ライフサイエンスコーパス: delirium

1 ssion (recalibrated prediction model for ICU delirium).

2 r scheduled noncardiac surgery (N = 566; 24% delirium).

3 between children who did and did not develop delirium.

4 cidating this may offer routes to mitigating delirium.

5 uld consider delineating motoric subtypes of delirium.

6 ications including cognitive dysfunction and delirium.

7 POD2 NfL levels were more likely to develop delirium.

8 ompared with children who did not experience delirium.

9 al evidence for neuroaxonal injury following delirium.

10 = 0.002) domains than ICU admissions without delirium.

11 dmissions (83%) involved one or more days of delirium.

12 re consistent risk factors for postoperative delirium.

13 not decrease the incidence of postoperative delirium.

14 id not significantly reduce the incidence of delirium.

15 ants were assessed daily postoperatively for delirium.

16 were independent predictors of postoperative delirium.

17 -generation antipsychotics for prevention of delirium.

18 esia, has been associated with postoperative delirium.

19 to predict ICU patients' risk of developing delirium.

20 were associated with greater odds of having delirium.

21 set atrial fibrillation and the incidence of delirium.

22 tation in patients with cancer with terminal delirium.

23 ssociations were not modified by hyperactive delirium.

24 up had a median of 26 days free from coma or delirium.

25 Next, we tested the relationship with delirium.

26 in humans during inflammatory trauma-induced delirium.

27 African haplogroup (adjusted rate ratio for delirium 0.60; 95% CI, 0.38-0.94; p = 0.03).

28 sian haplogroup (age-adjusted rate ratio for delirium 1.36; 95% CI, 1.13-1.64; p = 0.001).

29 acetaminophen had a significant reduction in delirium (10% vs 28% placebo; difference, -18% [95% CI,

30 vs propofol had no significant difference in delirium (17% vs 21%; difference, -4% [95% CI, -18% to 1

31 tric outcomes were defined: 1) postoperative delirium, 2) physical function on postoperative day 30,

32 irium most frequent (61%), followed by mixed delirium (39%).

33 r localized conduit necrosis (9%), and acute delirium (5%).

34 as the most common measure used to ascertain delirium (51, 35%).

35 45%) and was associated with higher rates of delirium (62% vs 39%) and unfavorable 3-months outcome (

36 more common and persistent than hyperactive delirium (71% vs 17%; median 3 vs 1 d).

37 , a 2-fold increase in odds of postoperative delirium (95% CI 1.65-2.66), a 27% increase in odds of l

38 p affect susceptibility to sepsis-associated delirium, a common manifestation of acute brain dysfunct

39 Delirium, a heterogenous syndrome, is associated with wo

40 Delirium, a syndrome characterized by an acute change in

41 events, the number of days free from coma or delirium, acute kidney injury according to severity, the

42 uartile (Q4) had increased risk for incident delirium (adjusted odds ratio [OR] = 3.7 [95% confidence

43 Episodes of delirium also contribute to rates of long-term cognitive

44 Patient CSF from inflammatory trauma-induced delirium also shows altered brain carbohydrate metabolis

45 All patients are at risk for delirium, although those with more vulnerabilities (such

46 e the duration of mechanical ventilation and delirium among patients in the intensive care unit (ICU)

47 Delirium and acute kidney injury during ICU stay were pr

48 n between days of hypoactive and hyperactive delirium and adjusted for baseline and in-hospital covar

49 mation during SAE, which ultimately leads to delirium and cognitive dysfunction, remains elusive.

50 occurrence rate of acute brain dysfunction (delirium and coma) was 68.4% in the deep sedation group

51 tabolomic data readily distinguished between delirium and control groups (R2 <= 0.56; Q2 <= 0.10).

52 udy shows an independent association between delirium and decreased quality of life after hospital di

53 M) and CAM-S (Severity) were used to measure delirium and delirium severity, respectively.

54 Elevated NfL at PO1MO was associated with delirium and greater cognitive decline.

55 We assessed delirium and level of consciousness using the Confusion

56 to determine associations between pediatric delirium and modifiable risk factors such as benzodiazep

57 the driver of further complications such as delirium and other perioperative neurocognitive disorder

58 impair cognition with relevance to dementia, delirium and post-operative cognitive dysfunction.

