Confusion Assessment Method is the most appropriate tool to quickly detect delirium in hospitalised patients at the bedside

Mitchell, Alex J.

doi:10.1136/ebmh.14.1.4

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…The Clinical Global Impression–Improvement (CGI–I)33 and the Modified (nine-item) Simpson–Angus Scale (MSAS) were applied daily. The primary outcome was the DRS-R-98 severity score 27,31. Secondary outcomes included the DRS-R-98 noncognitive and cognitive subscale scores, the response rate, remission rate, the total time of sleep, and the CGI–I scores 33.…”

Section: Outcome Measuresmentioning

confidence: 99%

Quetiapine versus haloperidol in the treatment of delirium: a double-blind, randomized, controlled trial

Maneeton¹,

Maneeton²,

Srisurapanont³

et al. 2013

DDDT

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BackgroundAtypical antipsychotic drugs may have low propensity to induce extrapyramidal side effects in delirious patients. This study aimed to compare the efficacy and tolerability between quetiapine and haloperidol in controlling delirious behavior.MethodsA 7-day prospective, double-blind, randomized controlled trial was conducted from June 2009 to April 2011 in medically ill patients with delirium. Measures used for daily assessment included the Delirium Rating Scale-revised-98 (DRS-R-98) and total sleep time. The Clinical Global Impression, Improvement (CGI–I) and the Modified (nine-item) Simpson– Angus Scale were applied daily. The primary outcome was the DRS-R-98 severity scores. The data were analyzed on an intention-to-treat basis.ResultsFifty-two subjects (35 males and 17 females) were randomized to receive 25–100 mg/day of quetiapine (n = 24) or 0.5–2.0 mg/day of haloperidol (n = 28). Mean (standard deviation) doses of quetiapine and haloperidol were 67.6 (9.7) and 0.8 (0.3) mg/day, respectively. Over the trial period, means (standard deviation) of the DRS-R-98 severity scores were not significantly different between the quetiapine and haloperidol groups (−22.9 [6.9] versus −21.7 [6.7]; P = 0.59). The DRS-R-98 noncognitive and cognitive subscale scores were not significantly different. At end point, the response and remission rates, the total sleep time, and the Modified (nine-item) Simpson–Angus scores were also not significantly different between groups. Hypersomnia was common in the quetiapine-treated patients (33.3%), but not significantly higher than that in the haloperidol-treated group (21.4%).LimitationsPatients were excluded if they were not able to take oral medications, and the sample size was small.ConclusionLow-dose quetiapine and haloperidol may be equally effective and safe for controlling delirium symptoms.Clinical trials registration numberclinicaltrials.gov NCT00954603.

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Section: Outcome Measuresmentioning

confidence: 99%

Quetiapine versus haloperidol in the treatment of delirium: a double-blind, randomized, controlled trial

Maneeton¹,

Maneeton²,

Srisurapanont³

et al. 2013

DDDT

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“…For the diagnosis of delirium, it requires the presence of both acute onset with fluctuating course and inattention and either of disorganized thinking or altered level of consciousness. 11,12 If the patients were found to be delirious by the CAM, they were further administered the delirium rating scale-revised (DRS-R-98) to investigate the phenomenology of delirium. [13][14][15] The DRS-R-98 is a severity scale which has 13 items rated from zero to three points.…”

Section: Study Instrumentsmentioning

confidence: 99%

Prevalence, phenomenology and etiology of delirium in medically ill patients

2016

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INTRODUCTIONDelirium is characterized by an acute decline in the level of consciousness and cognition with particular impairment in attention. Other associated features include abnormal psychomotor activity, sleep cycle impairment and psychiatric symptoms such as abnormalities of mood, perception and behaviour.1 It develops over a short period of time and fluctuates during the course of the day. It is a common neuro cognitive disorder which heralds an increase in morbidity and mortality.2 It is also known by other terms such as acute confusional state, toxic psychosis and metabolic encephalopathy. 1 Delirium is usually rapid in onset with a diurnally fluctuating course and duration of less than six months. Based on the etiology, DSM 5 classifies delirium as substance intoxication delirium, substance withdrawal delirium, medication-induced delirium, delirium due to another medical condition and delirium due to multiple etiologies.2 It is also further specified as hyperactive delirium, hypoactive delirium and mixed delirium based on the level of psychomotor activity.2,3 The cause of ABSTRACT Background: Delirium is one of the most common causes of referral of medically ill patients for psychiatric management and is associated with significant morbidity and mortality. The aim of the study was to determine the prevalence and etiology of delirium among medically ill patients and to describe its phenomenology. Methods: A cross-sectional descriptive study was conducted in the general medical ward of a tertiary care hospital. Four hundred patients were screened for delirium using the confusion assessment method. The delirium rating scale revised-98 was used to further characterize the severity and phenomenology of delirium. Descriptive statistics such as frequencies, means and standard deviation were used. Chi square test was applied to compare categorical variables and Fisher's exact test was used to test associations. Student t test was used to compare the means of independent groups. Results: The prevalence of delirium was 9.75%. Male gender (69.23%) and age above 60 years (66.67%) were significantly associated with delirium (p values of 0.04 and <0.001 respectively). Mixed delirium was the most common motor subtype (46.15%). The most common cause of delirium was metabolic encephalopathy (43.59%). There was significant association between hyperactive delirium and psychotic symptoms. Delirium went undiagnosed in 61.64% of the cases. Conclusions: Delirium is a common problem among medically ill patients and runs the risk of being undiagnosed. Clinicians should routinely screen patients at high risk for delirium to decrease the morbidity and mortality associated with this dreaded, yet potentially reversible entity.

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“…Delirium ble vurdert ved observasjon tredje postoperative dag ved hjelp av «Confusion Assessment Method» (CAM) kortversjon. CAM er en sensitiv og spesifikk metode som egner seg godt til å kartlegge delirium (21). Det består av fem spørsmål relatert til fire sentrale kjennetegn for delirium, som akutt debut og vekslende forløp, uoppmerksomhet, desorganisert tankegang og endret bevissthetsnivå (20).…”

Section: Risikofaktorerunclassified

Trenger oppfølging etter hoftebrudd

Bentzen¹,

Domaas²

2015

Sykepleien

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Confusion Assessment Method is the most appropriate tool to quickly detect delirium in hospitalised patients at the bedside

Cited by 6 publications

References 5 publications

Quetiapine versus haloperidol in the treatment of delirium: a double-blind, randomized, controlled trial

Quetiapine versus haloperidol in the treatment of delirium: a double-blind, randomized, controlled trial

Prevalence, phenomenology and etiology of delirium in medically ill patients

Trenger oppfølging etter hoftebrudd

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