delirium in elderly patients.

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Delirium in hospitalized older adults

Cited by 60 publications

References 106 publications

Levels of S100 calcium binding protein B (S100B), neuron-specific enolase (NSE), and cyclophilin A (CypA) in the serum of patients with severe craniocerebral injury and multiple injuries combined with delirium transferred from the ICU and their prognostic value

Levels of S100 calcium binding protein B (S100B), neuron-specific enolase (NSE), and cyclophilin A (CypA) in the serum of patients with severe craniocerebral injury and multiple injuries combined with delirium transferred from the ICU and their prognostic value

Prevention, diagnosis, and treatment of delirium in older adults with COVID-19. Literature review

Diagnosis and Risk Factors for Delirium in Elderly Patients in the Emergency Rooms and Intensive Care Unit of the National Geriatric Hospital Emergency Department: A Cross-Sectional Observational Study

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