Delirium Bibliography

The searchable delirium bibliography page is one of our most popular features, allowing you to quickly gain access to the literature on delirium and acute care of older persons.  The HELP team keeps it updated for you on a monthly basis!  Feel free to search by author, title, keywords. It is primarily intended for clinicians and researchers interested in exploring these topics.

Each article is indexed by keywords taken from MEDLINE and other relevant databases.

You may base your search on as many search terms as you like. A search term can be a keyword, an author's name, all or part of an article's title, or any word or phrase that you might expect to find in an article's abstract. You may then indicate whether you would like to limit the search to one or more options.

The results are prioritized so that entries including all search terms will be listed first, but you can indicate whether to then sort by title (the default), by author, by journal name or by publication year.

You may further restrict to a topic category. Note: If you do not enter any search terms, the results will include all of the entries for the selected topic category.

More information about each entry on this page is available by moving the mouse over the green information symbols.

Please note that Pub Med Central (PMC) full text links are provided wherever available.  However, due to copyright restrictions, only abstracts can be provided for articles not available in PMC.

Total Results: 3105

  • Prospective, multi-centric benchmark study assessing delirium: prevalence, incidence and its correlates in hospitalized elderly Lebanese patients. 2019 Zrour, C. Haddad, R. Zoghbi, M. Kharsa, Z. Hijazi, M. Naja, W.. Aging Clin Exp Res,
    • Title

      Prospective, multi-centric benchmark study assessing delirium: prevalence, incidence and its correlates in hospitalized elderly Lebanese patients.

    • Authors
      Zrour, C. Haddad, R. Zoghbi, M. Kharsa, Z. Hijazi, M. Naja, W.
    • Year
      2019
    • Journal
      Aging Clin Exp Res
    • URL
    • Abstract
      BACKGROUND: With the increase in the proportion of elderly Lebanese patients, little is known about delirium's prevalence, incidence and correlated factors. AIMS: To identify the prevalence, incidence and factors associated with overall and incident delirium in hospitalized elderly Lebanese patients. METHODS: A convenient sample was recruited from three university hospitals affiliated to the Lebanese university faculty of medical sciences. We included patients aged more than 65 years. Baseline factors were examined upon presentation and the confusion assessment method (CAM) was used to detect prevalent delirium upon admission or within the first 48 h. Enrolled patients were then assessed every other day to detect incident delirium cases. RESULTS: Among the 230 patients included, delirium prevalence was 17% and incidence 8.7%. We found that a history of falls (odds ratio (OR) = 5.12; p = 0.001), immobilization (OR = 7.33; p = 0.035), polypharmacy (OR = 5.07; p = 0.026) along with tachycardia (OR = 6.94; p = 0.03) and severe anemia (OR = 12.5; p = 0.005) upon admission were significant factors associated with overall delirium (incident and prevalent delirium cases). Whereas, living alone was significantly associated with lower odds for overall delirium (OR = 0.03; p = 0.02). Moreover, current smoking (OR = 14; p = 0.02), low oxygen saturation (OR = 9.6; p = 0.008) and severe anemia (OR = 8.4; p = 0.013) upon admission remained significantly associated with higher odds for incident delirium along with urine catheter placement (OR = 7.8; p = 0.015). CONCLUSION: Secondary to the burden of delirium and its impact on mortality among elderly population, trying to understand and adjust modifiable factors would promote more appropriate prevention strategies.
    • PubMed ID
  • Prognostic Impact of Postoperative Complications on Overall Survival in 287 Patients With Oral Cancer: A Retrospective Single-Institution Study. 2019 Zhang, C. Xi, M. Y. Zeng, J. Li, Y. Yu, C.. Journal of Oral and Maxillofacial Surgery, 77:7 (1471-9)
    • Title

      Prognostic Impact of Postoperative Complications on Overall Survival in 287 Patients With Oral Cancer: A Retrospective Single-Institution Study.

