Delirium and its motoric subtypes: A study of 614 critically ill patients
Abstract
OBJECTIVES: To describe the motoric subtypes of delirium in critically ill patients and compare patients aged 65 and older with a younger cohort. DESIGN: Prospective cohort study. SETTING: The medical intensive care unit (MICU) of a tertiary care academic medical center. PARTICIPANTS: Six hundred fourteen MICU patients admitted during a process improvement initiative to monitor levels of sedation and delirium. MEASUREMENTS: MICU nursing staff assessed delirium and level of consciousness in all MICU patients at least once per 12-hour shift using the Confusion Assessment Method for the Intensive Care Unit and the Richmond Agitation-Sedation Scale. Delirium episodes were categorized as hypoactive, hyperactive, and mixed type. RESULTS: Delirium was detected in 112 of 156 (71.8%) subjects aged 65 and older and 263 of 458 (57.4%) subjects younger than 65. Mixed type was most common (54.9%), followed by hypoactive delirium (43.5%) and purely hyperactive delirium (1.6%). Patients aged 65 and older experienced hypoactive delirium at a greater rate than younger patients (41.0% vs 21.6%, P<.001) and never experienced hyperactive delirium. Older age was strongly and independently associated with hypoactive delirium (adjusted odds ratio=3.0, 95% confidence interval=1.7-5.3), compared with no delirium in a model that adjusted for other important determinants of delirium including severity of illness, sedative medication use, and ventilation status. CONCLUSION: Older age is a strong predictor of hypoactive delirium in MICU patients, and this motoric subtype of delirium may be missed in the absence of active monitoring.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Hyperactive delirium most often comes to clinical attention, but the mixed and hypoactive presentations are far more common.
“Hyperactive delirium most often comes to clinical attention, but the mixed and hypoactive presentations are far more common [7,59,60,61].”
From Psychological and Psychiatric Comorbidities in Youth with Serious Physical Illness (2022) · cites this paper as [59]
Cites
Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987) · Journal of Chronic Diseases · doi:10.1016/0021-9681(87)90171-8 · Cited by 49,742 · see citing works
Knaus, W. A., Draper, E. A., Wagner, D. P., & Zimmerman, J. E. (1985) · Critical Care Medicine · doi:10.1097/00003246-198510000-00009 · Cited by 15,333 · see citing works
APACHE II-A Severity of Disease Classification System
Knaus, W. A., Draper, E. A., Wagner, D. P., & Zimmerman, J. E. (1986) · Critical Care Medicine · doi:10.1097/00003246-198608000-00028 · Cited by 13,379 · see citing works
ASSESSMENT OF COMA AND IMPAIRED CONSCIOUSNESS
Teasdale, G., & Jennett, B. (1974) · The Lancet · doi:10.1016/s0140-6736(74)91639-0 · Cited by 13,215 · see citing works
Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases
DEYO, R. (1992) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(92)90133-8 · Cited by 10,452 · see citing works
Ely, E. W., Inouye, S. K., Bernard, G. R., Gordon, S., Francis, J., May, L., Truman, B., Speroff, T., Gautam, S., Margolin, R., et al. (2001) · JAMA · doi:10.1001/jama.286.21.2703 · Cited by 3,210 · see citing works
Delirium as a Predictor of Mortality in Mechanically Ventilated Patients in the Intensive Care Unit
Ely, E. W. (2004) · JAMA · doi:10.1001/jama.291.14.1753 · Cited by 3,073 · see citing works
A Multicomponent Intervention to Prevent Delirium in Hospitalized Older Patients
Inouye, S. K., Bogardus, S. T., Charpentier, P. A., Leo-Summers, L. S., Acampora, D., Holford, T. R., & Cooney, L. M. (1999) · New England Journal of Medicine · doi:10.1056/nejm199903043400901 · Cited by 2,904 · see citing works
Monitoring Sedation Status Over Time in ICU Patients
Ely, E. W., Truman, B., Shintani, A., Thomason, J. W. W., Wheeler, A. P., Gordon, S., Francis, J., Speroff, T., Gautam, S., Margolin, R. A., et al. (2003) · JAMA · doi:10.1001/jama.289.22.2983 · Cited by 1,704 · see citing works
