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Latest & greatest articles for delirium
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on delirium or other clinical topics then use Trip today.
This page lists the very latest high quality evidence on delirium and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.
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How can healthcare workers adapt non-pharmacological treatment – whilst maintaining safety – when treating people with COVID-19 and delirium? How can healthcare workers adapt non-pharmacological treatment - whilst maintaining safety - when treating people with COVID-19 and delirium? - CEBM CEBM The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare. Navigate this website How can healthcare workers adapt non-pharmacological treatment – whilst (...) maintaining safety – when treating people with COVID-19 and delirium? May 6, 2020 Louise Jones, Bridget Candy, Nia Roberts, Tamara Ondrušková , Tamara Short, Elizabeth L Sampson On behalf of the Oxford COVID-19 Evidence Service Team Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences University of Oxford Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL Correspondence to VERDICT Delirium may be part of the spectrum of COVID-19 symptoms
End of Life Care in Frailty: Delirium End of Life Care in Frailty: Delirium | British Geriatrics Society Toggle main menu visibility Search Search Search Resources (menu position rule) Date Published: 12 May 2020 Last updated: 12 February 2020 The aim of this guidance series is to support clinicians and others to consider the needs of frail older people as they move towards the end of their lives and help them to provide high quality care. This chapter examines the identification and management (...) of delirium in older people at the end of life. Please to view the other chapters in this series. Delirium – ‘acute confusion’ - is important to consider at the end of life. It may be almost universal in non-sudden death, especially in those with . Delirium has a poor prognosis, regardless of how well it is identified, investigated and treated, especially the hypoactive (drowsy) form. Half of those with delirium on general and geriatric medical wards will die within six months. It is important to be aware
The association of delirium severity with patient and health system outcomes in hospitalised patients: a systematic review. delirium is an acute state of confusion that affects >20% of hospitalised patients. Recent literature indicates that more severe delirium may lead to worse patient outcomes and health system outcomes, such as increased mortality, cognitive impairment and length of stay (LOS).using systematic review methodology, we summarised associations between delirium severity (...) and patient or health system outcomes in hospitalised adults. We searched MEDLINE, EMBASE, PsycINFO, CINAHL and Scopus databases with no restrictions, from inception to 25 October 2018. We included original observational research conducted in hospitalised adults that reported on associations between delirium severity and patient or health system outcomes. Quality of included articles was assessed using the Newcastle-Ottawa Scale. The level of evidence was quantified based on the consistency of findings
Postoperative delirium after hip surgery is a potential risk factor for incident dementia: A systematic review and meta-analysis of prospective studies. Although a few trials have explored the relationship between postoperative delirium (POD) and incident dementia in patients with hip surgery, the numbers of participants in each study are relatively small. Thus, we performed a meta-analysis to examine whether POD after hip surgery is a risk factor for incident dementia.Six prospective cohort
Effect of early cognitive interventions on delirium in critically ill patients: a systematic review. A systematic review of the literature was conducted to determine the effects of early cognitive interventions on delirium outcomes in critically ill patients.Search strategies were developed for MEDLINE, EMBASE, Joanna Briggs Institute, Cochrane, Scopus, and CINAHL databases. Eligible studies described the application of early cognitive interventions for delirium prevention or treatment within (...) reduction in delirium incidence, duration, occurrence, and development was found in four studies. Feasibility of cognitive interventions was measured in three studies. Cognitive stimulation techniques were described in the majority of studies.The study of early cognitive interventions in critically ill patients was identified in a small number of studies with limited sample sizes. An overall high risk of bias and variability within protocols limit the utility of the findings for widespread practice