    • Authors
      Zhang, C. Xi, M. Y. Zeng, J. Li, Y. Yu, C.
    • Year
      2019
    • Journal
      Journal of Oral and Maxillofacial Surgery
    • URL
    • Abstract
      Purpose: To investigate the relation between postoperative complications and long-term survival in patients with oral cancer after surgery and to explore the methods that improve survival rate through analyzing risk factors for postoperative complications. Materials and Methods: This is a retrospective single-institution study of a cohort of 287 patients with oral cancer who underwent surgery at the Stomatological Hospital of the Chongqing Medical University (Chongqing, China) from January 1, 2007 through December 31, 2012. Results: Postoperative complications occurred in 80 patients (27.9%). Patients with pulmonary complications or delirium had worse overall survival than those without these complications, whereas other postoperative complications, such as surgical site infection, postoperative bleeding, salivary fistula, and chylothorax, were not associated with overall survival. American Society of Anesthesiologists (ASA) status and tracheostomy were risk factors for postoperative pulmonary complications according to the Pearson χ2 test or multivariate analysis. Using the Pearson χ2 test, age, comorbidity, and ASA status were risk factors for the incidence of postoperative delirium. However, in multivariate analysis, only comorbidity and ASA status were identified as risk factors. Conclusions: Postoperative pulmonary complications and postoperative delirium could be independent predictors of poorer long-term survival in patients with oral cancer. The risk factors for postoperative pulmonary complications and postoperative delirium could help identify patients who are at high risk and help clinicians take some actions to prevent them.
    • PubMed ID
  • Diagnosis of postoperative delirium in older adults using the Confusion Assessment Method for the intensive care unit in non-intensive care unit settings: A test modification might improve its diagnostic performance. 2019 Wongviriyawong, T. Sura-Arunsumrit, P. Chaiwat, O. To-Adithep, P. Ramlee, R. Srinonprasert, V.. Geriatr Gerontol Int,
    • Title

      Diagnosis of postoperative delirium in older adults using the Confusion Assessment Method for the intensive care unit in non-intensive care unit settings: A test modification might improve its diagnostic performance.

    • Authors
      Wongviriyawong, T. Sura-Arunsumrit, P. Chaiwat, O. To-Adithep, P. Ramlee, R. Srinonprasert, V.
    • Year
      2019
    • Journal
      Geriatr Gerontol Int
    • URL
    • Abstract
      AIM: To evaluate the diagnostic performance of the Confusion Assessment Method for the intensive care unit (CAM-ICU) among postoperative older patients in non-ICU settings. METHODS: The CAM-ICU was used by trained staff to prospectively evaluate postoperative patients for delirium. The patients were aged >/=60 years, were in general wards and had no critical illnesses. The assessments occurred for 7 consecutive days after surgery. The results were compared with delirium diagnoses obtained by geriatricians using Diagnostic and Statistical Manual of Mental Disorders 5th edition criteria as the reference standard. RESULTS: The sensitivity of delirium detection for the CAM-ICU was 31.6% (95% confidence interval [CI] 12.6-56.6), while the specificity was 97.6% (95% CI 94.9-99.1), positive predictive value was 50.0% (95% CI 26.3-73.7) and negative predictive value was 95.0% (95% CI 93.3-96.3). Feature 4 (disorganized thinking) yielded the highest sensitivity (60%; 95% CI 14.7-94.7), whereas feature 2 (inattention) had low sensitivity (36.8%; 95% CI 16.3-61.6). Further analyses to explore the highest sensitive criteria showed that if CAM-ICU diagnoses were made by the presence of any two out of feature 1 (acute change or fluctuation of cognition), feature 3 (altered level of consciousness) or feature 4, the sensitivity increased substantially to 80.0% (95% CI 28.4-99.5), with a reasonably high specificity of 81.8% (95% CI 48.2-97.7). CONCLUSIONS: Modification of the flow of delirium diagnosis using the CAM-ICU appears to offer a better sensitivity for detecting delirium in non-ICU settings. Furthermore, changing feature 2 to evaluate patients' attention levels over a longer period of time might yield a better diagnostic performance. Geriatr Gerontol Int 2019; **: **-**.
    • PubMed ID
  • Psychiatric consultation in the nursing home: reasons for referral and recognition of delirium. 2019 Wilson, L. Power, C. Owens, R. Lawlor, B.. Ir J Psychol Med, 36:2 (121-127)
    • Title

      Psychiatric consultation in the nursing home: reasons for referral and recognition of delirium.

