| Author | Patel, Mayur B. | |
| Author | Bednarik, Josef | |
| Author | Lee, Patricia | |
| Author | Shehabi, Yahya | |
| Author | Salluh, Jorge I. | |
| Author | Slooter, Arjen J. | |
| Author | Klein, Kate E. | |
| Author | Skrobik, Yoanna | |
| Author | Morandi, Alessandro | |
| Author | Spronk, Peter E. | |
| Author | Naidech, Andrew M. | |
| Author | Pun, Brenda T. | |
| Author | Bozza, Fernando A. | |
| Author | Marra, Annachiara | |
| Author | John, Sayona | |
| Author | Pandharipande, Pratik P. | |
| Author | Ely, E. Wesley | |
| Access date | 2019-07-08T14:14:09Z | |
| Available date | 2019-07-08T14:14:09Z | |
| Document date | 2018 | |
| Citation | PATEL, Mayur B. et al. Delirium monitoring in neurocritically Ill patients: a systematic review. Critical Care Medicine, v. 46, n. 11, p. 1832-1841, Nov. 2018. | pt_BR |
| ISSN | 0090-3493 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/33878 | |
| Sponsorship | Dr. Patel’s institution received funding from National Institutes of Health (NIH) HL111111 and NIH GM120484; he received funding from Pfizer/Hospira (education presentation); and he disclosed that funding was provided by federal sources including the Veterans Affairs (VA) Tennessee Valley Geriatric Research, Education and Clinical Center (Nashville, TN) and the NIH AG027472, AG035117, HL111111, GM120484 (Bethesda, MD). Drs. Patel and Ely received support for article research from the NIH. Ms. Klein’s institution received funding from Hill Rom Co. Dr. Naidech received support for article research from the Agency for Healthcare Research and Quality (K18 HS023437). Dr. Pun received funding from the Society of Critical Care Medicine, the American Association of Critical Care Medicine, and the France Foundation to provide continuing education. Dr. John disclosed other support from CSL Behring (speaker). Dr. Pandharipande’s institution received funding from Hospira. Dr. Ely’s institution received funding from NIH and VA funding, and he received funding from Orion Laboratories, Abbott Laboratories, and Pfizer. Dr. Pandharipande has received a research grant from Hospira Inc, in collaboration with the NIH. Dr. Ely has conducted Continuing Medical Education activities sponsored by Abbott, Hospira, and Orion. The remaining authors have disclosed that they do not have any potential conflicts of interest. | |
| Language | eng | pt_BR |
| Publisher | Lippincott, Williams & Wilkins | pt_BR |
| Rights | open access | pt_BR |
| Title | Delirium monitoring in neurocritically Ill patients: a systematic review | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1097/CCM.0000000000003349 | |
| Abstract | Objectives: The Society of Critical Care Medicine recommends routine delirium monitoring, based on data in critically ill patients without primary neurologic injury. We sought to answer whether there are valid and reliable tools to monitor delirium in neurocritically ill patients and whether delirium is associated with relevant clinical outcomes (e.g., survival, length of stay, functional independence, cognition) in this population. Data Sources: We systematically reviewed Cumulative Index to Nursing and Allied Health Literature, Web of Science, and PubMed. Study Selection and Data Extraction: Inclusion criteria allowed any study design investigating delirium monitoring in neurocritically ill patients (e.g., neurotrauma, ischemic, and/or hemorrhagic stroke) of any age. We extracted data relevant to delirium tool sensitivity, specificity, negative predictive value, positive predictive value, interrater reliability, and associated clinical outcomes. Data Synthesis: Among seven prospective cohort studies and a total of 1,173 patients, delirium was assessed in neurocritically patients using validated delirium tools after considering primary neurologic diagnoses and associated complications, finding a pooled prevalence rate of 12–43%. When able to compare against a common reference standard, "Diagnostic and Statistical Manual of Mental Disorders", Fourth Edition, the test characteristics showed a sensitivity of 62–76%, specificity of 74–98%, positive predictive value of 63–91%, negative predictive value of 70–94%, and reliability kappa of 0.64–0.94. Among four studies reporting multivariable analyses, delirium in neurocritically patients was associated with increased hospital length of stay (n = 3) and ICU length of stay (n = 1), as well as worse functional independence (n = 1) and cognition (n = 2), but not survival. Conclusions: These data from studies of neurocritically ill patients demonstrate that patients with primary neurologic diagnoses can meet diagnostic criteria for delirium and that delirious features may predict relevant untoward clinical outcomes. There is a need for ongoing investigations regarding delirium in these complicated neurocritically ill patients. | pt_BR |