59 Both the early prediction model for ICU delirium and recalibrated prediction model for ICU delir

60 ecognize patients at risk for and those with delirium and to immediately identify and treat factors c

61 Of 1040 patients, 71% experienced delirium, and 47% and 41% of survivors had RBANS scores

62 th reversible cognitive deficits, resembling delirium, and acute brain injury contributing to long-te

63 h prevalence in mood disorders, overlap with delirium, and comorbidity with medical conditions.

64 nts at a higher risk of severe and prolonged delirium, and delirium related complications during hosp

65 rbidity, polypharmacy, cognitive decline and delirium, and frailty) may be inadvertently exacerbated

66 up had a median of 27 days free from coma or delirium, and those in the sedation group had a median o

67 as to identify novel preoperative markers of delirium, and to assess potential correlations with clin

68 Coma-, delirium-, and invasive mechanical ventilation-free pati

69 0.22-0.36), coma (AOR, 0.35; CI, 0.22-0.56), delirium (AOR, 0.60; CI, 0.49-0.72), physical restraint

70 determine if duration of motoric subtypes of delirium are associated with worse cognition.

71 Atrial fibrillation and delirium are common consequences of cardiac surgery.

72 um and recalibrated prediction model for ICU delirium are externally validated using either the Confu

73 e nonpharmacological interventions to manage delirium are needed.

74 We defined a day with hypoactive delirium as a day with positive Confusion Assessment Met

75 han or equal to 0 and a day with hyperactive delirium as a day with positive Confusion Assessment Met

76 CU delirium was 0.67 (95% CI, 0.64-0.71) for delirium as assessed using the Confusion Assessment Meth

77 or Choice of Analgesia and Sedation; "D" for Delirium Assess, Prevent, and Manage; "E" for Early Mobi

78 ensive Care Delirium Screening Checklist for delirium assessment.

79 Family-administered delirium assessments (Family Confusion Assessment Method

80 ducted the reference standard assessments of delirium (based on Diagnostic and Statistical Manual for

81 maladaptive, cognitive dysfunction including delirium, but our understanding of delirium pathophysiol

82 Antipsychotics are used to prevent delirium, but their benefits and harms are unclear.

83 ICU totaling 10,216 visits were screened for delirium by means of the Confusion Assessment Method.

84 um using the Cornell Assessment of Pediatric Delirium by the bedside nurse.

85 e was incidence of postoperative in-hospital delirium by the Confusion Assessment Method.

86 Cornell Assessment of Pediatric Delirium (CAPD) scores >=9 had 94% sensitivity and 33% s

87 Delirium case-no delirium control (n = 108) pairs were m

88 At PO1MO, delirium cases had continued high NfL (adjusted OR = 9.7

89 Delirium cases had higher NfL on POD2 and PO1MO (median

90 n biomarkers collected at delirium onset and delirium-/coma-free days assessed through Richmond Agita

91 evels in quartile 4 were not associated with delirium-/coma-free days at both time points.

92 n quartile 4 were negatively associated with delirium-/coma-free days by 1 week and 30 days post enro

93 light rose more sharply in participants with delirium compared to non-sufferers [mean difference (95%

94 wed elevated CSF lactate and pyruvate during delirium, consistent with acutely altered brain energy m

95 Delirium case-no delirium control (n = 108) pairs were matched by age, se

96 0%), 71.0% (95% CI, 66.0-76.0%) for possible delirium (cutpoint of 4) on the Sour Seven and 67.0% (95

97 our Seven and 67.0% (95% CI, 62.0-72.0%) for delirium (cutpoint of 9) on the Sour Seven.