Inouye, S. K., Viscoli, C. M., Horwitz, R. I., Hurst, L. D., & Tinetti, M. E. (1993) · Annals of Internal Medicine · doi:10.7326/0003-4819-119-6-199309150-00005 · Cited by 854 · see citing works
Nurses' Recognition of Delirium and Its Symptoms
Inouye, S. K. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.20.2467 · Cited by 774 · see citing works
Delirium in the Intensive Care Unit: Occurrence and Clinical Course in Older Patients
McNicoll, L., Pisani, M. A., Zhang, Y., Ely, E. W., Siegel, M. D., & Inouye, S. K. (2003) · Journal of the American Geriatrics Society · doi:10.1034/j.1600-0579.2003.00201.x · Cited by 568 · see citing works
Delirium in the Elderly Patient
Desforges, J. F., & Lipowski, Z. J. (1989) · New England Journal of Medicine · doi:10.1056/nejm198903023200907 · Cited by 496 · see citing works
An Empirical Study of Delirium Subtypes
Liptzin, B., & Levkoff, S. E. (1992) · The British Journal of Psychiatry · doi:10.1192/bjp.161.6.843 · Cited by 403 · see citing works
McCusker, J., Cole, M. G., Dendukuri, N., Belzile, É., & Primeau, F. (2001) · Europe PMC (PubMed Central) · Cited by 391 · see citing works
The Association Between Delirium and Cognitive Decline: A Review of the Empirical Literature
Jackson, J. C., Gordon, S. M., Hart, R. P., Hopkins, R. O., & Ely, E. W. (2004) · Neuropsychology Review · doi:10.1023/b:nerv.0000028080.39602.17 · Cited by 386 · see citing works
Transient cognitive disorders (delirium, acute confusional states) in the elderly
(1983) · American Journal of Psychiatry · doi:10.1176/ajp.140.11.1426 · Cited by 376 · see citing works
Science is Revolutionizing Our View of Addiction—and What to Do About It
Leshner, A. I. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.1.1 · Cited by 370 · see citing works
Transient Cognitive Disorders (Delirium, Acute Confusional Sates) in the Elderly
Lipowski, Z. J. (1983) · Springer eBooks · doi:10.1007/978-1-4613-2509-3_16 · Cited by 339 · see citing works
Delirium Severity and Psychomotor Types: Their Relationship with Outcomes after Hip Fracture Repair
Marcantonio, E. R., Ta, T., Duthie, E. H., & Resnick, N. M. (2002) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2002.50210.x · Cited by 320 · see citing works
Practice Guidelines for the Treatment of Patients With Delirium
Hofmann, M. T., & Schneider, D. (2007) · Humana Press eBooks · doi:10.1007/978-1-59745-313-4_27 · Cited by 314 · see citing works
Pun, B. T., Gordon, S. M., Peterson, J. F., Shintani, A., Jackson, J. C., Foss, J., Harding, S. D., Bernard, G. R., Dittus, R. S., & Ely, E. W. (2005) · Critical Care Medicine · doi:10.1097/01.ccm.0000166867.78320.ac · Cited by 258 · see citing works
Relationship Between Symptoms and Motoric Subtype of Delirium
Meagher, D. J., O'Hanlon, D., O’Mahony, E., Casey, P., & Trzepacz, P. T. (2000) · Journal of Neuropsychiatry · doi:10.1176/jnp.12.1.51 · Cited by 230 · see citing works
Dolan, M. M., Hawkes, W., Zimmerman, S. I., Morrison, R. S., Gruber‐Baldini, A. L., Hebel, J. R., & Magaziner, J. S. (2000) · The Journals of Gerontology Series A · doi:10.1093/gerona/55.9.m527 · Cited by 229 · see citing works
Marcantonio, E. R., Simon, S. E., Bergmann, M. A., Jones, R. N., Murphy, K. M., & Morris, J. N. (2003) · Journal of the American Geriatrics Society · doi:10.1034/j.1601-5215.2002.51002.x · Cited by 223 · see citing works
Meagher, D. J., & Trzepacz, P. T. (2000) · PubMed · Cited by 171 · see citing works
Etiologic and Outcome Profiles in Hypoactive and Hyperactive Subtypes of Delirium
Camus, V., Gonthier, R., Dubos, G., Schwed, P., & Siméone, I. (2000) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/089198870001300106 · Cited by 98 · see citing works
Disinhibitory reactions to benzodiazepines: A review
van der Bijl, P., & Roelofse, J. (1991) · Journal of Oral and Maxillofacial Surgery · doi:10.1016/0278-2391(91)90180-t · Cited by 87 · see citing works
American Psychiatric Association.
