Understanding international differences in terminology for delirium and other types of acute brain dysfunction in critically ill patients

Morandi, Alessandro; Pandharipande, Pratik P.; Trabucchi, Marco; Rozzini, Renzo; Mistraletti, Giovanni; Trompeo, Anna Chiara; Gregoretti, Cesare; Gattinoni, Luciano; Ranieri, Marco; Brochard, Laurent; Annane, Djillali; Putensen, Christian; Guenther, Ulf; Fuentes, Paola; Tobar, Eduardo; Anzueto, Antonio; Esteban, Andrés; Skrobik, Yoanna; Salluh, Jorge I.; Soares, Márcio; Granja, Cristina; Stubhaug, Audun; Rooij, Sophia E. de; Ely, E. Wesley

doi:10.1007/s00134-008-1177-6

Cited by 166 publications

(117 citation statements)

References 38 publications

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“…Asimismo, los α-2 agonistas (clonidina y dexmedetomidina) podrían también ser opciones para el manejo de pacientes (35,36,37) críticamente enfermos .…”

Section: Otros Fármacos Potenciales Para El Deliriumunclassified

Delirium: an update for internists and psychiatrists

Torales

Barrios

Armoa

2017

Rev. virtual Soc. Parag. Med. Int

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RESUMENA lo largo del tiempo, al delirium se lo ha conocido por diversos nombres: falla cerebral aguda, síndrome cerebral orgánico agudo, síndrome confusional o psicosis postquirúrgica. No obstante, el término preferido en la actualidad es delirium (de latín delirare, que significa "arar fuera del surco"). El delirium, como síndrome, es un conjunto de signos y síntomas de inicio agudo caracterizado por deterioro cognitivo fluctuante, con enturbiamiento de la conciencia y capacidad disminuida de mantener y cambiar la atención de un punto a otro.Numerosos estudios han demostrado que los pacientes que desarrollan delirium tienen un riesgo aumentado de resultados adversos tanto durante la hospitalización como tras el alta. Este riesgo es independiente de cualquier comorbilidad existente, de la severidad de la enfermedad, la edad u otras variables asociadas. Asimismo, el delirium está asociado a un incremento en la mortalidad, aumento del tiempo de hospitalización y desarrollo de disfunciones cognitivas posteriores al alta.Este artículo de revisión presenta una actualización acerca de la fisiopatología del delirium, de las herramientas de reconocimiento del cuadro y de su tratamiento. Todas estas informaciones resultan útiles en el manejo diario de este tipo de pacientes, tanto por médicos internistas como por médicos psiquiatras. Palabras claves:ABSTRACT Over time, delirium has been known by several names: acute brain failure, acute organic brain syndrome, confusional syndrome, or post-surgical psychosis. However, the currently preferred term is delirium (from the Latin term delirare, which means "to go out of the furrow"). Delirium, as a syndrome, is a set of signs and symptoms of acute onset characterized by fluctuating cognitive impairment, clouding of consciousness and diminished ability to maintain and shift attention from one point to another. Numerous studies have shown that patients who develop delirium have an increased risk of adverse outcomes both during hospitalization and after discharge. This risk is independent of any existing comorbidity, severity of disease, age or other associated variables. Likewise, delirium is associated with an increase in mortality, delirio, trastornos neurocognitivos, síndrome confusional, delirio -fisiopatología, delirio -tratamiento farmacológico

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“…Asimismo, los α-2 agonistas (clonidina y dexmedetomidina) podrían también ser opciones para el manejo de pacientes (35,36,37) críticamente enfermos .…”

Section: Otros Fármacos Potenciales Para El Deliriumunclassified

Delirium: an update for internists and psychiatrists

Torales

Barrios

Armoa

2017

Rev. virtual Soc. Parag. Med. Int

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“…The knowledge and the interest on delirium in critically ill patients have progressively increased over the course of the last few years. 33,35 Nonetheless, there is still a lack of homogeneity in the use of terminology especially by physicians and health-care personnel who do not specialise in neuropsychiatric disciplines and for different background training and categorisation system. In a previous international survey, 33 we found that two terms are very consistently used when referring to acute brain dysfunction in critically ill patients: 100% of the selected languages use the term 'coma' or 'koma' to describe patients unresponsive to verbal and/or physical stimuli, and 100% use delirium tremens to define delirium due to alcohol withdrawal.…”