98 Family-administered delirium detection is feasible and has fair, but lower d

99 The effective implementation of delirium detection, treatment and prevention strategies

100 ndividual symptom prevalence and established delirium diagnoses using Diagnostic and Statistical Manu

101 cephalopathy, defined as a main diagnosis of delirium, disorientation, transient alteration of awaren

102 d ratio, 0.65 [0.42-1.00]; p = 0.01), longer delirium duration (incidence rate ratio, 2.47 [1.36-4.49

103 acebo for 3 prespecified secondary outcomes: delirium duration (median, 1 vs 2 days; difference, -1 [

104 Both delirium duration and delirium severity are associated w

105 Serum biomarkers associated with delirium duration and delirium severity in ICU patients

106 Brain dysfunction improved: the mean delirium duration decreased from 5.6 to 3.3 days (-2.2 d

107 Delirium duration, as assessed by the number of delirium

108 Secondary outcomes included delirium duration, cognitive decline, breakthrough analg

109 on, and astrocyte activation associated with delirium duration, delirium severity, and in-hospital mo

110 glial activation were associated with longer delirium duration, higher delirium severity, and in-hosp

111 e in sedation status (low and moderate SOE), delirium duration, hospital length of stay (moderate SOE

112 such as race, education, hospital type, and delirium duration, were linked to worse PICS ICU-related

113 The incidence of delirium during ICU stay was not significantly different

114 Primary outcome was incidence of delirium during ICU stay, assessed using the CAM-ICU.

115 After delirium during ICU stay, LTCI has been increasingly rec

116 The primary outcome was incident delirium during postoperative days 1 through 5.

117 Delirium during postoperative days 1 to 5 occurred in 15

118 ysfunction contribute to the pathogenesis of delirium during sepsis so that targeted treatments can b

119 Fifty-six children (27%) developed delirium during their PICU stay.

120 ed to determine the prevalence of individual delirium features and the frequency with which they coul

121 ative CSF of patients (n = 54) who developed delirium following arthroplasty (n = 28) and those who d

122 Delirium following surgery is common and associated with

123 ge) age of 20 months (11-37 mo), and 44% had delirium for at least 1 day (1-2 d).

124 irium duration, as assessed by the number of delirium-free days was also similar in both groups (plac

125 improved health professionals' adherence to delirium guidelines and reduced brain dysfunction.

126 Implementation of delirium guidelines at ICUs is suboptimal.

127 ng, and guideline) implementation program of delirium guidelines in adult ICUs.

128 d multifaceted implementation program of ICU delirium guidelines on processes of care and clinical ou

129 The primary outcome was adherence changes to delirium guidelines recommendations, based on the Pain,

130 sures based on the 2013 Pain, Agitation, and Delirium guidelines showed improved health professionals

131 mendations, based on the Pain, Agitation and Delirium guidelines.

132 Delirium has serious short and long-term sequelae but me

133 s (for example, urinary tract infection) for delirium have been described, with most patients having

134 Reversible delirium, headache, decreased level of consciousness, tr

135 Organ Failure Assessment, duration of coma, delirium, hypoxemia, sepsis, education level, hospital t

136 itochondrial DNA haplogroups and duration of delirium, identified using the Confusion Assessment Meth

137 hort-term use of antipsychotics for treating delirium in adult inpatients, but potentially harmful ca

138 or second-generation antipsychotics to treat delirium in adult inpatients.

139 ated with development of and protection from delirium in Caucasians and African Americans during seps

140 Delirium in critically ill patients is associated with p

141 .79 (95% CI, 0.75-0.83); early prediction of delirium in ICU patients was 0.72 (95% CI, 0.67-0.77); a

142 % CI, 0.75-0.83); recalibrated prediction of delirium in ICU patients was 0.79 (95% CI, 0.75-0.83); e

143 ceiver operating curve for the prediction of delirium in ICU patients was 0.79 (95% CI, 0.75-0.83); r

144 elirium in ICU patients, early prediction of delirium in ICU patients, and Lanzhou models.

145 ted for each patient using the prediction of delirium in ICU patients, early prediction of delirium i

146 ium or recalibrated prediction model for ICU delirium in ICUs around the world regardless of whether

147 lucose availability on sickness behavior and delirium in mice and humans.

148 of ketamine for prevention of postoperative delirium in older adults.

149 Ramelteon 8 mg did not prevent postoperative delirium in patients admitted for elective cardiac surge

150 be infused to reduce atrial fibrillation or delirium in patients having cardiac surgery.

