Use of the Cognitive Test for Delirium in Patients With Traumatic Brain Injury

Kennedy, Richard E.; Nakase-Thompson, Risa; Nick, Todd G.; Sherer, Mark

doi:10.1176/appi.psy.44.4.283

Cited by 23 publications

(16 citation statements)

References 30 publications

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“…In comparison, Kennedy et al [15] found a 72% sensitivity and 71% specificity in distinguishing delirious patients from non-delirious patients in an acute rehabilitation setting following ABI using a cut-off score of 22 on the Cognitive Test for Delirium, where multivariate regression analysis showed that only the vigilance item made a unique contribution after other items were controlled [24]. The high accuracy demonstrated by the DDT-Pro suggests that it captures the most salient core domains for delirium following ABI and holds the potential to improve the recognition and treatment of this common disorder in rehabilitation and other medical settings.…”

Section: Discussionmentioning

confidence: 89%

“…From a psychiatric perspective, TBI is one of many aetiologies for delirium, which includes structural, metabolic, injury, inflammatory, infectious, neoplastic and pharmacological causes. There are many advantages of aligning terminology and utilizing validated measures for delirium which have also been used successfully in rehabilitation settings [9,10,15], including collaborative research and clinical management and the opportunity to advance the understanding of the neuropathophysiology of delirium through the study of patients with known structural lesions.…”

Section: Introductionmentioning

confidence: 99%

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Initial validation of a brief provisional diagnostic scale for delirium

et al. 2010

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Initial validation of a brief provisional diagnostic scale for delirium

et al. 2010

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“…Delirium develops over a short period of time, usually hours to a few days, and tends to fluctuate during the course of the day [1]. Delirium often results in poor outcomes, including not only high mortality but also increased hospital stay duration, cost of care, institutional placement rate, and functional and cognitive decline [234]. Therefore, delirium must be prevented or managed properly for achieving a successful rehabilitation outcome.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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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.

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“…It is sensitive and specific to acute confusion in many study samples, including those composed exclusively of patients with TBI 5 6. Designed for use in acutely ill patients, the test permits use of non-verbal responses in the form of pointing, nodding the head or raising the hand.…”

Section: Methodsmentioning

confidence: 99%