Delirium: a synthesis of current knowledge

Munster, Barbara C. Van; Rooij, S de

doi:10.7861/clinmedicine.14-2-192

Cited by 12 publications

(3 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The criteria for delirium in DSM-V underwent a substantial change by narrowing the spectrum of arousal states in which delirium can be identified [13]. According to a previous research, the prevalence of delirium was 14%–56% in internal medicine inpatients based on the criteria for delirium in DSM-III [8], and 5%–20% in patients in elderly hospital settings based on the criteria in DSM-IV [141516].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Delirium During Acute and Subacute Stages of Various Disorders in Patients Admitted to Rehabilitation Units

et al. 2016

View full text Add to dashboard Cite

ObjectiveTo assess the risk factors for delirium in patients admitted to a rehabilitation unit for acute or subacute neurological or musculoskeletal disorders.MethodsWe reviewed the medical records of 537 patients admitted to a rehabilitation unit and selected 398 patients in the acute or subacute stage of various neurological or musculoskeletal disorders. Among them, patients who had suffered from delirium were categorized into the delirium group (n=65), and the other patients were categorized into the non-delirium group (n=333). As potential risk factors for delirium, the patients' diagnosis, underlying disease, demographic data, hospital stay duration, surgery, and laboratory findings were reviewed, and the differences between the two groups with respect to independent risk factors were analyzed.ResultsThe average age in the delirium group was higher; the hospital stay and pre-transfer periods were longer. A large proportion of the patients were admitted for musculoskeletal disorders, and many patients had diabetes mellitus, dementia, and depression as underlying diseases. Laboratory tests revealed increases in the white blood cells (WBC), glucose, blood urea nitrogen (BUN), total bilirubin, aspartate transaminase (AST), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels in the delirium group, while the hemoglobin, calcium, phosphorus, protein, albumin, and potassium levels were decreased. Depression, musculoskeletal disorders, traumatic brain injury, elevated WBC, BUN, AST, and CRP levels, and decreased potassium and phosphorus levels were identified as independent risk factors for delirium.ConclusionRisk factors treatable before delirium onset were identified in rehabilitation patients in acute and subacute stages of various disorders. Early diagnosis and prevention of these risk factors could decrease delirium occurrence and increase rehabilitation effectiveness.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk Factors for Delirium During Acute and Subacute Stages of Various Disorders in Patients Admitted to Rehabilitation Units

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Our findings may therefore be perceived as a minimum. Delirium can be difficult to recognize because of the fluctuation of symptoms, different forms, often lacking of obvious symptoms and is therefore often underdiagnosed (15).…”

Section: Discussionmentioning

confidence: 99%

Serious Consequences of Malnutrition and Delirium in Frail Older Patients

Rosted

Prokofievа

Sanders

2018

Journal of Nutrition in Gerontology and Geriatrics

View full text Add to dashboard Cite

Malnutrition is highly prevalent in geriatric patients and is associated with an increased risk of death. In addition, delirium is a common condition of the older hospitalized patients. As brain has a high nutritional requirement, malnutrition may play an important role in cognitive dysfunction including the development of delirium. This study investigated the association between delirium and malnutrition in frail older patients and the effects on adverse outcomes. It was found that 75% of the patients with delirium suffered from malnutrition indicating that malnutrition contributes to the development of delirium in older hospitalized patients. Patients suffering from both malnutrition and delirium had a four times higher mortality in one month follow-up, a seven times increased rate of discharge to nursing homes and three days more in hospital. All older patients should routinely be assessed for malnutrition and delirium at admission to hospital and to prevent the development of delirium a close follow-up must take place to ensure adequate nutrition.

show abstract

“…Taking as an example a case–control post-mortem study of deceased ICU patients without direct brain injury, higher levels of inflammatory cells were reported in the hippocampi of deceased patients with delirium than in patients without delirium [ 5 ]. This indicates that when neuroinflammation is triggered, by direct brain insult, aberrant systemic stress response, or some other mechanism, it may be associated with cognitive dysfunction [ 5 , 12 , 13 ]. However, it is likely that there are many factors beyond neuroinflammation that can contribute to cognitive impairment in the ICU, such as medications, immobility, overload of sensory input and lack of adequate sleep [ 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Systematic review of cognitive impairment and brain insult after mechanical ventilation

2021

View full text Add to dashboard Cite

We conducted a systematic review following the PRISMA protocol primarily to identify publications that assessed any links between mechanical ventilation (MV) and either cognitive impairment or brain insult, independent of underlying medical conditions. Secondary objectives were to identify possible gaps in the literature that can be used to inform future studies and move toward a better understanding of this complex problem. The preclinical literature suggests that MV is associated with neuroinflammation, cognitive impairment, and brain insult, reporting higher neuroinflammatory markers, greater evidence of brain injury markers, and lower cognitive scores in subjects that were ventilated longer, compared to those ventilated less, and to never-ventilated subjects. The clinical literature suggests an association between MV and delirium, and that delirium in mechanically ventilated patients may be associated with greater likelihood of long-term cognitive impairment; our systematic review found no clinical study that demonstrated a causal link between MV, cognitive dysfunction, and brain insult. More studies should be designed to investigate ventilation-induced brain injury pathways as well as any causative linkage between MV, cognitive impairment, and brain insult.

show abstract

Delirium: a synthesis of current knowledge

Cited by 12 publications

References 33 publications

Risk Factors for Delirium During Acute and Subacute Stages of Various Disorders in Patients Admitted to Rehabilitation Units

Risk Factors for Delirium During Acute and Subacute Stages of Various Disorders in Patients Admitted to Rehabilitation Units

Serious Consequences of Malnutrition and Delirium in Frail Older Patients

Systematic review of cognitive impairment and brain insult after mechanical ventilation

Contact Info

Product

Resources

About