Predictors and outcomes of delirium

Minden, Sarah L.; Carbone, Lisa; Barsky, Arthur J.; Borus, Jonathan F.; Fife, Alison; Fricchione, Gregory L.; Orav, E. John

doi:10.1016/j.genhosppsych.2004.12.004

Cited by 70 publications

(55 citation statements)

References 46 publications

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“…As the management of surgical and systemic postoperative complications in these patients is a challenge, the postoperative course may further be complicated by delirium. [4][5][6][7] Specific research has been performed to describe and understand the risk factors that favor the development of a postoperative delirium. Known risk factors include poor preoperative functional status, cognitive impairment, depression, alcoholism, vascular disease, comorbidity, and older age.…”

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confidence: 99%

Postoperative Course After Emergency Colorectal Surgery for Secondary Peritonitis in the Elderly Is Often Complicated by Delirium

Engelberger

Zürcher

Schuld

et al. 2012

International Surgery

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Postoperative delirium, morbidity, and mortality in our elderly patients with secondary perionitis of colorectal origin is described. This is a chart-based retrospective analysis of 63 patients who were operated on at the University Hospital Basel from April 2001 to May 2004. Postoperative delirium occurred in 33%. Overall morbidity was 71.4%. Surgery-related morbidity was 43.4%. Mortality was 14.4%. There was no statistical significance between delirium, morbidity and mortality (P = 0.279 and P = 0.364). There was no statistically significant correlation between the analyzed scores (American Society of Anesthesiologists classification, Mannheimer Peritonitis Index, Acute Physiology and Chronic Health Evaluation score II, physiological and operative surgical severity and enumeration of morbidity and mortality score' or short 'cr-POSSUM') and postoperative delirium, morbidity or mortality. Postoperative delirium occurred in one-third of the patients, who seem to have a trend to higher morbidity. Even if the different scores already had proven to be predictive in terms of morbidity and mortality, they do not help the risk stratification of postoperative delirium, morbidity, or mortality in our collective population.

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confidence: 99%

Postoperative Course After Emergency Colorectal Surgery for Secondary Peritonitis in the Elderly Is Often Complicated by Delirium

Engelberger

Zürcher

Schuld

et al. 2012

International Surgery

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“…[3][4][5][6] Studies have used different cutoff scores for the Mini-Mental State Examination (MMSE), or changes in the MMSE score, to predict delirium. Regarding the MCI, only a few studies have evaluated this condition using a validated measurement tool.…”

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High Incidence of Preoperative Mild Cognitive Impairment in Elderly Surgical Patients

Newman

Cummings²,

Chertkow³

et al. 2014

CJGIM

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“…Acute delirium is therefore typically under reported (Kales, Kamholz, Visnic & Blow, 2003, Minden et al, 2005. Regardless, acute delirium is clearly understood as a serious health condition.…”

Section: Introductionmentioning

confidence: 99%

“…This includes a history of depression or alcohol use, hypoxia, prior cognitive impairment, dementia, stress, advanced age, untreated pain, polypharmacy, sleep deprivation, major trauma, electrolyte or acid-base imbalances, and near death states. Pre-admission screening is recommended to identify at-risk people and thus help prevent acute delirium or enable its early treatment (Minden et al, 2005). Regardless, most literature has focused on the medical care of patients after they exhibit acute delirium.…”

Section: Introductionmentioning

confidence: 99%

“…Dementia, senility, mood disorders, and functional psychoses are often diagnosed instead of acute delirium (Meagher, 2001). Many different precipitating factors for acute delirium have been identified to date (Minden et al, 2005). This includes a history of depression or alcohol use, hypoxia, prior cognitive impairment, dementia, stress, advanced age, untreated pain, polypharmacy, sleep deprivation, major trauma, electrolyte or acid-base imbalances, and near death states.…”

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Nursing Practices to Detect Acute Delirium, Safeguard Patients Experiencing Acute Delirium, and Help Reduce or Eliminate Acute Delirium

Wilson¹,

Low²,

Thurston³

et al. 2010

GJHS

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Acute delirium is very common among hospital patients, particularly older patients. Nurses have a major role in the care of these patients, yet there are no evidence-based nursing care guidelines to help nurses detect patients who are experiencing acute delirium, safeguard them, and assist their recovery. This study sought to identify and prioritize nursing practices for detecting these patients, safeguarding them, and assisting their recovery from acute delirium. A two-stage voluntary paper Delphi survey was used for this purpose. This study targeted all nurses who worked on adult medical/surgical units at two full-service acute care hospitals in Western Canada Global Journal of Health Science www.ccsenet.org/gjhs 82 who had cared for a patient diagnosed with acute delirium in the past 12 months. The first survey revealed many nursing practices exist to detect, safeguard, and assist recovery. The second revealed one preferred practice and four others for each of the following: Detecting acute delirium, safeguarding patients, and helping patients recover. Research is now needed to establish if these constitute "best practice" nursing care for enhanced patient outcomes.Keywords: Acute delirium, Confusion, Delphi technique, Hospital care, Nursing practice, Survey Acute delirium is common among hospital patients, although it is often unrecognized or misdiagnosed (Morandi et al., 2009). Acute delirium is therefore typically under reported (Kales, Kamholz, Visnic & Blow, 2003, Minden et al., 2005. Regardless, acute delirium is clearly understood as a serious health condition. It is associated with prolonged hospital stays, long-standing (if not permanent) cognitive impairment, high risk of nursing home admission, and death (Gonzalez et al., 2009;MacLullich, Beaglehole, Hall & Meagher, 2009). Many studies have sought to identify the incidence or prevalence of acute delirium, its many causes, and its medical management. Few studies have focused on the nursing perspective, yet nurses are the most likely healthcare professional to detect patients who are experiencing acute delirium. Nurses are also responsible for planning and managing the day-to-day care of these patients with a need to be kept safe and a need for nursing care that will help them recover.No studies were found through a systematic review of acute delirium research that reveal how nurses identify patients who are experiencing acute delirium, what they do to safeguard these patients, and what they do to help them recover. This research gap lends credence to the assertion of Rapp, Mentes, and Titler (2001) that over half of all nursing care that is considered "appropriate" practice is not evidence based. The need for nurse researchers to focus on acute delirium was pointed out many years ago. In 1996, Meagher, O'Hanlon, O'Mahony, and Casey emphasized the importance of early nursing identification of patients who are confused, as well as the need for best-practice nursing care for patients who are suffering from acute delirium. This lack of nursing r...

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Predictors and outcomes of delirium

Cited by 70 publications

References 46 publications

Postoperative Course After Emergency Colorectal Surgery for Secondary Peritonitis in the Elderly Is Often Complicated by Delirium

Postoperative Course After Emergency Colorectal Surgery for Secondary Peritonitis in the Elderly Is Often Complicated by Delirium

High Incidence of Preoperative Mild Cognitive Impairment in Elderly Surgical Patients

Nursing Practices to Detect Acute Delirium, Safeguard Patients Experiencing Acute Delirium, and Help Reduce or Eliminate Acute Delirium

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