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2015, Number 3

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Medisur 2015; 13 (3)

Clinical practice guideline for the care of elderly patients hospitalized with delirium

Romero CÁJ, Amores HL, Alonso CE, Olascoaga PF, Fernández CE

Language: Spanish
References: 37
Page: 458-466
PDF size: 206.93 Kb.


ABSTRACT

Delirium is a frequent disorder found in people of advanced age in the hospital setting. It is characterized by an acute disorder of consciousness and alterations in behavior, posing a diagnostic and therapeutic challenge for the doctors that look after geriatric patients. A clinical practice guideline drawn up by consensus is presented. It highlights the clinical and therapeutic aspects of this complex syndrome. An algorithm that facilitates the management of this condition at Dr. Gustavo Aldereguía Lima University General Hospital of Cienfuegos is included.


REFERENCES

  1. Munk L, Andersen LP, Gögenur I. Emergence delirium. J Perioper Pract. 2013 ; 23 (11): 251-4.

  2. Varghese NC, Macaden L, Premkumar B, Mathews P, Kumar S. Delirium in older people in hospital: an education programme. Br J Nurs. 2014 ; 23 (13): 704-9.

  3. Tifuh Amba K. Delirium in the elderly adult in critical care. Crit Care Nurs Clin North Am. 2014 ; 26 (1): 139-45.

  4. Vega PE, Nazar JC, Rattalino FM, Pedemonte TJ, Carrasco GM. Postoperative delirium among older people. Rev Med Chil. 2014 ; 142 (4): 481-93.

  5. Romero AJ. Fallo mental I: Delirium. In: Asistencia clínica al adulto mayor. La Habana: Editorial Ciencias Médicas; 2012. p. 112-8.

  6. Inouye SK. Delirium in older persons. N Engl J Med. 2006 ; 354: 1157-65.

  7. Young J, Inouye SK. Delirium in older people. BMJ. 2007 ; 334 (7598): 842-6.

  8. Szendi I. Delirium a common complication of severe pathological conditions. Orv Hetil. 2014 ; 155 (48): 1895-901.

  9. Siddigi N, House AO, Holmes JD. Occurrence and outcome of delirium in medical in-patients: a systematic review. Age Ageing. 2006 ; 35 (4): 350-64.

  10. Merkin A, Borisov I, Shushkevitch A, Dinov E, Brandt Y, Cheremushkin E, et al. Difficulties in diagnosing delirium in elderly patients in a general hospital. Asian J Psychiatr. 2014 ; 9: 85-6.

  11. Cole MG, Ciampi A, Belzile E, Zhong L. Persistent delirium in older hospital patients: a systematic review of frequency and prognosis. Age Ageing. 2009 ; 38 (1): 19-26.

  12. Dasgupta M, Hillier LM. Factors associated with prolonged delirium: a systematic review. Int Psychogeriatr. 2010 ; 22 (3): 373-94.

  13. Cole MG, Ciampi A, Belzile E, Dubuc-Sarrasin M. Subsyndromal delirium in older people: a systematic review of frequency, risk factors, course and outcomes. Int J Geriatr Psychiatry. 2013 ; 28 (8): 771-80.

  14. Higuet S, Higuet A. Delirium in the elderly. Rev Med Brux. 2014 ; 35 (2): 78-85.

  15. Naeije G, Pepersack T. Delirium in elderly people. Lancet. 2014 ; 383 (9934): 2044-5.

  16. Popeo DM. Delirium in older adults. Mt Sinai J Med. 2011 ; 78 (4): 571-582.

  17. Ryan DJ, O´Regan NA, Caoimh RO, Clare J, O´Connor M, Leonard M, et al. Delirium in an adult acute hospital population: predictors, prevalence and detection. BMJ Open [revista en Internet]. 2013 [ cited 23 Mar 2014 ] ; 13 (1): [aprox. 23p]. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC35 49230/.

  18. Flaherty JH. The evaluation and management of delirium among older persons. Med Clin North Am. 2011 ; 95 (3): 555-77.