Zarin, D. A., & Sabshin, M. (2000) · Oxford University Press eBooks · doi:10.1037/10516-050 · Cited by 82 · see citing works
Delirium in the Intensive Care Unit
Marshall, M. C., & Soucy, M. D. (2003) · Critical Care Nursing Quarterly · doi:10.1097/00002727-200307000-00002 · Cited by 44 · see citing works
Flagged first, then by citations
1 of the 31 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Barr, J., Fraser, G. L., Puntillo, K., Ely, E. W., Gélinas, C., Dasta, J. F., Davidson, J. E., Devlin, J. W., Kress, J. P., Joffe, A. M., et al. (2012) · Critical Care Medicine · doi:10.1097/ccm.0b013e3182783b72 · Cited by 3,785 · see citing works
Su, X. W., Meng, Z., Wu, X., Cui, F., Li, H.-L., Wang, D., Zhu, X. D., Zhu, S., Maze, M., & Ma, D. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30580-3 · Cited by 800 · see citing works
Postoperative Delirium in the Elderly
Robinson, T. N., Raeburn, C. D., Tran, Z. V., Angles, E. M., Brenner, L. A., & Moss, M. (2008) · Annals of Surgery · doi:10.1097/sla.0b013e31818e4776 · Cited by 653 · see citing works
Delirium in the intensive care unit
Girard, T. D., Pandharipande, P. P., & Ely, E. W. (2008) · Critical Care · doi:10.1186/cc6149 · Cited by 628 · see citing works
Sedation and Delirium in the Intensive Care Unit
Reade, M. C., & Finfer, S. R. (2014) · New England Journal of Medicine · doi:10.1056/nejmra1208705 · Cited by 619 · see citing works
Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness
Girard, T. D., Exline, M. C., Carson, S. S., Hough, C. L., Rock, P., Gong, M. N., Douglas, I. S., Malhotra, A., Owens, R. L., Feinstein, D., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1808217 · Cited by 576 · see citing works
Pandharipande, P. P., Cotton, B. A., Shintani, A., Thompson, J. L., Pun, B. T., Morris, J. A., Dittus, R. S., & Ely, E. W. (2008) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e31814b2c4d · Cited by 560 · see citing works
Smith, H. A. B., Besunder, J. B., Betters, K. A., Johnson, P. N., Srinivasan, V., Stormorken, A., Farrington, E., Golianu, B. J., Godshall, A. J., Acinelli, L., et al. (2022) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0000000000002873 · Cited by 537 · see citing works
Devlin, J. W., Roberts, R. J., Fong, J. J., Skrobik, Y. K., Riker, R. R., Hill, N. S., Robbins, T., & Garpestad, E. (2010) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181b9e302 · Cited by 532 · see citing works
Pun, B. T., Badenes, R., Calle, G. H. L., Orun, O. M., Chen, W., Chandrasekhar, R., Simpson, B. K., Wilson-Linville, S., Olmedillo, B. H., de la Cueva, A. V., et al. (2021) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(20)30552-x · Cited by 528 · see citing works
Delirium in critical illness: clinical manifestations, outcomes, and management
Stollings, J. L., Kotfis, K., Chanques, G., Pun, B. T., Pandharipande, P. P., & Ely, E. W. (2021) · Intensive Care Medicine · doi:10.1007/s00134-021-06503-1 · Cited by 542 · see citing works
Delirium in Older Emergency Department Patients: Recognition, Risk Factors, and Psychomotor Subtypes
Han, J. H., Zimmerman, E. E., Cutler, N. S., Schnelle, J. F., Morandi, A., Dittus, R. S., Storrow, A. B., & Ely, E. W. (2009) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2008.00339.x · Cited by 435 · see citing works
Page, V. J., Ely, E. W., Gates, S., Zhao, X. B., Alce, T. M., Shintani, A., Jackson, J. C., Perkins, G. D., & McAuley, D. F. (2013) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(13)70166-8 · Cited by 409 · see citing works
Epidemiology and risk factors for delirium across hospital settings
Vasilevskis, E. E., Han, J. H., Hughes, C. G., & Ely, E. W. (2012) · Best practice & research. Clinical anaesthesiology · doi:10.1016/j.bpa.2012.07.003 · Cited by 393 · see citing works