151 decrease postoperative atrial arrhythmias or delirium in patients recovering from cardiac surgery.

152 on antipsychotics may lower the incidence of delirium in postoperative patients, but more research is

153 tients; p = 0.002) and increased duration of delirium in sedated patients (median 5 vs 1 d; p < 0.001

154 Assessing motoric subtypes of delirium in the ICU might aid in prognosis and intervent

155 We found more patients with delirium in the sedated group (96% vs 69% of patients; p

156 d produces disproportionate effects, such as delirium, in vulnerable individuals.

157 Delirium incidence (147, 75% of studies), duration (67,

158 ependent association between CSF Abeta42 and delirium incidence in an elective surgical population, s

159 t second-generation antipsychotics may lower delirium incidence in the postoperative setting.

160 There were no differences in delirium incidence or duration, hospital length of stay

161 icity, may contribute to the pathogenesis of delirium independent of inflammation.

162 Delirium is a marker of brain vulnerability, associated

163 Delirium is a prevalent complication of critical illness

164 Delirium is a serious acute neurocognitive condition fre

165 Delirium is an acute confusional state that is common an

166 Delirium is an acute disorder marked by impairments in a

167 While delirium is associated with cognitive decline and dement

168 These data suggest delirium is associated with exaggerated increases in neu

169 We tested whether delirium is associated with neuronal injury in 114 surgi

170 Delirium is common after intracerebral hemorrhage, but s

171 Postoperative delirium is common following cardiac surgery and may be

172 Delirium is common in hospitalized patients and is assoc

173 e role of neuroleptics for terminal agitated delirium is controversial.

174 ICUs around the world regardless of whether delirium is evaluated with the Confusion Assessment Meth

175 The pathophysiologic cause of delirium is not well understood.

176 nalgesics, on the incidence of postoperative delirium is warranted.

177 xicity may contribute to the pathogenesis of delirium itself, independent of changes in inflammation.

178 o single intervention or medication to treat delirium, making it challenging to manage.

179 Delirium may be prevented or attenuated when multimodal

180 Poststroke delirium may be underdiagnosed due to the challenges of

181 Clarification of how delirium may cause cognitive decline, perhaps through ev

182 al population, suggesting that postoperative delirium may indicate incipient Alzheimer disease.

183 udy in 30 selected patients with and without delirium (median age, 63 yr; range, 23-84) who were asse

184 ts the Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobil

185 tributed between the groups, with hypoactive delirium most frequent (61%), followed by mixed delirium

186 sidered an important driver of postoperative delirium, next we tested whether neurofilament light, as

187 Adjusted analysis indicated that delirium, non-White race, lower education, and civilian

188 Delirium occurred in 22 of 58 patients allocated to plac

189 rimary outcomes were atrial fibrillation and delirium occurring between intensive care unit admission

190 Delirium occurs frequently in critically ill children, w

191 st performed 257 total daily assessments for delirium on 60 patients (mean age 68.0 [SD 18.4], 62% ma

192 study was to measure the residual effect of delirium on quality of life at 1 and 3 months after hosp

193 throplasty were postoperatively assessed for delirium once-daily for three days.

194 associations between biomarkers collected at delirium onset and delirium-/coma-free days assessed thr

195 Utility of these biomarkers early in delirium onset to identify patients at a higher risk of

196 tly predicted according to the occurrence of delirium or acute kidney injury during their ICU stay.

197 Secondary outcomes were brain dysfunction (delirium or coma), length of ICU stay, and hospital mort

198 of either the early prediction model for ICU delirium or recalibrated prediction model for ICU deliri

199 eased pain [odds ratio (OR) 3.5, P < 0.001], delirium (OR 3.0, P = 0.004), and pulmonary complication

200 CU admission (early prediction model for ICU delirium) or within 24 hours of ICU admission (recalibra

201 This large pre-post implementation study of delirium-oriented measures based on the 2013 Pain, Agita

202 gnosis was longer (P < .0001); at diagnosis, delirium (P = .034), behavior impairment (P = .045), ren

203 ration of night sleep, and the occurrence of delirium, pain, and anxiety.