Section: Delirium Terminologymentioning

confidence: 99%

“…The reason of this underdetection might be related to barriers in the terminology used to define these cognitive impairments. 33 We have previously reported that among 13 languages using the Romanic characters, only 54% use the term 'delirium' to indicate the disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 34 Even with LTCI-CI, there is still an uncertainty on how to define it in comparison to other cognitive impairment entities such as mild cognitive impairment (MCI), dementia and postoperative cognitive decline (POCD).…”

Section: Introductionmentioning

confidence: 99%

Understanding terminology of delirium and long-term cognitive impairment in critically ill patients

Morandi

Pandharipande

Jackson

et al. 2012

Best Practice & Research Clinical Anaesthesiology

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Keywords: delirium long-term cognitive impairment terminology critical careDelirium, an acute brain dysfunction, frequently affects intensive care unit (ICU) patients during the course of a critical illness. Besides the acute morbidities, ICU survivors often experience longterm sequelae in the form of cognitive impairment (LTCI-CI). Though delirium and LTCI-CI are associated with adverse outcomes, little is known on the terminology used to define these acute and chronic co-morbidities. The use of a correct terminology is a key factor to spread the knowledge on clinical conditions. Therefore, we first review the epidemiology, definition of delirium and its related terminology. Second, we report on the epidemiology of LTCI-CI and compare its definition to other forms of cognitive impairments. In particular, we define mild cognitive impairment, dementia and finally postoperative cognitive dysfunction. Future research is needed to interpret the trajectories of LTCI-CI, to differentiate it from neurodegenerative diseases and to provide a formal disease classification.

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“…In the intensive care unit it occurs in 70-80% of elderly persons and is often a symptom that heralds the presence of life threatening conditions. 2 Then, approximately, one third of patients aged 70 or older admitted to the general medical service of an acute care hospital experience delirium. In the hospital, delirium has been associated with a 10-fold increased risk for death and with a 3-to 5-fold increased N o n -c o m m e r c i a l u s e o n l y risk for nosocomial complications, prolonged length of stay, and greater need for nursing home placement after discharge.…”

Section: Introductionmentioning

confidence: 99%

Delirium: the invisible syndrome

Gnerre¹,

Regina²,

Bozzano

et al. 2016

Ital J Med

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Delirium is a neuropsychiatric sindrome characterized by acute onset, a fluctuating course, an altered level of consciousness, disturbances in orientation, memory, attention, thinking, perception and behaviour. One third of patients aged 70 or older were admitted to the general medical service of an acute care hospital experience delirium. The development of delirium is associated with worse outcome increased a 10-fold risk for death and a 3-to 5-fold risk for nosocomial complications, prolonged length of stay, and greater need for nursing home placement after discharge. Therefore patients with delirium have higher morbidity and mortality rates, higher re-admission rates, and a greater risk of long term institutionalization care, thereby having a significant impact on both health and social care expenditure. The cost of delirium to the health-care system is then substantial. Despite its clinical importance and health-related costs, it often remains under-recognized and inadequately managed. Recent evidence suggests that a better understanding and knowledge of delirium among health care professionals can lead to early detection, the reduction of modifiable risk factors, and better management of the condition in the acute phase.

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Understanding international differences in terminology for delirium and other types of acute brain dysfunction in critically ill patients

Abstract: Attempts towards standardization in terminology, or at least awareness of differences across languages and specialties, will help cross-talk among clinicians and researchers.

Cited by 166 publications

References 38 publications

Delirium: an update for internists and psychiatrists

Delirium: an update for internists and psychiatrists

Understanding terminology of delirium and long-term cognitive impairment in critically ill patients

Delirium: the invisible syndrome

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