Hughes, C. G., Boncyk, C. S., Culley, D. J., Fleisher, L. A., Leung, J. M., McDonagh, D. L., Gan, T. J., McEvoy, M. D., Miller, T. E., & Workgroup, F. T. P. Q. I. (. 6. (2020) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000004641 · Cited by 405 · see citing works
Krewulak, K. D., Stelfox, H. T., Leigh, J. P., Ely, E. W., & Fiest, K. M. (2018) · Critical Care Medicine · doi:10.1097/ccm.0000000000003402 · Cited by 398 · see citing works
Dorman, T. (2011) · Yearbook of Critical Care Medicine · doi:10.1016/s0734-3299(10)79437-5 · Cited by 385 · see citing works
Delirium and Mortality in Critically Ill Children: Epidemiology and Outcomes of Pediatric Delirium
Traube, C., Silver, G., Gerber, L. M., Kaur, S., Mauer, E. A., Kerson, A., Joyce, C., & Greenwald, B. M. (2017) · Critical Care Medicine · doi:10.1097/ccm.0000000000002324 · Cited by 379 · see citing works
van den Boogaard, M., Schoonhoven, L., Evers, A. W. M., van der Hoeven, J. G., van Achterberg, T., & Pickkers, P. (2012) · Critical Care Medicine · doi:10.1097/ccm.0b013e31822e9fc9 · Cited by 361 · see citing works
Septic-Associated Encephalopathy: a Comprehensive Review
Mazeraud, A., Righy, C., Bouchereau, E., Benghanem, S., Bozza, F. A., & Sharshar, T. (2020) · Neurotherapeutics · doi:10.1007/s13311-020-00862-1 · Cited by 344 · see citing works
Smith, H. A. B., Boyd, J., Fuchs, D. C., Melvin, K. E., Berry, P., Shintani, A., Eden, S., Terrell, M. K., Boswell, T., Wolfram, K. B., et al. (2010) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181feb489 · Cited by 334 · see citing works
Comparison of delirium assessment tools in a mixed intensive care unit*
van Eijk, M. M. J., van Marum, R. J., Klijn, I., de Wit, N., Kesecioğlu, J., & Slooter, A. J. C. (2009) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181a00118 · Cited by 333 · see citing works
Baron, R., Binder, A., Biniek, R., Braune, S., Buerkle, H., Dall, P., Demirakça, S., Eckardt, R., Eggers, V., Eichler, I., et al. (2015) · German medical science : GMS e-journal · doi:10.3205/000223 · Cited by 326 · see citing works
Patel, R. P., Gambrell, M., Speroff, T., Scott, T. A., Pun, B. T., Okahashi, J., Strength, C., Pandharipande, P. P., Girard, T. D., Burgess, H., et al. (2009) · Critical Care Medicine · doi:10.1097/ccm.0b013e31819b8608 · Cited by 319 · see citing works
Delirium in the ICU and Subsequent Long-Term Disability Among Survivors of Mechanical Ventilation*
Brummel, N. E., Jackson, J. C., Pandharipande, P. P., Thompson, J. L., Shintani, A., Dittus, R. S., Gill, T. M., Bernard, G. R., Ely, E. W., & Girard, T. D. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e3182a645bd · Cited by 310 · see citing works
The Importance of Diagnosing and Managing ICU Delirium
Pun, B. T., & Ely, E. W. (2007) · Chest · doi:10.1378/chest.06-1795 · Cited by 287 · see citing works
Routine Use of the Confusion Assessment Method for the Intensive Care Unit: A Multicenter Study
van Eijk, M. M. J., van den Boogaard, M., van Marum, R. J., Benner, P., Eikelenboom, P., Honing, M. L. H., van der Hoven, B., Horn, J., Izaks, G. J., Kalf, A., et al. (2011) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201101-0065oc · Cited by 285 · see citing works
Vasilevskis, E. E., Ely, E. W., Speroff, T., Pun, B. T., Boehm, L. M., & Dittus, R. S. (2010) · CHEST Journal · doi:10.1378/chest.10-0466 · Cited by 280 · see citing works
Bench-to-bedside review: Delirium in ICU patients - importance of sleep deprivation
Weinhouse, G. L., Schwab, R. J., Watson, P. L., Patil, N., Vaccaro, B., Pandharipande, P. P., & Ely, E. W. (2009) · Critical Care · doi:10.1186/cc8131 · Cited by 276 · see citing works
Delirium in the Cardiovascular ICU