Developing delirium best practice: a systematic review of education interventions for healthcare professionals working in inpatient settings. Understanding the quality of evidence of delirium education studies will assist in designing future education interventions that seek to improve the well-known deficits in delirium prevention, detection and care. The aim of this study is to systematically review the methodological strengths and limitations, as well as the impact of delirium educational (...) interventions for healthcare professionals working in inpatient settings.MEDLINE, EMBASE, The Cochrane Library, PsychINFO and CINAHL databases were searched according to PRISMA guidelines for delirium educational interventions in hospital inpatient settings from 2007 to 2017. Identified studies were rated using a standardised quality assessment criteria checklist (Kmet). Reported outcomes were organised by level on the Kirkpatrick model for educational outcomes. The search was repeated in March 2018.1354
A systematic review of the overlap of fluid biomarkers in delirium and advanced cancer-related syndromes. Delirium is a serious and distressing neurocognitive disorder of physiological aetiology that is common in advanced cancer. Understanding of delirium pathophysiology is largely hypothetical, with some evidence for involvement of inflammatory systems, neurotransmitter alterations and glucose metabolism. To date, there has been limited empirical consideration of the distinction between (...) delirium pathophysiology and that of the underlying disease, for example, cancer where these mechanisms are also common in advanced cancer syndromes such as pain and fatigue. This systematic review explores biomarker overlap in delirium, specific advanced cancer-related syndromes and prediction of cancer prognosis.A systematic review (PROSPERO CRD42017068662) was conducted, using MEDLINE, PubMed, Embase, CINAHL, CENTRAL and Web of Science, to identify body fluid biomarkers in delirium, cancer prognosis
Comparative efficacy and acceptability of pharmacological interventions for the treatment and prevention of delirium: A systematic review and network meta-analysis. We performed a network meta-analysis to build clear hierarchies of efficacy and tolerability of pharmacological interventions for the treatment and prevention of delirium. Electronic databases including PubMed, Google Scholar, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, and MEDLINE were searched published up (...) to February 22, 2019. A total of 108 randomized controlled trials (RCTs) investigating pharmacotherapy on delirium were included for analysis, and the strength of evidence (SoE) was evaluated for critical outcomes. In terms of treatment, quetiapine (low SoE), morphine (low SoE), and dexmedetomidine (moderate SoE) were effective in the intensive care unit (ICU) patients. In terms of prevention, dexmedetomidine (high SoE) and risperidone (high SoE) significantly reduced the incidence of delirium in ICU
Assessment of Melatonergics in Prevention of Delirium: A Systematic Review and Meta-Analysis. Background: Delirium is a commonly found comorbidity in hospitalized patients and is associated with adverse outcomes. Melatonin is an endogenous hormone that exerts multiple biological effects, mainly in regulating diurnal rhythms and in inflammatory process and immune responses. We aimed to assess the efficacy of exogenous melatonergics in the prevention of delirium. Methods: We conducted a search (...) to identify relevant randomized controlled studies (RCTs) in PubMed, Cochrane Library, and EMBASE databases that had been published up to December 2019. Hospitalized adult patients administered melatonergics were included. The primary outcome measure was the incidence of delirium. The secondary outcome measure was the length of stay in intensive care unit (ICU-LOS). The pooled effects were analyzed as the risk ratio (RR) for delirium incidence, weighted mean difference (WMD) for ICU-LOS, and 95
Dexmedetomidine in the prevention of postoperative delirium in elderly patients following non-cardiac surgery: A systematic review and meta-analysis. The efficacy of dexmedetomidine in the prevention of postoperative delirium (POD) remains ambiguous, however, it has been used to reduce the incidence of delirium in elderly patients. Here, we conducted a meta-analysis study for assessing the effects of dexmedetomidine on POD among elderly patients following non-cardiac surgery. A systematic
Delirium management: Let's get physical? A systematic review and meta-analysis. To investigate whether physical training (alone or in a multi-component intervention) is effective in preventing delirium or improving outcomes for adult patients with delirium in the hospital setting.A systematic review, qualitative synthesis and meta-analysis of randomised controlled trials identified by searches of electronic databases, combining key concepts of delirium and physical training (the target (...) intervention). Outcomes were incidence of delirium (for prevention trials) and delirium duration, delirium severity and hospital outcomes (for management trials).Seven trials were included, five of which were multi-component. The odds of developing delirium were lower for patients who received physical training compared with a control intervention [odds ratio 0.46 (95% confidence interval 0.32-0.65), P < 0.01] (moderate-quality evidence). There was insufficient evidence to draw conclusions about managing
