Recognizing and Treating Delirium in Patients Admitted to General Hospitals

Fj, Kane; R, Remmel; Moody, Scott

doi:10.1097/00007611-199309000-00001

Cited by 4 publications

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“…Lipowski proposed the designation "transitory cognitive disorders" for delirium and pseudodelirium; the term pseudodelirium was used by this author to name the situations analogous to the pseudodementia, i.e., social conditions that induce to the false diagnosis of delirium 1 . Several authors call attention to the need to train physicians and nurses to diagnose delirium 22,23 .…”

Section: Discussionmentioning

confidence: 99%

The diagnosis of delirium in 80 emergency unit patients

Neves

Sesso

Ferraz

et al. 1998

Arq. Neuro-Psiquiatr.

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-We evaluated the initial and final diagnosis of 80 patients with delirium arriving at the emergence unit of a university hospital in a large Brazilian city over a period of 30 months up to December 1991. The diagnosis was based on the DSM-IIIR criteria. Patients with a known history of head trauma or epileptic seizure and patients younger than 13 years were excluded. Only patients with a disease of up to 7 days were included.The patients were subdivided into four etiologic groups: vascular; associated with the use of alcohol; infectiousparasitic; miscellaneous.The results showed a rate of correct diagnosis ranging from 65 to 80% with the use of kappa test (standard good to excelent). Sensitivity, specificity, positive predictive and negative predictive values had results showing different conditions for initial diagnosis in each group. This study can help the initial diagnosis of delirium and the choice for diagnostic testing.KEY WORDS: delirium, diagnosis, acute confusional state. Delirium is a quite common syndrome but is often underestimated. The synonymy of this disease includes about thirty other terms. The first scientific description of delirium was probably made by Hippocrates. He used the word phrenitis, derived from phrenes, a word used to mean mind and also the muscle diaphragm. The word delirium was first used by Celsius, in the first century before Christ 1 . Great progress in the knowledge of acquired cognitive disturbances was first made in the nineteenth century. The linkage between brain and behavior was assumed to exist in a modern scientific meaning after the description of a left brain lesion associated with aphasia by Broca. Description of neurosyphilis, Huntington's chorea and Pick's disease were made by other authors. In 1906, Alzheimer described signs of neuronal degeneration in the brain of a woman with a progressive memory disorder 2 . Diagnóstico de delirium em 80 pacientes atendidos no pronto socorro

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Section: Discussionmentioning

confidence: 99%

The diagnosis of delirium in 80 emergency unit patients

Neves

Sesso

Ferraz

et al. 1998

Arq. Neuro-Psiquiatr.

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“…Vitamin deficiency, such as thiamine, B12, nicotinic acid, folic acid, is a common factor contributing to the development of delirium (Kane et al, 1993, O'Keeffe et al, 1994, Harrington et al, 2011).…”

Section: Vitamin Deficiencymentioning

confidence: 99%

Management of Delirium

Maneeton¹,

Maneeton²

2013

Mental Disorders - Theoretical and Empirical Perspectives

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Delirium is categorized in the cognitive disorders, characterized by acute onset, global impairment in cognitive, emotional, mental, and behavioral functioning, fluctuating level of consciousness, attention impairment, decreased or increased psychomotor activity and the disturbance of sleep-wake cycle. Emotional and behavioral abnormalities are common presented with some neurological manifestations, e.g., tremor, asterixis, nystagmus, incoordination, urinary incontinence. Delirium is a behavioral disturbance and serious complication commonly found in consultation-liaison psychiatry. Its prevalence and incidence rates are varied, possibly depend on severity of illness, patient population, the method of assessment and the diagnostic criteria. Prevalence of delirium ranges from 10% to 30% and its incidence is between 3% and 29% for patients admitted in general hospitals (Siddiqi et al., 2006, Maneeton et al., 2007a, Praditsuwan et al., 2012). High prevalence and incidence are noted in elderly and severely ill patients. For instance, the prevalence of delirium in elderly and ICU patients are up to 40% and 80%, respectively (Bledowski and Trutia, 2012, Praditsuwan et al., 2012). An occurrence of delirium is associated with miserable clinical outcomes. It often increases morbidity, mortality, length of hospitalization, institutionalization, and poor functional outcome (Siddiqi et al., 2006, Cole et al., 2009, Fong et al., 2012). The mortality rate is higher in patients with hypoactive subtype of delirium (Yang et al., 2009). Delirium is often under recognized by health professionals. There are many faces for the clinical presentation of delirium. It can be caused by a variety of etiology. To prevent and minimize the consequences of delirium, physician should prompt intervenes for this condition (Attard et al., 2008).

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Role of the Orthopaedist in Fracture Prevention

Day¹,

Munski²

2004

Techniques in Orthopaedics

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Recognizing and Treating Delirium in Patients Admitted to General Hospitals

Cited by 4 publications

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The diagnosis of delirium in 80 emergency unit patients

The diagnosis of delirium in 80 emergency unit patients

Management of Delirium

Role of the Orthopaedist in Fracture Prevention

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