McPherson, J., Wagner, C. E., Boehm, L. M., Hall, J. D., Johnson, D., Miller, L. R., Burns, K., Thompson, J. L., Shintani, A., Ely, E. W., et al. (2012) · Critical Care Medicine · doi:10.1097/ccm.0b013e31826ab49b · Cited by 277 · see citing works
Nurse practitioners and physician assistants in the intensive care unit: An evidence-based review
Kleinpell, R. M., Ely, E. W., & Grabenkort, R. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e318186ba8c · Cited by 275 · see citing works
Delirium in the ICU: an overview
Cavallazzi, R., Saad, M., & Marik, P. E. (2012) · Annals of Intensive Care · doi:10.1186/2110-5820-2-49 · Cited by 275 · see citing works
Pandharipande, P. P., Cotton, B. A., Shintani, A., Thompson, J. L., Costabile, S., Pun, B. T., Dittus, R. S., & Ely, E. W. (2007) · Intensive Care Medicine · doi:10.1007/s00134-007-0687-y · Cited by 268 · see citing works
Sleep and delirium in ICU patients: a review of mechanisms and manifestations
Figueroa-Ramos, M. I., Arroyo-Novoa, C. M., Lee, K. A., PADILLA, G. V., & Puntillo, K. (2009) · Intensive Care Medicine · doi:10.1007/s00134-009-1397-4 · Cited by 268 · see citing works
Motor Subtypes of Postoperative Delirium in Older Adults
Robinson, T. N. (2011) · Archives of Surgery · doi:10.1001/archsurg.2011.14 · Cited by 250 · see citing works
Prevention and Management of Delirium in the Intensive Care Unit
Mart, M. F., Roberson, S. W., Salas, B., Pandharipande, P. P., & Ely, E. W. (2020) · Seminars in Respiratory and Critical Care Medicine · doi:10.1055/s-0040-1710572 · Cited by 262 · see citing works
van den Boogaard, M., Schoonhoven, L., van der Hoeven, J. G., van Achterberg, T., & Pickkers, P. (2011) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2011.11.016 · Cited by 231 · see citing works
Delirium assessment in the critically ill
Devlin, J. W., Fong, J. J., Fraser, G. L., & Riker, R. R. (2007) · Intensive Care Medicine · doi:10.1007/s00134-007-0603-5 · Cited by 222 · see citing works
Motor subtypes of delirium: Past, present and future
Meagher, D. J. (2009) · International Review of Psychiatry · doi:10.1080/09540260802675460 · Cited by 214 · see citing works
Validity and Reliability of the CAM-ICU Flowsheet to diagnose delirium in surgical ICU patients
Guenther, U., Popp, J., Koecher, L., Muders, T., Wrigge, H., Ely, E. W., & Putensen, C. (2009) · Journal of Critical Care · doi:10.1016/j.jcrc.2009.08.005 · Cited by 213 · see citing works
Janssen, T. L., Alberts, A. R., Hooft, L., Mattace-Raso, F. U. S., Mosk, C. A., & van der Laan, L. (2019) · Clinical Interventions in Aging · doi:10.2147/cia.s201323 · Cited by 220 · see citing works
Assessment of Delirium in the Intensive Care Unit: Nursing Practices And Perceptions
Devlin, J. W., Fong, J. J., Howard, E., Skrobik, Y. K., McCoy, N., Yasuda, C., & Marshall, J. (2008) · American Journal of Critical Care · doi:10.4037/ajcc2008.17.6.555 · Cited by 211 · see citing works
The intensive care delirium research agenda: a multinational, interprofessional perspective
Pandharipande, P. P., Ely, E. W., Arora, R. C., Balas, M. C., Boustani, M. A., Calle, G. H. L., Cunningham, C. M., Devlin, J. W., Elefante, J., Han, J. H., et al. (2017) · Intensive Care Medicine · doi:10.1007/s00134-017-4860-7 · Cited by 211 · see citing works
Schön, J., Meyerrose, J., Paarmann, H., Heringlake, M., Hueppe, M., & Berger, K.-U. (2011) · Critical Care · doi:10.1186/cc10454 · Cited by 207 · see citing works
ICU delirium ― a diagnostic and therapeutic challenge in the intensive care unit
Kotfis, K., Marra, A., & Ely, E. W. (2018) · Anaesthesiology Intensive Therapy · doi:10.5603/ait.a2018.0011 · Cited by 206 · see citing works
