Background: Delirium is an independent predictor of increased length of stay, mortality, and treatment costs in critical care patients. Its incidence may be underestimated or overestimated if delirium is assessed by using subjective clinical impression alone rather than an objective instrument.
Objectives: To determine frequency of discrepancies between subjective and objective delirium monitoring.
Methods: An observational cohort study was performed in a surgical-cardiosurgical 31-bed intensive care unit of a university hospital. Patients' delirium status was rated daily by bedside nurses on the basis of subjective individual clinical impressions and by medical students on the basis of scores on the objective Confusion Assessment Method for the Intensive Care Unit.
Results: Of 160 patients suitable for analysis, 38.8% (n = 62) had delirium according to objective criteria at some time during their stay in the intensive care unit. A total of 436 paired observations were analyzed. Delirium was diagnosed in 26.1% of observations (n = 114) with the objective method. This percentage included 6.4% (n = 28) in whom delirium was not recognized via subjective criteria. According to subjective criteria, delirium was present in 29.4% of paired observations (n = 128), including 9.6% (n = 42) with no objective indications of delirium. A total of 8 patients with no evidence of delirium according to the objective criteria were prescribed haloperidol and lorazepam because the subjective method indicated they had delirium.
Conclusions: Use of objective criteria helped detect delirium in more patients and also identified patients mistakenly thought to have delirium who actually did not meet objective criteria for diagnosis of the condition.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.4037/ajcc2012735 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Identification of an ANCA-associated vasculitis cohort using deep learning and electronic health records.
Int J Med Inform
January 2025
Rheumatology and Allergy Clinical Epidemiology Research Center and Division of Rheumatology, Allergy, and Immunology, and Mongan Institute, Department of Medicine, Massachusetts General Hospital Boston MA USA. Electronic address:
Background: ANCA-associated vasculitis (AAV) is a rare but serious disease. Traditional case-identification methods using claims data can be time-intensive and may miss important subgroups. We hypothesized that a deep learning model analyzing electronic health records (EHR) can more accurately identify AAV cases.
View Article and Find Full Text PDFTesting an Electronic Patient-Reported Outcome Platform in the Context of Traumatic Brain Injury: PRiORiTy Usability Study.
JMIR Form Res
January 2025
Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.
Background: Traumatic brain injury (TBI) is a significant public health issue and a leading cause of death and disability globally. Advances in clinical care have improved survival rates, leading to a growing population living with long-term effects of TBI, which can impact physical, cognitive, and emotional health. These effects often require continuous management and individualized care.
View Article and Find Full Text PDFDoes oral hygiene prevents nosocomial infections in hospitalized patients? A systematic review and meta-analysis.
Med Oral Patol Oral Cir Bucal
January 2025
Background: This study aimed to evaluate the impact of oral hygiene (OH) with chlorhexidine (CHX) on the evolution of nosocomial infections (NI).
Material And Methods: Electronic searches were carried out in PubMed, Scopus, Cochrane Library, Web of Science, VHL, and Grey Literature databases. Randomized clinical trials were included.
Protocol for investigating astrocytic mitochondria in neurons of adult mice using two-photon microscopy.
STAR Protoc
January 2025
Department of Neurosurgery, the First Affiliated Hospital of Jinan University, Guangzhou, China; Department of Neurosurgery, the Affiliated Hospital, Southwest Medical University, Luzhou 646000, China; Laboratory of Neurological Diseases and Brain Function, the Affiliated Hospital, Southwest Medical University, Luzhou 646000, China. Electronic address:
Under pathological conditions, astrocytes can transfer mitochondria to neurons, where they exert neuroprotective effects. In this context, we present a protocol for capturing astrocytic mitochondria in neurons of adult mice using a two-photon microscope. We describe an approach for constructing a mouse model with combined labeling of astrocytic mitochondria and neurons.
View Article and Find Full Text PDFPoint-of-care ultrasound in the diagnosis of hepatic gas gangrene.
J Ultrasound
January 2025
Argentinian Critical Care Ultrasonography Association (ASARUC), Buenos Aires, Argentina.
Hepatic gas gangrene (HGG) is a rare but life-threatening condition typically caused by anaerobic bacteria such as Clostridium perfringens, though Gram-negative bacteria like Escherichia coli and Klebsiella species have also been implicated. Traditionally diagnosed via computed tomography (CT), point-of-care ultrasound (POCUS) has emerged as a valuable tool in critical care settings for its non-invasive, bedside utility. We report the case of a 51-year-old female with choledochal syndrome secondary to cholangiocarcinoma who developed HGG following left extended hepatectomy and biliary reconstruction.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!