Delirium: guidelines for general hospitals.

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State: Public
Version: author
Serval ID
serval:BIB_6E597EBAA250
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Title
Delirium: guidelines for general hospitals.
Journal
Journal of Psychosomatic Research
Author(s)
Michaud L., Büla C., Berney A., Camus V., Voellinger R., Stiefel F., Burnand B.
Working group(s)
Delirium Guidelines Development Group
ISSN
0022-3999 (Print)
ISSN-L
0022-3999
Publication state
Published
Issued date
2007
Peer-reviewed
Oui
Volume
62
Number
3
Pages
371-383
Language
english
Notes
Publication types: Journal Article ; Review Publication Status: ppublish
Abstract
OBJECTIVE: Delirium is highly prevalent in general hospitals but remains underrecognized and undertreated despite its association with increased morbidity, mortality, and health services utilization. To enhance its management, we developed guidelines covering all aspects, from risk factor identification to preventive, diagnostic, and therapeutic interventions in adult patients.
METHODS: Guidelines, systematic reviews, randomized controlled trials (RCT), and cohort studies were systematically searched and evaluated. Based on a synthesis of retrieved high-quality documents, recommendation items were submitted to a multidisciplinary expert panel. Experts scored the appropriateness of recommendation items, using an evidence-based, explicit, multidisciplinary panel approach. Each recommendation was graded according to this process' results.
RESULTS: Rated recommendations were mostly supported by a low level of evidence (1.3% RCT and systematic reviews, 14.3% nonrandomized trials vs. 84.4% observational studies or expert opinions). Nevertheless, 71.1% of recommendations were considered appropriate by the experts. Prevention of delirium and its nonpharmacological management should be fostered. Haloperidol remains the first-choice drug, whereas the role of atypical antipsychotics is still uncertain.
CONCLUSIONS: While many topics addressed in these guidelines have not yet been adequately studied, an explicit panel and evidence-based approach allowed the proposal of comprehensive recommendations for the prevention and management of delirium in general hospitals.
Keywords
Adult, Aged, Delirium/diagnosis, Delirium/etiology, Evidence-Based Medicine, Hospitalization, Hospitals, General, Humans, Practice Guidelines as Topic, Switzerland
Pubmed
Web of science
Open Access
Yes
Create date
05/02/2008 12:22
Last modification date
20/08/2019 14:27
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