Morandi, A., Pandharipande, P. P., Trabucchi, M., Rozzini, R., Mistraletti, G., Trompeo, A. C., Gregoretti, C., Gattinoni, L., Ranieri, M. V., Brochard, L. J., et al. (2008) · Intensive Care Medicine · doi:10.1007/s00134-008-1177-6 · Cited by 201 · see citing works
Patient-Focused Sedation and Analgesia in the ICU
Sessler, C. N., & Gill, K. V. (2008) · CHEST Journal · doi:10.1378/chest.07-2026 · Cited by 186 · see citing works
Martin, J., Heymann, A., Bäsell, K., Baron, R., Biniek, R., Bürkle, H., Dall, P., Dictus, C., Eggers, V., Eichler, I., et al. (2010) · PubMed Central · doi:10.3205/000091 · Cited by 184 · see citing works
Prevalence and Risk Factors for Development of Delirium in Burn Intensive Care Unit Patients
Agarwal, V., O’Neill, P. J., Cotton, B. A., Pun, B. T., Haney, S., Thompson, J. L., Kassebaum, N. J., Shintani, A., Guy, J., Ely, E. W., et al. (2010) · Journal of Burn Care & Research · doi:10.1097/bcr.0b013e3181eebee9 · Cited by 185 · see citing works
Hayhurst, C. J., Pandharipande, P. P., & Hughes, C. G. (2016) · Anesthesiology · doi:10.1097/aln.0000000000001378 · Cited by 184 · see citing works
Assessment scales for delirium: A review
Grover, S. (2012) · World Journal of Psychiatry · doi:10.5498/wjp.v2.i4.58 · Cited by 183 · see citing works
Cunningham, C. M., & MacLullich, A. M. J. (2012) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2012.07.012 · Cited by 178 · see citing works
Kiely, D. K., Jones, R. N., Bergmann, M. A., & Marcantonio, E. R. (2007) · The Journals of Gerontology Series A · doi:10.1093/gerona/62.2.174 · Cited by 171 · see citing works
Li, Y., Li, H.-J., Li, H., Zhao, B.-J., Guo, X., Feng, Y., Zuo, M., Yu, Y.-P., Kong, H., Zhao, Y., et al. (2021) · Anesthesiology · doi:10.1097/aln.0000000000003834 · Cited by 167 · see citing works
Devlin, J. W., Marquis, F., Riker, R. R., Robbins, T., Garpestad, E., Fong, J. J., Didomenico, D., & Skrobik, Y. K. (2008) · Critical Care · doi:10.1186/cc6793 · Cited by 161 · see citing works
Altered Mental Status in Older Patients in the Emergency Department
Han, J. H., & Wilber, S. T. (2012) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2012.09.005 · Cited by 158 · see citing works
Implementing Delirium Screening in the ICU
Brummel, N. E., Vasilevskis, E. E., Han, J. H., Boehm, L. M., Pun, B. T., & Ely, E. W. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e31829a6f1e · Cited by 158 · see citing works
Smith, H. A. B., Gangopadhyay, M., Goben, C. M., Jacobowski, N., Chestnut, M. H., Thompson, J. L., Chandrasekhar, R., Williams, S. R., Griffith, K., Ely, E. W., et al. (2017) · Critical Care Medicine · doi:10.1097/ccm.0000000000002515 · Cited by 157 · see citing works
Sepsis-Associated Encephalopathy: from Pathophysiology to Progress in Experimental Studies
Catarina, A. V., Branchini, G., Bettoni, L., De Oliveira, J. R., & Nunes, F. B. (2021) · Molecular Neurobiology · doi:10.1007/s12035-021-02303-2 · Cited by 155 · see citing works
Oh, S.-T., & Park, J. Y. (2018) · Korean Journal of Anesthesiology · doi:10.4097/kja.d.18.00073.1 · Cited by 155 · see citing works
Bienvenu, O. J., Gellar, J. E., Althouse, B. M., Colantuoni, E., Sricharoenchai, T., Méndez-Téllez, P. A., Shanholtz, C. B., Himmelfarb, C. D., Pronovost, P. J., & Needham, D. M. (2013) · Psychological Medicine · doi:10.1017/s0033291713000214 · Cited by 152 · see citing works
Rengel, K. F., Pandharipande, P. P., & Hughes, C. G. (2018) · La Presse Médicale · doi:10.1016/j.lpm.2018.03.012 · Cited by 149 · see citing works
Recognizing Delirium Superimposed on Dementia: Assessing Nurses' Knowledge Using Case Vignettes
Fick, D. M., Hodo, D. M., Lawrence, F., & Inouye, S. K. (2007) · Journal of Gerontological Nursing · doi:10.3928/00989134-20070201-09 · Cited by 146 · see citing works