    • Authors
      Wilson, L. Power, C. Owens, R. Lawlor, B.
    • Year
      2019
    • Journal
      Ir J Psychol Med
    • URL
    • Abstract
      OBJECTIVE: To describe the behavioural and psychiatric problems found in nursing home psychiatric referrals in the Dublin South city area. METHODS: We undertook two consecutive surveys of nursing home referrals to the St James's Hospital psychiatry of old age service over a 2-year period. During the second survey a new clinical nurse specialist was specifically appointed to manage the seven nursing homes included in the study. RESULTS: The most common reason for referral during survey one was uncooperative/aggressive behaviour (22%). For survey two, patients were most commonly referred for low mood (31%) or agitation (29%). During survey one, the majority of patients assessed were diagnosed with behavioural and psychological symptoms of dementia (41%). This was also a prevalent diagnosis during survey two, affecting 27% of those referred. Only 7% of patients were considered to be delirious during survey one. This rose to 31% the following year making it the most common diagnosis during survey two. Over the 2-year study period, 7% of referred patients were diagnosed with depression. In terms of prescribing practices, the discontinuation rate of antipsychotic mediation following psychiatric input was 13% in survey one. By survey two, this had risen to 47%. CONCLUSIONS: Delirium is often undetected and untreated in nursing homes. Residents presenting with psychiatric symptoms should undergo routine bloods and urinalysis prior to psychiatric referral. Dedicated input from trained psychiatric nursing staff can lead to both an improvement in the recognition of delirium and reduced prescribing rates of antipsychotic medication.
    • PubMed ID
  • The incidence and prevalence of delirium across palliative care settings: A systematic review. 2019 Watt, C. L. Momoli, F. Ansari, M. T. Sikora, L. Bush, S. H. Hosie, A. Kabir, M. Rosenberg, E. Kanji, S. Lawlor, P. G.. Palliat Med,
    • Title

      The incidence and prevalence of delirium across palliative care settings: A systematic review.

    • Authors
      Watt, C. L. Momoli, F. Ansari, M. T. Sikora, L. Bush, S. H. Hosie, A. Kabir, M. Rosenberg, E. Kanji, S. Lawlor, P. G.
    • Year
      2019
    • Journal
      Palliat Med
    • URL
    • Abstract
      BACKGROUND: Delirium is a common and distressing neurocognitive condition that frequently affects patients in palliative care settings and is often underdiagnosed. AIM: Expanding on a 2013 review, this systematic review examines the incidence and prevalence of delirium across all palliative care settings. DESIGN: This systematic review and meta-analyses were prospectively registered with PROSPERO and included a risk of bias assessment. DATA SOURCES: Five electronic databases were examined for primary research studies published between 1980 and 2018. Studies on adult, non-intensive care and non-postoperative populations, either receiving or eligible to receive palliative care, underwent dual reviewer screening and data extraction. Studies using standardized delirium diagnostic criteria or valid assessment tools were included. RESULTS: Following initial screening of 2596 records, and full-text screening of 153 papers, 42 studies were included. Patient populations diagnosed with predominantly cancer ( n = 34) and mixed diagnoses ( n = 8) were represented. Delirium point prevalence estimates were 4%-12% in the community, 9%-57% across hospital palliative care consultative services, and 6%-74% in inpatient palliative care units. The prevalence of delirium prior to death across all palliative care settings ( n = 8) was 42%-88%. Pooled point prevalence on admission to inpatient palliative care units was 35% (confidence interval = 0.29-0.40, n = 14). Only one study had an overall low risk of bias. Varying delirium screening and diagnostic practices were used. CONCLUSION: Delirium is prevalent across all palliative care settings, with one-third of patients delirious at the time of admission to inpatient palliative care. Study heterogeneity limits meta-analyses and highlights the future need for rigorous studies.
    • PubMed ID
  • Nomogram for Predicting Postoperative Delirium after Deep Brain Stimulation Surgery for Parkinson's Disease. 2019 Wang, X. Q. Zhuang, H. X. Zhang, L. X. Chen, X. Niu, C. S. Zhao, M.. World Neurosurg,
    • Title

      Nomogram for Predicting Postoperative Delirium after Deep Brain Stimulation Surgery for Parkinson's Disease.

    • Authors
      Wang, X. Q. Zhuang, H. X. Zhang, L. X. Chen, X. Niu, C. S. Zhao, M.
    • Year
      2019
    • Journal
      World Neurosurg
    • URL
    • Abstract
    • PubMed ID
  • The Prognostic Value of a Geriatric Risk Score for Older Patients with Colorectal Cancer. 2019 Souwer, E. T. D. Hultink, D. Bastiaannet, E. Hamaker, M. E. Schiphorst, A. Pronk, A. van der Bol, J. M. Steup, W. H. Dekker, J. W. T. Portielje, J. E. A. van den Bos, F.. Annals of Surgical Oncology, 26:1 (71-78)
    • Title

      The Prognostic Value of a Geriatric Risk Score for Older Patients with Colorectal Cancer.