| Affilliation | Critical Illness, Brain dysfunction, and ICU Survivorship Center. Center for Health Services Research. Vanderbilt University Medical Center. Nashville, TN, USA / Geriatric Research Education and Clinical Center. Department of Veterans Affairs Medical Center. Tennessee Valley Healthcare System. Nashville, TN, USA / Section of Surgical Sciences. Departments of Surgery, Neurosurgery, Hearing & Speech Sciences. Division of Trauma, Surgical Critical Care, and Emergency General Surgery. Vanderbilt Brain Institute. Vanderbilt University Medical Center. Nashville, TN, USA / Surgical Service. Department of Veterans Affairs Medical Center. Tennessee Valley Healthcare System. Nashville, TN, USA. | pt_BR |
| Affilliation | University Hospital Brno. Department of Neurology. Brno, Czech Republic / Masaryk University. Central European Institute of Technology. Applied Neuroscience Research Group. Brno, Czech Republic. | pt_BR |
| Affilliation | Vanderbilt University Medical Center. Center for Knowledge Management. Nashville, TN, USA. | pt_BR |
| Affilliation | University New South Wales. Clinical School of Medicine. Prince of Wales Hospital. Randwick, NSW, Australia. | pt_BR |
| Affilliation | D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | University Medical Center Utrecht. Brain Center Rudolf Magnus. Department of Intensive Care Medicine. Utrecht. The Netherlands. | pt_BR |
| Affilliation | Novant Health Presbyterian Medical Center. Charlotte, NC, USA. | pt_BR |
| Affilliation | McGill University. Department of Medicine. Montreal, QC, Canada. | pt_BR |
| Affilliation | Fondazione Camplani. Ancelle Hospital. Department of Rehabilitation and Aged Care. Cremona, Italy / Geriatric Research Group. Brescia, Italy. | pt_BR |
| Affilliation | Gelre Ziekenhuizen. Department of Intensive Care. Apeldoorn, The Netherlands. | pt_BR |
| Affilliation | Northwestern University. Feinberg School of Medicine. Departments of Neurology (Stroke and Neurocritical Care). Neurological Surgery, Anesthesiology, Medical Social Sciences, and Preventive Medicine (Health and Biomedical Informatics). Chicago, IL, USA. | pt_BR |
| Affilliation | Vanderbilt University Medical Center. Department of Medicine. Division of Allergy, Pulmonary and Critical Care Medicine. Nashville, TN, USA. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Medicina Intensiva. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | University of Naples. Department of Neurosciences and Department of Public Health. Naples, Italy. | pt_BR |
| Affilliation | Rush University Medical Center. Department of Neurological Sciences. Section of Neurocritical Care. Chicago, IL, USA. | pt_BR |
| Affilliation | Critical Illness, Brain dysfunction, and ICU Survivorship Center. Center for Health Services Research. Vanderbilt University Medical Center. Nashville, TN, USA / Geriatric Research Education and Clinical Center. Department of Veterans Affairs Medical Center. Tennessee Valley Healthcare System. Nashville, TN, USA / Department of Anesthesiology, Division of Critical Care Medicine. Vanderbilt University Medical Center. Nashville, TN, USA / Anesthesiology Service. Department of Veterans Affairs Medical Center. Tennessee Valley Healthcare System. Nashville, TN, USA. | pt_BR |
| Affilliation | Critical Illness, Brain dysfunction, and ICU Survivorship Center. Center for Health Services Research. Vanderbilt University Medical Center. Nashville, TN, USA / Geriatric Research Education and Clinical Center. Department of Veterans Affairs Medical Center. Tennessee Valley Healthcare System. Nashville, TN, USA / Department of Medicine. Division of Allergy, Pulmonary and Critical Care Medicine. Vanderbilt University Medical Center. Nashville, TN, USA. | pt_BR |
| Subject | Delirium | pt_BR |
| Subject | Intensive care unit | pt_BR |
| Subject | Neurocritical care | pt_BR |
| Subject | Neurotrauma | pt_BR |
| Subject | Stroke | pt_BR |
| Subject | Traumatic brain injury | pt_BR |
| e-ISSN | 1530-0293 | |
