Unrecognized delirium may lead to negative outcomes, such as increased morbidity, longer hospital stays, and increased health care costs. A prospective cohort design study was used to determine the incidence and prevalence of delirium and percentage of patients with unrecognized delirium in a hospital inpatient unit. The sample consisted of 141 patients admitted to a urology/nephrology unit over a six-week period. Data were collected using the Confusion Assessment Method (CAM) and the Charlson Comorbidity Index (CCI). Results showed the incidence of delirium was 6%, and the prevalence was 12% in this sample. Out of 17 patients with delirium, 6 patient records (35%) had no documentation of delirium by physicians. In the nursing assessment, 1 of 17 (6%) had no documentation of any signs/symptoms of delirium. This study provided baseline data for the development, implementation, and evaluation of a delirium recognition program using the CAM. The CAM may represent an easy-to-use, valid, and reliable instrument to detect delirium as part of a routine nursing assessment.
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Injury
January 2025
Brigham and Women's Hospital, Dpt. of Orthopaedic Surgery, Boston, MA, United States; Harvard Medical School Orthopedic Trauma Initiative, Boston, MA, United States.
Background: Older adults with rib fractures pose an increasing clinical and financial burden on healthcare. Identifying and addressing the increased risk of adverse outcomes has been a key objective in geriatric co-management of surgical patients. The Comprehensive Geriatric Assessment-based Frailty Index (FI-CGA) is a useful predictor of complications and mortality in older adults, but its value in rib fracture management remains unclear.
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January 2025
Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London.
Background: Delirium is a common and serious syndrome of acute brain dysfunction associated with negative outcomes. Melatonin may have a role in delirium prevention for critically ill adults based on data from non-critically ill patient populations. Our objective was to assess the feasibility of a multi-centre, randomized, placebo-controlled trial testing the hypothesis that low-dose melatonin prevents delirium in critically ill adults.
View Article and Find Full Text PDFDiagnostics (Basel)
January 2025
Department of Continuity of Care and Multicomplexity, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy.
: Point-of-care lung ultrasonography (LUS) represents an accurate diagnostic tool in older patients with respiratory failure. The integration of LUS with ultrasonographic assessment of diaphragm thickness and excursion, right vastus lateralis (RVL) muscle thickness and cross-sectional area (CSA) could provide real-time information on frailty and sarcopenia. The primary aim of this proof-of-concept prospective study was to evaluate clinical correlates of thoracic, diaphragmatic, and muscular ultrasound to characterize the associations between frailty, respiratory failure, and sarcopenia in older patients hospitalized for acute respiratory complaints.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Anesthesiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China.
Background: This study compares the outcomes of general anesthesia (GA) and regional anesthesia (RA) in geriatric hip fracture surgery to determine optimal anesthesia strategies for this population.
Methods: A comprehensive literature review was conducted, analyzing studies comparing GA and RA in elderly patients undergoing hip fracture surgery. Studies encompassed various designs, including randomized controlled trials, cohort studies, and meta-analyses.
Crit Care Med
November 2024
Department of Intensive Care, Copenhagen University Hospital, Copenhagen, Denmark.
Objectives: Rocking motion therapy has been shown to calm people with dementia but has never been investigated in delirious patients in the ICU. The aim of this clinical trial was to investigate the efficacy and safety of a rocking motion vs. nonrocking motion chair on the duration of delirium and intensity of agitation in ICU patients with delirium.
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