Delir beim Intensivpatienten

Zoremba, Norbert; Coburn, Mark; Schälte, Gereon

doi:10.1007/s00101-018-0497-3

Cited by 15 publications

(8 citation statements)

References 77 publications

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“…Der Therapieschwerpunkt liegt in der Delirprävention. Studien zeigen eine deutliche Reduzierung der Delirinzidenz von 44 % bei konsequenter Umsetzung von nichtmedikamentösen Maßnahmen 5 . Eine Trias von Reorientierungsmaßnahmen, Angstvermeidung und allgemeinen Maßnahmen wie z.…”

Section: Die Therapieunclassified

“…Delire haben gerade zu Coronazeiten einen hohen Stellenwert. Die Inzidenz für ein Delir nach großen chirurgischen Eingriffen liegt bei über 50 %, die Mortalität beträgt 10 %, außerdem sind dreifach höhere und frühere Pflegeheimeintritte mit Pflegebedürftigkeit zu verzeichnen 3 4 5 .…”

Section: Merkeunclassified

“…Der Einsatz von validen Assessments sollte daher kontinuierlich erfolgen. Knapp 30 % der Krankenhäuser in Europa nutzten Screeningverfahren regelmäßig 5 . Für Deutschland entspricht das grob einem Prozent.…”

Section: Merkeunclassified

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Angehörige von Delir-patienten im Fokus der Therapiebegleitung

Ewers¹

2022

intensiv

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Section: Die Therapieunclassified

Section: Merkeunclassified

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Angehörige von Delir-patienten im Fokus der Therapiebegleitung

Ewers¹

2022

intensiv

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“…[33][34][35][36] Delirium prevalence is variable according to patient setting and group, being higher for older populations and those hospitalized in more complex units. 11,14,[37][38][39][40] It is estimated to be between 11% and 42% for elderly patients on medical wards. 11,41 In critically ill patients, the overall prevalence of delirium varies across different populations and ranges from 16% to 89%.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of delirium in hospitalized patients in Latin America: A systematic review

Bravo

Sebastian

Estefania

et al. 2022

Acta Psychiatr Scand

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BackgroundAccurate epidemiological data are essential for the planning of policies aimed at the identification, prevention, and management of delirium. The reported occurrence of delirium in hospitalized patients varies widely among studies, ranging between 5% to more than 80% in the international literature. The exact occurrence in Latin America is not well described.ObjectiveThe aim of this study is to conduct a systematic analysis of the published data on the epidemiology of delirium in hospitalized patients in Latin America.MethodsWe conducted a systematic review following PRISMA guidelines. Both MEDLINE and LILACS databases were searched for original research articles reporting the occurrence of delirium among adult hospitalized patients in Latin American countries. Studies including pediatric populations were excluded from this analysis. Two authors independently applied eligibility criteria, assessed quality, and extracted data. The corresponding authors of the original articles were contacted to obtain relevant information about the study when this was not present in the published manuscripts.ResultsSeven hundred and eighteen original articles were identified. After screening titles and abstracts, 149 studies were included in the final analysis. The occurrence of delirium varied depending on the clinical scenario: (1) in the general medico‐surgical wards, it ranged from 2.1% to 60.4%, (2) in the Intensive Care Units (ICUs), from 9.6% to 94.8%, (3) in the post‐operatory population, from 5.45% and 52.3%, and (4) it was found to be between 10.7% and 62% in the emergency department setting. The most used delirium assessment tools were the “Confusion Assessment Method” (CAM; in the general population), and the “Confusion Assessment Method for the ICU” (CAM‐ICU). Fourteen out of 149 studies were conducted in clinical settings who actively implemented some form of non‐pharmacological delirium prevention bundles, most of them as part of ICU sedation‐analgesia protocols.ConclusionDelirium occurs frequently in hospitalized patients in Latin America throughout a variety of clinical scenarios, including ICU, general wards, post‐operatory populations, and among the emergency department setting. The CAM and the CAM‐ICU are the most used delirium assessment tools. Bundles of non‐pharmacological interventions to prevent delirium are not universally implemented.

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“…Delirium is linked to longer hospital and ICU Length of Stay (LoS) and long-term cognitive impairment a [9]. The development of delirium in ICU patients may be contribute by fluctuations in sedation levels and a non-adequate pain management [10,11].…”

Section: Introductionmentioning

confidence: 99%

Effects of pain, sedation and delirium monitoring on clinical and economic outcome: A retrospective study

et al. 2020

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Background Significant improvements in clinical outcome can be achieved by implementing effective strategies to optimise pain management, reduce sedative exposure, and prevent and treat delirium in ICU patients. One important strategy is the monitoring of pain, agitation and delirium (PAD bundle). We hypothesised that there is no sufficient financial benefit to implement a monitoring strategy in a Diagnosis Related Group (DRG)-based reimbursement system, therefore we expected better clinical and decreased economic outcome for monitored patients. Methods This is a retrospective observational study using routinely collected data. We used univariate and multiple linear analysis, machine-learning analysis and a novel correlation statistic (maximal information coefficient) to explore the association between monitoring adherence and resulting clinical and economic outcome. For univariate analysis we split patients in an adherence achieved and an adherence non-achieved group. Results In total 1,323 adult patients from two campuses of a German tertiary medical centre, who spent at least one day in the ICU between admission and discharge between 1. January 2016 and 31. December 2016. Adherence to PAD monitoring was associated with shorter hospital LoS (e.g. pain monitoring 13 vs. 10 days; p<0.001), ICU LoS, duration of mechanical ventilation shown by univariate analysis. Despite the improved clinical outcome, adherence to PAD elements was associated with a decreased case mix per day and profit per day

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Delir beim Intensivpatienten

Cited by 15 publications

References 77 publications

Angehörige von Delir-patienten im Fokus der Therapiebegleitung

Angehörige von Delir-patienten im Fokus der Therapiebegleitung

Epidemiology of delirium in hospitalized patients in Latin America: A systematic review

Effects of pain, sedation and delirium monitoring on clinical and economic outcome: A retrospective study

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