Computed Tomography Findings in Delirium

Koponen, Hannu; Hurri, Leevi; Stenbäck, Ulla; Mattila, Esa; Riekkinen, P.

doi:10.1097/00005053-198904000-00006

Cited by 53 publications

(25 citation statements)

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“…Other electrolyte derangements and abnormal glucose or leukocytes demonstrated a weak association, whereas abnormal hemoglobin, albumin, 27 calcium, 13 liver function tests, 13 or presence of leukocytes in the urine 27 did not. Bergmann and Eastham found both abnormal electrocardiogram and chest x-ray findings to be risk factors, 31 but this finding was not reproduced by Jitapunkul et al 27 Two studies of psychiatric patients noted structural brain abnormalities as risk factors 39,42 ; however, history of cerebrovascular accident did not show such an association.…”

Section: Risk Factor Analysismentioning

confidence: 96%

“…Nine were done on surgical patients, 12,19-26 11 on medical patients, 13,27-36 2 on a mixed population of medical and surgical patients, 37,38 and 5 on psychiatric patients. [39][40][41][42][43] Two of these latter studies looked at patients receiving electroconvulsive therapy. 42,43 A total of 1,365 cases of delirium were studied with 5,513 control subjects ( Table 1).…”

Section: Articles Selected and Datamentioning

confidence: 99%

“…42,43 A total of 1,365 cases of delirium were studied with 5,513 control subjects ( Table 1). The subjects in Marcantonio et al 12,23 and Koponen et al [39][40][41] were counted only once because the same population of cases was analyzed looking at different risk factors. The number of delirium cases per study varied from 8 to 301 with a mean of 59.…”

Section: Articles Selected and Datamentioning

confidence: 99%

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Delirium risk factors in elderly hospitalized patients

et al. 1998

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OBJECTIVE: Delirium is frequent in elderly hospitalized patients. Many studies have examined its risk factors, but results have been quite variable. Thus, the goal of this study is to identify through systematic literature review the risk factors associated with the development of delirium in hospitalized geriatric patients. MEASUREMENTS AND MAIN RESULTS:First, MEDLINE / CURRENT CONTENTS databases were screened for relevant articles published from 1966 to December 1995, and from bibliographies of identified articles additional reports were selected. Second, the reports were screened by two different investigators and retained only if meeting the five following criteria: (1) original research in French or English; (2) prospective study; (3) patients over age 50; (4) minimum of one risk factor examined; (5) acceptable definition of delirium. Third, the methodology of each study was graded according to specific criteria for risk factor studies. Fourth, risk factors were identified and tabulated, unadjusted odds ratios (ORs) were computed, and where appropriate a combined OR with the Mantel-Haenszel estimator was calculated. Twenty-seven articles were retained meeting all of the above criteria. Among these studies, 11 were done on medical patients, 9 on surgical patients, 2 on medical and surgical patients, and 5 on psychiatric patients. In total 1,365 subjects with delirium were studied. Sixty-one different risk factors were examined, the five most common being dementia, medication, medical illness, age, and male gender. Mantel-Haenszel estimator was calculated for 10 risk factors, the most strongly associated being dementia (OR 5.2; 95% confidence interval [CI] 4.2, 6.3), medical illness (OR 3.8; 95% CI 2.2, 6.4), alcohol abuse (OR 3.3; 95% CI 1.9, 5.5), and depression (OR 1.9; 95% CI 1.3, 2.6). Methodologic weaknesses were present in many studies.

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Section: Risk Factor Analysismentioning

confidence: 96%

Section: Articles Selected and Datamentioning

confidence: 99%

Section: Articles Selected and Datamentioning

confidence: 99%

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Delirium risk factors in elderly hospitalized patients

et al. 1998

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“…The few functional neuroimaging studies that have evaluated delirious patients in acute states are reviewed [19][20][21]. Structural imaging findings are then examined that describe neuronal atrophy that may be related to delirium [22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

Section: Neuroimaging and Neuroanatomic Correlates Of Deliriummentioning

confidence: 99%

“…Has the potential to account parsimoniously for multiple instances of delirium [19][20][21][22][23][24][25][26][27][28][29][30]34,35].…”

Section: Pathogenic Mechanismmentioning

confidence: 99%

Pathophysiology of Delirium in the Intensive Care Unit

Gunther

Morandi

Ely

2008

Critical Care Clinics

156

101

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Association of pre‐operative brain pathology with post‐operative delirium in a cohort of non‐small cell lung cancer patients undergoing surgical resection

et al. 2013

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Objective Post-operative delirium is associated with pre-operative cognitive difficulties and diminished functional independence, both of which suggest that brain pathology may be present in affected individuals prior to surgery. Currently, there are few studies that have examined imaging correlates of post-operative delirium. To our knowledge, none have examined the association of delirium with existing structural pathology in pre-operative cancer patients. Here, we present a novel, retrospective strategy to assess pre-operative structural brain pathology and its association with post-operative delirium. Standard of care structural magnetic resonance imaging (MRIs) from a cohort of surgical candidates prior to surgery were analyzed for white matter hyperintensities and cerebral atrophy. Methods We identified 23 non-small cell lung cancer patients with no evidence of metastases in the brain pre-operatively, through retrospective chart review, who met criteria for post-operative delirium within 4 days of surgery. 24 age- and gender-matched control subjects were identified for comparison to the delirium sample. T1 and fluid-attenuated inversion recovery sequences were collected from standard of care pre-operative MRI screening and assessed for white matter pathology and atrophy. Results We found significant differences in white matter pathology between groups with the delirium group exhibiting significantly greater white matter pathology than the non-delirium group. Measure of cerebral atrophy demonstrated no significant difference between the delirium and non-delirium group. Conclusions In this preliminary study utilizing standard of care pre-operative brain MRIs for assessment of structural risk factors to delirium, we found white matter pathology to be a significant risk factor in post-operative delirium. Limitations and implications for further investigation are discussed.

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Computed Tomography Findings in Delirium

Cited by 53 publications

References 0 publications

Delirium risk factors in elderly hospitalized patients

Delirium risk factors in elderly hospitalized patients

Pathophysiology of Delirium in the Intensive Care Unit

Association of pre‐operative brain pathology with post‐operative delirium in a cohort of non‐small cell lung cancer patients undergoing surgical resection

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