204 The prevalence of delirium, pain, anxiety, adverse reactions, duration of

205 mptom-related (mechanical ventilation, coma, delirium, pain, restraint use), and system-related (ICU

206 neurobiological processes that contribute to delirium pathogenesis, including neuroinflammation, brai

207 including delirium, but our understanding of delirium pathophysiology remains limited.

208 ive experiences: people with dementia and/or delirium; people with difficulty communicating, hearing

209 Per delirium prediction model, both assessment tools showed

210 Data required for delirium predictor models were obtained retrospectively

211 orrhage score 1.5 [interquartile range 1-2], delirium prevalence 57% [n = 34]).

212 ion with a growing role in communication and delirium prevention and care.

213 ity between haloperidol and placebo used for delirium prevention.

214 emerged: (i) encephalopathies (n = 10) with delirium/psychosis and no distinct MRI or CSF abnormalit

215 ignificant differences in handgrip strength, delirium rate, intensive care unit mortality, hospital m

216 Virtual ACE increased mobility and decreased delirium rates for surgical patients.

217 r risk of severe and prolonged delirium, and delirium related complications during hospitalization ne

218 ilding stage of a core outcome set to inform delirium research in the critically ill.

219 survival, mechanical ventilation use, coma, delirium, restraint-free care, ICU readmissions, and pos

220 may be useful as a predictive biomarker for delirium risk and long-term cognitive decline, and once

221 Delirium risk was calculated for each patient using the

222 els could be useful markers of postoperative delirium risk, particularly when combined with Abeta42,

223 elirium status, children who had experienced delirium scored lower in every quality of life domain wh

224 ements after the implementation pertained to delirium screening (from 35% to 96%; p < 0.001), use of

225 ic curves were lower than the Intensive Care Delirium Screening Checklist (standard of care) and Conf

226 ssment Method for the ICU and Intensive Care Delirium Screening Checklist against reference-standard

227 linical assessments using the Intensive Care Delirium Screening Checklist and Confusion Assessment Me

228 Method and Sour Seven to the Intensive Care Delirium Screening Checklist and Confusion Assessment Me

229 ion Assessment Method-ICU and Intensive Care Delirium Screening Checklist cohort, and compared with b

230 Assessment Method-ICU or the Intensive Care Delirium Screening Checklist for delirium assessment.

231 Since the Intensive Care Delirium Screening Checklist may be positive without the

232 Method or Sour Seven with the Intensive Care Delirium Screening Checklist or Confusion Assessment Met

233 r some combinations, than the Intensive Care Delirium Screening Checklist or Confusion Assessment Met

234 The Intensive Care Delirium Screening Checklist's inclusion of nonverbal fe

235 ssessment Method for the ICU, Intensive Care Delirium Screening Checklist, a focused bedside cognitiv

236 ICU-assessed patients and 892 Intensive Care Delirium Screening Checklist-assessed patients were incl

237 (95% CI, 0.67-0.75) using the Intensive Care Delirium Screening Checklist.

238 (95% CI, 0.66-0.74) using the Intensive Care Delirium Screening Checklist.

239 Assessment Method-ICU or the Intensive Care Delirium Screening Checklist.

240 sion Assessment Method-ICU or Intensive Care Delirium Screening Checklist.

241 iazepines, older than 70 years with a failed delirium screening questionnaire, pregnant or nursing, u

242 ndard diagnosis is made, although many other delirium screening tools have been developed given the i

243 Multifaceted, three-phase (baseline, delirium screening, and guideline) implementation progra

244 onal impairments), during (e.g., duration of delirium, sepsis, acute respiratory distress syndrome),

245 neurofilament light rose proportionately to delirium severity (DeltaR2 = 0.199, P < 0.001).

246 ine IL-8 exhibited a strong correlation with delirium severity (DeltaR2 = 0.208, P < 0.001).

247 effect of haloperidol on cognitive function, delirium severity (insufficient SOE), inappropriate cont

248 There was no difference in delirium severity (moderate SOE) and cognitive functioni

249 ment light was independently associated with delirium severity after adjusting for the change in infl

250 ytokines, with contemporaneous assessment of delirium severity and incidence.

