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09-Apr-2020 03:32

Because a multitude of underlying causes may be involved, a broad diagnostic approach is needed and clinicians should keep an open mind about the possibility of more than one contributing medical problem. The workup should include a detailed assessment to search for the precipitant, whether it is an acute medical illness, a change in therapy, or the destabilization of a chronic condition. 3D-CAM: Derivation and validation of a 3-minute diagnostic interview for CAM-defined delirium: A cross-sectional diagnostic test study. The pathogenesis behind delirium is not fully understood, but several mechanisms have been postulated. Systemic inflammatory cytokine response and neurotransmitter disruption are the two main mechanisms thought to link multifactorial medical conditions and delirium.[5] During a systemic inflammatory response such as sepsis, proinflammatory cytokines released in the peripheral circulation enter the central nervous system, altering endothelial function, diminishing perfusion, activating microglia, and causing neuronal apoptosis and neurotoxicity. An evaluation of a proactive geriatric trauma consultation service. While antipsychotics can be used off-label to manage symptoms of delirium, they do not treat the underlying cause and are associated with side effects. Recognizing delirium promptly and treating the underlying cause can prevent the significant consequences of an acute disturbance in cognition, which include cognitive and functional decline, falls, and admission to long-term care. Risk of death with atypical antipsychotic drug treatment for dementia: Meta-analysis of randomized placebo-controlled trials.

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Many hospitals now include a version of the CAM on nursing assessment flow-sheets, helping physicians to quickly scan the chart for signs of delirium. A multicomponent intervention to prevent delirium in hospitalized older patients. Therapy focuses on treating the triggering cause as well as addressing patient-specific and environmental risk factors that may contribute to the development or worsening of delirium.

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