Haloperidol for the treatment of delirium in critically ill patients: A systematic review with meta-analysis and Trial Sequential Analysis. Haloperidol is the most frequently used drug to treat delirium in the critically ill patients. Yet, no systematic review has focussed on the effects of haloperidol in critically ill patients with delirium.We conducted a systematic review with meta-analysis and Trial Sequential Analysis of randomized clinical trials (RCTs) assessing the effects (...) of haloperidol vs any intervention on all-cause mortality, serious adverse reactions/events, days alive without delirium, health-related quality of life (HRQoL), cognitive function and delirium severity in critically ill patients with delirium. We also report on QTc prolongation, delirium resolution and extrapyramidal symptoms.We included 8 RCTs with 11 comparisons (n = 951). We adjudicated one trial as having overall low risk of bias. Three trials used rescue haloperidol; excluding these, we did not find
Prevalence and risk factors of postoperative delirium after spinal surgery: a meta-analysis. Postoperative delirium (POD) was common after spinal surgery, but the main findings in previous studies remained conflicting. This current meta-analysis was aimed at exploring the prevalence and risk factors of POD after spinal surgery.PubMed and Embase were searched from inception to June 2019. Studies which reported the prevalence and risk factors of POD after spinal surgery were included. STATA
Perioperative dexmedetomidine and postoperative delirium in non-cardiac surgery: a meta-analysis. To compare the effects of perioperative dexmedetomidine with placebo (or other sedation) on the rate of postoperative delirium in adult patients who underwent non-cardiac surgeries.A meta-analysis was performed on randomized, controlled trials. MEDLINE, the Cochrane Central Register of Controlled Trials, and Embase (to March 20, 2019) were searched for literature retrieval. The standardized primary (...) outcome was postoperative delirium. We pooled risk ratios using a random-effects model.From 10 trials with 2,286 total participants, we recorded 363 postoperative delirium events during the follow-up periods. Compared with the control group, patients in the dexmedetomidine group had a postoperative delirium relative risk of 0.53 [95% confidence interval (CI), 0.37-0.76]. When the dexmedetomidine infusion rate was higher than 0.2 μg/kg/h, the relative risk of postoperative delirium reduced
Dexmedetomidine's Relationship to Delirium in Patients Undergoing Cardiac Surgery: A Systematic Review. This systematic review aims to determine the relationship between postoperative delirium and the use of dexmedetomidine in comparison with commonly used sedatives/analgesics in the postoperative cardiac surgery patient. A systematic literature search of PubMed plus, CINAHL, Scopus, and Ovid, and limited to the English language in the last 10 years, was performed. Randomized controlled trials (...) , observational and retrospective studies, and meta-analyses with at least 1 delirium assessment tool were included. The search found 196 potential articles; however, only 12 met the criteria outlined. The systematic review revealed a decrease in postoperative delirium for patients receiving dexmedetomidine in all studies. Seven studies demonstrated statistically significant reductions in postoperative delirium with dexmedetomidine compared with other sedatives/analgesics. One study also revealed reduction
The consistent burden in published estimates of delirium occurrence in medical inpatients over four decades: a systematic review and meta-analysis study. Delirium is associated with a wide range of adverse patient safety outcomes, yet it remains consistently under-diagnosed. We undertook a systematic review of studies describing delirium in adult medical patients in secondary care. We investigated if changes in healthcare complexity were associated with trends in reported delirium over the last (...) four decades.We used identical criteria to a previous systematic review, only including studies using internationally accepted diagnostic criteria for delirium (the Diagnostic and Statistical Manual of Mental Disorders and the International Statistical Classification of Diseases). Estimates were pooled across studies using random effects meta-analysis, and we estimated temporal changes using meta-regression. We investigated publication bias with funnel plots.We identified 15 further studies to add