251 Both delirium duration and delirium severity are associated with adverse patient ou

252 ale/Confusion Assessment Method for the ICU, delirium severity assessed through Confusion Assessment

253 evels in quartile 4 were not associated with delirium severity at both time points.

254 vels in quartile 4 were also associated with delirium severity by 1 week.

255 arkers associated with delirium duration and delirium severity in ICU patients have not been reliably

256 change in neurofilament light contributed to delirium severity independent of IL-8.

257 Dose-dependence of neuronal injury with delirium severity would further enhance the biological p

258 ciated with longer delirium duration, higher delirium severity, and in-hospital mortality.

259 ctivation associated with delirium duration, delirium severity, and in-hospital mortality.

260 (Severity) were used to measure delirium and delirium severity, respectively.

261 , and S-100beta lost their associations with delirium severity.

262 For both delirium-specific and nonspecific outcome domains, we fo

263 We identified a further 94 non-delirium-specific outcome domains within 19 Core Outcome

264 When analyzed by delirium status, children who had experienced delirium s

265 Delirium subtypes were equally distributed between the g

266 Pharmacological treatments for delirium (such as antipsychotic drugs) are not effective

267 e not different in patients with and without delirium, suggesting them to be distinct phenomena.

268 nosed due to the challenges of disentangling delirium symptoms from underlying neurologic deficits.

269 23-84) who were assessed with the Edinburgh Delirium Test Box-ICU on up to 5 separate days.

270 Edinburgh Delirium Test Box-ICU scores (range, 0-11) were lower fo

271 al DNA haplogroup clade IWX experienced more delirium than the 49% in haplogroup H, the most common C

272 ns the 24% in haplogroup L2 experienced less delirium than those in haplogroup L3, the most common Af

273 s (range, 0-11) were lower for patients with delirium than those without at the first (median, 0 vs 9

274 36-4.49]; p = 0.005), and increased risk for delirium the following day (odds ratio, 2.83 [1.27-6.59]

275 e factors are implicated in the aetiology of delirium, there are likely several neurobiological proce

276 and December 31, 2017, were assessed bid for delirium throughout their ICU stay using the Confusion A

277 (using the Cornell Assessment for Pediatric Delirium) throughout their stay in the PICU.

278 m was 0.75 (95% CI, 0.72-0.78) for assessing delirium using the Confusion Assessment Method-ICU and 0

279 Children were screened for delirium using the Cornell Assessment of Pediatric Delir

280 All children were screened for delirium (using the Cornell Assessment for Pediatric Del

281 ofol or dexmedetomidine, reduced in-hospital delirium vs placebo.

282 Mental status (normal vs. delirium vs. coma) was assessed daily with the Confusion

283 curve of the early prediction model for ICU delirium was 0.67 (95% CI, 0.64-0.71) for delirium as as

284 of the recalibrated prediction model for ICU delirium was 0.75 (95% CI, 0.72-0.78) for assessing deli

285 Delirium was assessed using the Confusion Assessment Met

286 Longer duration of hypoactive delirium was associated with worse global cognition at 3

287 Delirium was independently associated with a decreased r

288 Longer duration of hypoactive delirium was independently associated with worse long-te

289 Incident delirium was measured twice daily using the Confusion As

290 Hypoactive delirium was more common and persistent than hyperactive

291 The incidence of delirium was non-significantly increased from 12% in pat

292 Hyperactive delirium was not associated with global cognition or exe

293 edict altered carbohydrate metabolism during delirium, we assessed glycolytic metabolite levels in CS

294 ICU admissions with delirium were associated with greater declines in memory

295 home sleep quality, home sleep aid use, and delirium were factors associated with sleep disruption i

296 or severely cognitively impaired, often had delirium, were very physically disabled, and many were a

297 gs were more pronounced in those who develop delirium while in the ICU.

298 Fifty-five percent had new-onset delirium with a median duration of 2 days (interquartile

299 s between days of hypoactive and hyperactive delirium with cognition outcomes.

300 ], respectively) and experienced more severe delirium, with sum CAM-S scores 7.8 points (95% CI = 1.6