Diseases, Conditions, Syndromes

To prevent delirium, increase mobility, connection and sleep

Accelerated cognitive decline in patients with and without existing dementia is one of the most disturbing outcomes of hospitalizations for older adults, affecting at least 2.6 million Americans every year.

Surgery

Study shows economic impact of post-op delirium

Results of a study published today in JAMA Surgery reveal the impact post-operative delirium has on health care costs in the U.S. Data from the study shows that if delirium were prevented or made less severe for patients, ...

Surgery

Steps outlined to reduce postop delirium in older adults

(HealthDay)—In an article published online Jan. 4 in the British Journal of Anaesthesia, six recommendations are presented that can be implemented by anesthesiologists and their partners to reduce the incidence of delirium.

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Delirium

Delirium or acute confusional state is a common and severe neuropsychiatric syndrome with core features of acute onset and fluctuating course, attentional deficits and generalized severe disorganization of behavior. It typically involves other cognitive deficits, changes in arousal (hyperactive, hypoactive, or mixed), perceptual deficits, altered sleep-wake cycle, and psychotic features such as hallucinations and delusions. It is often caused by a disease process outside the brain, such as infection (urinary tract infection, pneumonia) or drug effects, particularly anticholinergics or other CNS depressants (benzodiazepines and opioids). Although hallucinations and delusions are sometimes present, these are not required for the diagnosis, and the symptoms of delirium are clinically distinct from those induced by psychosis or hallucinogens (with the exception of deliriants.)

Delirium itself is not a disease, but rather a clinical syndrome (a set of symptoms), which result from an underlying disease or new problem with mentation. Like its components (inability to focus attention, mental confusion and various impairments in awareness and temporal and spatial orientation), delirium is simply the common symptomatic manifestation of early brain or mental dysfunction (for any reason). Without careful assessment, delirium can easily be confused with a number of psychiatric disorders because many of the signs and symptoms are conditions present in dementia, depression, and psychosis.

Treatment of delirium requires treatment of the underlying causes. In some cases, temporary or palliative or symptomatic treatments are used to comfort patients or to allow better patient management (for example, a patient who, without understanding, is trying to pull out a ventilation tube that is required for survival). Delirium is probably the single most common acute disorder affecting adults in general hospitals. It affects 10-20% of all hospitalized adults, and 30-40% of elderly hospitalized patients and up to 80% of ICU patients.

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