    • Authors
      Souwer, E. T. D. Hultink, D. Bastiaannet, E. Hamaker, M. E. Schiphorst, A. Pronk, A. van der Bol, J. M. Steup, W. H. Dekker, J. W. T. Portielje, J. E. A. van den Bos, F.
    • Year
      2019
    • Journal
      Annals of Surgical Oncology
    • URL
    • Abstract
      Introduction: VMS is a Dutch risk assessment tool for hospitalized older adults that includes a short evaluation of four geriatric domains: risk for delirium, risk for undernutrition, risk for physical impairments, and fall risk. We investigated whether the information derived from this tool has prognostic value for outcomes of colorectal surgery. Methods: All consecutive patients over age 70 years who underwent elective colorectal cancer surgery in three Dutch hospitals (2014–2016) were studied. The presence of risk was scored prior to surgery and per geriatric domain as either 0 (risk absent) or 1 (risk present). The total number of geriatric risk factors was summed. The primary outcome was long-term survival. Secondary outcomes were postoperative complications, including delirium. Cox proportional hazards models were used to evaluate the sumscore and risk factors associated with overall survival. Results: Five hundred fifty patients were included. Median age was 76.5 years, and median follow-up was 870 days. Patients with intermediate (1–2) or high (3–4) sumscore were independently associated with lower overall survival, with hazard ratio (HR) of 1.9 [95% confidence interval (CI) 1.1–3.5; p = 0.03] and 8.7 (95% CI 4.0–19.2; p < 0.001), respectively. Sumscores were also associated with postoperative complications (intermediate sumscore OR 1.8; 95% CI 1.2–2.7; high sumscore OR 2.4; 95% CI 1.02–5.5). Conclusions: This easy-to-use geriatric sumscore has strong associations with long-term outcome and morbidity after colorectal cancer surgery. This information may be included in risk models for morbidity and mortality and can be used in shared decision-making.
    • PubMed ID
  • The use of a screening scale improves the recognition of delirium in older patients after cardiac surgery-A retrospective observational study. 2019 Smulter, N. Claesson Lingehall, H. Gustafson, Y. Olofsson, B. Engstrom, K. G.. J Clin Nurs, 28:11-12 (2309-2318)
    • Title

      The use of a screening scale improves the recognition of delirium in older patients after cardiac surgery-A retrospective observational study.

    • Authors
      Smulter, N. Claesson Lingehall, H. Gustafson, Y. Olofsson, B. Engstrom, K. G.
    • Year
      2019
    • Journal
      J Clin Nurs
    • URL
    • Abstract
      AIMS AND OBJECTIVES: To analyse postoperative delirium (POD) in clinical practice after cardiac surgery, how it is detected and documented and if the use of a screening scale improves the detection rate. BACKGROUND: Cardiac surgery is considered a routine procedure with few complications. However, POD remains a concern, although often being overlooked in clinical practice. DESIGN: Retrospective observational analysis. METHODS: Patients 70 years and older with POD (n = 78) undergoing cardiac surgery were included in the study. Discharge summaries of both nurses and physicians were reviewed together with the clinical database for information about POD, to be compared with symptom screening using the Nursing Delirium Screening Scale (Nu-DESC). A quantitative content analysis was used for the review of discharge summaries, with a coding scheme adopted from the Nu-DESC method. The STROBE checklist was followed. RESULTS: In discharge summaries, 41 of the 78 POD patients were correctly recognised, and 22 of these were identified in the clinical database. Screening by the Nu-DESC identified delirium at a measurably higher rate, 56/78 patients. The review of discharge summaries showed that patients expressing "inappropriate behaviour" was the most easily identified sign for POD for both nurses and physicians. CONCLUSIONS: Healthcare professionals underdiagnose delirium after cardiac surgery, with a low detection rate described in both discharge summaries and in the clinical database. Recognition of delirium improved when Nu-DESC was used for systematic screening. RELEVANCE TO CLINICAL PRACTICE: This study emphasises the need for better screening for the detection of delirium in daily clinical practice.
    • PubMed ID
  • The Bundled Hospital Elder Life Program-HELP and HELP in Home Care-and Its Association With Clinical Outcomes Among Older Adults Discharged to Home Healthcare. 2019 Simpson, M. Macias Tejada, J. Driscoll, A. Singh, M. Klein, M. Malone, M.. J Am Geriatr Soc,
    • Title

      The Bundled Hospital Elder Life Program-HELP and HELP in Home Care-and Its Association With Clinical Outcomes Among Older Adults Discharged to Home Healthcare.