  19. Rai D, Garg RK, Malhotra HS, Verma R, Jain A, Tiwari SC, et al. Acute confusional state/delirium: An etiological and prognostic evaluation. Ann Indian Acad Neurol. 2014 ; 17 (1): 30-4.

  20. Díez-Manglano J, Palazón-Fraile C, Diez-Massó F, Martínez-Álvarez R, Del Corral-Beamonte E, Carreño-Borrego P, et al. Factors associated with onset of delirium among internal medicine inpatients in Spain. Nurs Res. 2013 ; 62 (6): 445-9.

  21. Grover S, Ghormode D, Ghosh A, Avasthi A, Chakrabarti S, Mattoo SK, et al. Risk factors for delirium and inpatient mortality with delirium. J Postgrad Med. 2013 ; 59 (4): 263-70.

  22. Williams ST. Pathophysiology of encephalopathy and delirium. J Clin Neurophysiol. 2013 ; 30 (5): 435-7.

  23. Maclullich A, Anand A, Davis D, Jackson T, Barugh AJ, Hall RJ, et al. New horizons in the pathogenesis, assessment and management of delirium. Age Ageing. 2013 ; 42: 667-4.

  24. Gunther ML, Morandi A, Ely EW. Pathophysiology of delirium in the intensive care unit. Crit Care Clin. 2008 ; 24 (1): 45-65.

  25. Bogović TZ, Tonković D, Sekulić A, Bandić-Pavlović D, Baronica R, Bogović M. Pathophysiology of delirium. Acta Med Croatica. 2012 ; 66 (1): 61-6.

  26. Mu DL, Wang DX, Li LH, Shan GJ, Li J, Yu QJ, Shi CX. High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery: a prospective cohort study. Crit Care. 2010 ; 14 (6): R238.

  27. Fitzgerald JM, Adamis D, Trzepacz PT, O´Regan N, Timmons S, Dunne C, et al. Delirium: a disturbance of circadian integrity?. Med Hypotheses. 2013 ; 81 (4): 568-76.

  28. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th. ed. Washington, DC: American Psychiatric Association; 1994.

  29. Swain DG, Nightingale PG. Evaluation of a shortened version of the abbreviated mental test in a series of elderly patients. Clin Rehabil. 1997 ; 11 (3): 243-8.

  30. Graham E, Trudi M, Claire R. Comprehensive geriatric assessment in the emergency department. Clin Interv Aging. 2014 ; 9: 2033-43.

  31. Clasificación Internacional de Enfermedades. Modificación clínica. CIE-9-MC [Internet]. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad; 2014. [ cited 23 Ene 2015 ] Available from: http://www.msssi.gob.es/estadEstudios/estadistic as/docs/CIE9MC_2014_def_accesible.pdf.

  32. Holmes J. Delirium. In: Cooper N, Forrest K, Mulley G, editors. ABC of geriatric medicine. London: BMJ Books; 2009. p. 11-6.

  33. Marcantonio ER, Ngo LH, O´Connor M, Jones RN, Crane PK, Metzger ED, et al. 3D-CAM: derivation and validation of a 3-minute diagnostic interview for CAM-defined delirium: a cross-sectional diagnostic test study. Ann Intern Med. 2014 ; 161 (8): 554-61.

  34. Eremenko AA, Chernova EV. Treatment of delirium in the early postoperative period after cardiac surgery. Anesteziol Reanimatol. 2014 (3): 30-4.

  35. Kalish VB, Gillham JE, Unwin BK. Delirium in older persons: evaluation and management. Am Fam Physician. 2014 ; 90 (3): 150-8.

  36. Michaud CJ, Thomas WL, McAllen KJ. Early pharmacological treatment of delirium may reduce physical restraint use: a retrospective study. Ann Pharmacother. 2014 ; 48 (3): 328-34.

  37. Bellelli G, Morandi A, Zanetti E, Bozzini M, Lucchi E, Terrasi M, et al. Recognition and management of delirium among doctors, nurses, physiotherapists, and psychologists: an Italian survey. Int Psychogeriatr. 2014 ; 26 (12): 2093-102.




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