Delayed Treatment of Delirium Increases Mortality Rate in Intensive Care Unit Patients
Heymann, A., Radtke, F. M., Schiemann, A., Luetz, A., MacGuill, M., Wernecke, K.-D., & Spies, C. (2010) · Journal of International Medical Research · doi:10.1177/147323001003800503 · Cited by 142 · see citing works
Chaiwat, O., Chanidnuan, M., Pancharoen, W., Vijitmala, K., Danpornprasert, P., To-adithep, P., & Thanakiattiwibun, C. (2019) · BMC Anesthesiology · doi:10.1186/s12871-019-0694-x · Cited by 140 · see citing works
Sharma, A. D., Malhotra, S., Grover, S., & Jindal, S. K. (2012) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2012.06.009 · Cited by 138 · see citing works
The Pain, Agitation, and Delirium Care Bundle
Barr, J. A., & Pandharipande, P. P. (2013) · Critical Care Medicine · doi:10.1097/ccm.0b013e3182a16ff0 · Cited by 136 · see citing works
A research algorithm to improve detection of delirium in the intensive care unit
Pisani, M. A., Araujo, K. L. B., Ness, P. H. V., Zhang, Y., Ely, E. W., & Inouye, S. K. (2006) · Critical Care · doi:10.1186/cc5027 · Cited by 136 · see citing works
Haloperidol prophylaxis in critically ill patients with a high risk for delirium
van den Boogaard, M., Schoonhoven, L., van Achterberg, T., van der Hoeven, J. G., & Pickkers, P. (2013) · Critical Care · doi:10.1186/cc11933 · Cited by 133 · see citing works
Tobar, E. A., Romero, C. M., Galleguillos, T. G. B., Fuentes, P., Cornejo, R., Lira, M. T., de la Barrera, L., Sánchez, J. E., Bozán, F., Bugedo, G. J., et al. (2009) · Medicina Intensiva · doi:10.1016/j.medin.2009.04.003 · Cited by 131 · see citing works
Risk factors for intensive care delirium: A systematic review
Rompaey, B. V., Schuurmans, M. J., Shortridge‐Baggett, L. M., Truijen, S., & Bossaert, L. L. (2007) · Intensive and Critical Care Nursing · doi:10.1016/j.iccn.2007.08.005 · Cited by 130 · see citing works
Interventions for preventing intensive care unit delirium in adults
Herling, S. F., Greve, I. E., Vasilevskis, E. E., Egerod, I., Mortensen, C. B., Møller, A. M., Svenningsen, H., & Thomsen, T. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009783.pub2 · Cited by 128 · see citing works
Pharmacological and Nonpharmacological Management of Delirium in Critically Ill Patients
Hipp, D. M., & Ely, E. W. (2012) · Neurotherapeutics · doi:10.1007/s13311-011-0102-9 · Cited by 128 · see citing works
Delirium in Pediatric Critical Care
Patel, A. K., Bell, M. J., & Traube, C. (2017) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2017.06.009 · Cited by 122 · see citing works
Delirium in the Older Emergency Department Patient: A Quiet Epidemic
Han, J. H., Wilson, A., & Ely, E. W. (2010) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2010.03.005 · Cited by 124 · see citing works
Risk factors and outcomes among delirium subtypes in adult ICUs: A systematic review
Krewulak, K. D., Stelfox, H. T., Ely, E. W., & Fiest, K. M. (2020) · Journal of Critical Care · doi:10.1016/j.jcrc.2020.01.017 · Cited by 126 · see citing works
Soja, S. L., Pandharipande, P. P., Fleming, S. B., Cotton, B. A., Miller, L. R., Weaver, S. G., Lee, B. T., & Ely, E. W. (2008) · Intensive Care Medicine · doi:10.1007/s00134-008-1031-x · Cited by 121 · see citing works
Delirium in critically ill patients
Slooter, A. J. C., van de Leur, R. R., & Zaal, I. J. (2017) · Handbook of clinical neurology · doi:10.1016/b978-0-444-63599-0.00025-9 · Cited by 117 · see citing works
Cognitive impairment and pain management: Review of issues and challenges
Buffum, M. D., Hutt, E., Chang, V. T.-S., Craine, M. H., & Snow, A. L. (2007) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2006.06.0064 · Cited by 116 · see citing works
