Non-pharmacological interventions to prevent or treat delirium in older patients: Clinical practice recommendations the SENATOR-ONTOP series

Abraha, Iosief; Rimland, Joseph M.; Trotta, F.; Pierini, Valentina; Cruz-Jentoft, Alfonso J.; Soiza, Roy L.; O’Mahony, Denis; Cherubini, Antonio

doi:10.1007/s12603-016-0719-9

Cited by 50 publications

(43 citation statements)

References 41 publications

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“…Patients living independently may live as much or even more in social isolation as patients in nursing homes do. In the literature there is some evidence that the presence of family members in the hospital will help to reduce the incidence of delirium [30], moreover, that social isolation leads to a prolonged hospitalization [31]. …”

Section: Discussionmentioning

confidence: 99%

Complications after hip fracture surgery: are they preventable?

Flikweert

Wendt

Diercks

et al. 2017

Eur J Trauma Emerg Surg

118

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PurposeSurgery for hip fractures is frequently followed by complications that hinder the rehabilitation of patients. The aim of this study was to describe the incidence rate and type of complications, including mortality, after hip fracture surgery, and to identify the risk factors of these complications that may be amenable to prevention.MethodsProspective cohort study of all consecutive patients aged ≥60 treated for a hip fracture at University Medical Center Groningen between July 2009 and June 2013. All patients were treated in a comprehensive multidisciplinary care pathway. Logistic regression analyses were used to investigate which variables were significant risk factors for the occurrence of complications. Additional analyses were conducted to investigate whether the independent variables were significant risk factors for several specific complications and mortality.ResultsThe study population consisted of 479 patients with a mean age of 78.4 (SD 9.5) years; 33% were men. The overall complication rate was 75%. Delirium was the complication seen most frequently (19%); the incidence of surgical complications was 9%. Most risk factors for complications were not preventable (high comorbidity rate, high age and dependent living situation). However, general anesthesia (OR 1.51; 95% CI 0.97–2.35) and delay in surgery (OR 3.16; 95% CI 1.43–6.97) may be risk factors that can potentially be prevented. Overall, the mortality risk was not higher in patients with a complication, but delirium and pneumonia were risk factors for mortality.ConclusionThe overall complication rate after hip fracture surgery was high. Only few complications were potentially preventable.

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Section: Discussionmentioning

confidence: 99%

Complications after hip fracture surgery: are they preventable?

Flikweert

Wendt

Diercks

et al. 2017

Eur J Trauma Emerg Surg

118

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“…The systematic search and screening process yielded no PICS-speci c guidelines; in total, 32 guidelines and consensus statements reporting related content, such as risk factors, monitoring, diagnosis, evaluation, prevention, and treatment of PICS and PICS-F were retrieved (Table.1 [12][13][14][15], nine were developed by the corresponding state [16][17][18][19][20][21][22][23][24], and one was developed by a hospital [25]. In addition, the guidelines were divided into single and bundled theme guidelines.…”

Section: Basic Characteristicsmentioning

confidence: 99%

“…In addition, the guidelines were divided into single and bundled theme guidelines. Single guidelines included the prevention, management and non-pharmacological intervention of delirium [15,16,21], ICUAW diagnosis [20], rest and sleep improvement [25], rehabilitation of critically ill patients [24], and family-centered care [14]. Bundled guidelines included sedation/analgesia [17], management of PAD [12,19,22], and prevention and management of PASDIS [13].…”

Section: Basic Characteristicsmentioning

confidence: 99%

Developing Strategy of Clinical Practice Guidelines for Post-intensive Care Syndrome: A Systematic Review of 14 Practice Guidelines and 10 Consensus Statements

Wang

Zhang

et al. 2020

Preprint

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BackgroundPost-intensive care syndrome (PICS) seriously affects the quality of life of patients and their caregivers. This study systematically evaluates PICS related guidelines and consensuses to provide methodological and strategic guidance for the development and improvement of these guidelines and consensus.MethodsAn Internet search of PICS specific or related guidelines and consensus statements was conducted among academic databases and the websites. The AGREE II was used to evaluate their methodological quality. The themes and contents were evaluated based on the definition of PICS and the “patient-clinical problem-intervention-target” framework.ResultsWe included fourteen guidelines and 10 expert consensuses. The mean AGREE II score for scope and purpose was 86.89% ± 16.12%/ 79.47% ± 11.80%, 55.86% ± 29.17%/16.72% ± 16.39% for stakeholder involvement, 76.35% ± 15.82% /36.09% ±26.05% for rigor of development, 88.03% ± 15.55%/58.84% ± 28.94% for clarity of presentation, 61.79% ± 23.16/32.95% ± 20.91% for applicability, and 66.67% ± 37.96% /28.79% ± 36.54% for editorial independence in Guidelines/Consensus. Most only described a single or series of clinical related issues of PICS; only applicable for critically ill patients with clinical problems of ICUAW, pain, sleep disruption, agitation, and delirium. The interventions included risk assessment, monitoring/diagnosis, prevention, treatment, safety criteria, and home care of one or more symptoms of PICS.ConclusionsOur results suggested that development and improvement of guidelines/consensus should focus on refining the methodology, strengthening quality control, and improving presentation clarity, editorial independence, and applicability. The results may provide new idea for a future guidelines and consensus statements.

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“…We had to admit her again in private ward with a diagnosis of drug-induced Parkinsonism and delirium for evaluation. We stopped the offending antipsychotics (risperidone) gradually and ruled out other cause of delirium and multicomponent multidisciplinary non-pharmacological therapy instituted by targeting risk factors, like cognitive impairment, immobility, sensory impairment, sleep deprivation and dehydration [1].…”

Section: Delirium: Family Support Love and Carementioning

confidence: 99%