    • Authors
      Simpson, M. Macias Tejada, J. Driscoll, A. Singh, M. Klein, M. Malone, M.
    • Year
      2019
    • Journal
      J Am Geriatr Soc
    • URL
    • Abstract
      OBJECTIVES: To describe the Bundled Hospital Elder Life Program (HELP and HELP in Home Care), an adaptation of HELP, and examine the association of 30-day all-cause unplanned hospital readmission risk among older adults discharged to home care with and without Bundled HELP. DESIGN: Matched case-control study. SETTING: Two medical-surgical units within two midwestern rural hospitals and patient homes (home health). PARTICIPANTS: Hospitalized patients, aged 65 years and older, discharged to home healthcare with and without Bundled HELP exposure between January 1, 2015, and September 30, 2017. Each case (Bundled HELP, n = 148) was matched to a control (non-Bundled HELP, n = 148) on Charlson Comorbidity Index, primary hospital diagnosis of orthopedic condition or injury, and cardiovascular disease using propensity score matching. MEASUREMENTS: The primary study outcome was 30-day all-cause unplanned hospital readmission. Additional outcomes measured were 30-day emergency department (ED) visit, hospital length of stay (LOS), and total number of skilled home care visits. RESULTS: Fewer cases (16.8%) than controls (28.4%) had a 30-day all-cause unplanned hospital readmission. The fully adjusted model showed significantly lower risk of 30-day hospital readmission for case (Bundled HELP) patients (0.41; 95% confidence interval = 0.22-0.77; P < .01). The difference between case (10.8%) and control (15.5%) 30-day ED visit was not significant (P = .23). A lower LOS for the case group was shown (P < .01), while the number of skilled home care visits was not significantly different between groups (P = .28). CONCLUSION: HELP protocol implementation during a patient's hospital stay and as a continued component of home care among older adults at risk for cognitive and/or functional decline appears to be associated with favorable outcomes. Our initial evaluation supports continued study of the Bundled HELP. Further research is needed to confirm the initial findings and to evaluate the impact of the adapted model on functional outcomes and delirium incidence in the home. J Am Geriatr Soc 00:1-7, 2019.
    • PubMed ID
  • Association Between Critical Care Admissions and Cognitive Trajectories in Older Adults. 2019 Schulte, P. J. Warner, D. O. Martin, D. P. Deljou, A. Mielke, M. M. Knopman, D. S. Petersen, R. C. Weingarten, T. N. Warner, M. A. Rabinstein, A. A. Hanson, A. C. Schroeder, D. R. Sprung, J.. Crit Care Med,
    • Title

      Association Between Critical Care Admissions and Cognitive Trajectories in Older Adults.

    • Authors
      Schulte, P. J. Warner, D. O. Martin, D. P. Deljou, A. Mielke, M. M. Knopman, D. S. Petersen, R. C. Weingarten, T. N. Warner, M. A. Rabinstein, A. A. Hanson, A. C. Schroeder, D. R. Sprung, J.
    • Year
      2019
    • Journal
      Crit Care Med
    • URL
    • Abstract
      OBJECTIVES: Patients requiring admission to an ICU may subsequently experience cognitive decline. Our objective was to investigate longitudinal cognitive trajectories in older adults hospitalized in ICUs. We hypothesized that individuals hospitalized for critical illness develop greater cognitive decline compared with those who do not require ICU admission. DESIGN: A retrospective cohort study using prospectively collected cognitive scores of participants enrolled in the Mayo Clinic Study of Aging and ICU admissions retrospectively ascertained from electronic medical records. A covariate-adjusted linear mixed effects model with random intercepts and slopes assessed the relationship between ICU admissions and the slope of global cognitive z scores and domains scores (memory, attention/executive, visuospatial, and language). SETTING: ICU admissions and cognitive scores in the Mayo Clinic Study of Aging from October 1, 2004, to September 11, 2017. PATIENTS: Nondemented participants age 50 through 91 at enrollment in the Mayo Clinic Study of Aging with an initial cognitive assessment and at least one follow-up visit.None. MEASUREMENTS AND MAIN RESULTS: Of 3,673 participants, 372 had at least one ICU admission with median (25-75th percentile) follow-up after first ICU admission of 2.5 years (1.2-4.4 yr). For global cognitive z score, admission to an ICU was associated with greater decline in scores over time compared with participants not requiring ICU admission (difference in annual slope = -0.028; 95% CI, -0.044 to -0.012; p < 0.001). ICU admission was associated with greater declines in memory (-0.029; 95% CI, -0.047 to -0.011; p = 0.002), attention/executive (-0.020; 95% CI, -0.037 to -0.004; p = 0.016), and visuospatial (-0.013; 95% CI, -0.026 to -0.001; p = 0.041) domains. ICU admissions with delirium were associated with greater declines in memory (interaction p = 0.006) and language (interaction p = 0.002) domains than ICU admissions without delirium. CONCLUSIONS: In older adults, ICU admission was associated with greater long-term cognitive decline compared with patients without ICU admission. These findings were more pronounced in those who develop delirium while in the ICU.
    • PubMed ID
Page 1 of 311 pages    1 2 3 >  Last ›