Collet, M. O., Caballero, J., Sonneville, R., Bozza, F. A., Nydahl, P., Schandl, A., Wøien, H., Citerio, G., van den Boogaard, M., Hästbacka, J., et al. (2018) · Intensive Care Medicine · doi:10.1007/s00134-018-5204-y · Cited by 114 · see citing works
Delirium in Critically Ill Patients
Zaal, I. J., & Slooter, A. J. C. (2012) · Drugs · doi:10.2165/11635520-000000000-00000 · Cited by 110 · see citing works
Nishida, O., Ogura, H., Egi, M., Fujishima, S., Hayashi, Y., Iba, T., Imaizumi, H., Inoue, S., Kakihana, Y., Kotani, J., et al. (2018) · Journal of Intensive Care · doi:10.1186/s40560-017-0270-8 · Cited by 107 · see citing works
Cognitive Dysfunction, Delirium, and Stroke in Cardiac Surgery Patients
Cropsey, C. L., Kennedy, J. A., Han, J. H., & Pandharipande, P. P. (2015) · Seminars in Cardiothoracic and Vascular Anesthesia · doi:10.1177/1089253215570062 · Cited by 107 · see citing works
A national survey of the management of delirium in UK intensive care units
Sweeney, R. M., Barber, V. S., Page, V. J., Ely, E. W., Perkins, G. D., Young, D., & McAuley, D. F. (2010) · QJM · doi:10.1093/qjmed/hcp194 · Cited by 105 · see citing works
Association of Hypoactive and Hyperactive Delirium With Cognitive Function After Critical Illness
Hayhurst, C. J., Marra, A., Han, J. H., Patel, M. B., Brummel, N. E., Thompson, J. L., Jackson, J. C., Chandrasekhar, R., Ely, E. W., Pandharipande, P. P., et al. (2020) · Critical Care Medicine · doi:10.1097/ccm.0000000000004313 · Cited by 108 · see citing works
Neuroanatomy and Physiology of Brain Dysfunction in Sepsis
Mazeraud, A., Pascal, Q., Verdonk, F., Heming, N., Chrétien, F. C., & Sharshar, T. (2016) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2016.01.013 · Cited by 105 · see citing works
Patterns of Postoperative Delirium in Children
Meyburg, J., Dill, M.-L., Traube, C., Silver, G., & von Haken, R. (2017) · Pediatric Critical Care Medicine · doi:10.1097/pcc.0000000000000993 · Cited by 100 · see citing works
Effect of sedation level on the prevalence of delirium when assessed with CAM-ICU and ICDSC
Hænggi, M., Blum, S., Brechbuehl, R., Brunello, A., Jakob, S. M., & Takala, J. A. (2013) · Intensive Care Medicine · doi:10.1007/s00134-013-3034-5 · Cited by 100 · see citing works
Smith, H. A. B., Brink, E., Fuchs, D. C., Ely, E. W., & Pandharipande, P. P. (2013) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2013.02.010 · Cited by 98 · see citing works
Seven lessons from 20 years of follow-up of intensive care unit survivors
Griffiths, R. D., & Jones, C. (2007) · Current Opinion in Critical Care · doi:10.1097/mcc.0b013e3282efae05 · Cited by 98 · see citing works
Depression and end-of-life care for patients with cancer
Rosenstein, D. L. (2011) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2011.13.1/drosenstein · Cited by 92 · see citing works
Maniar, H. S., Lindman, B. R., Escallier, K. E., Avidan, M. S., Novak, E. L., Melby, S. J., Damiano, M. S., Lasala, J. M., Quader, N., Rao, R. S., et al. (2015) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2015.10.114 · Cited by 95 · see citing works
Delirium in the intensive care unit
El-Menyar, A. A., Arumugam, S., Al‐Hassani, A., Strandvik, G. F., Asim, M., Mekkodathil, A. A., Mudali, I. N., & Al-Thani, H. A. S. (2017) · Journal of Emergencies Trauma and Shock · doi:10.4103/0974-2700.199520 · Cited by 95 · see citing works
Han, J. H., Bryce, S., Ely, E. W., Kripalani, S. B., Morandi, A., Shintani, A., Jackson, J. C., Storrow, A. B., Dittus, R. S., & Schnelle, J. F. (2011) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2010.12.002 · Cited by 92 · see citing works
Delirium in the intensive care unit
Morandi, A., Jackson, J. C., & Ely, E. W. (2009) · International Review of Psychiatry · doi:10.1080/09540260802675296 · Cited by 94 · see citing works
Eertmans, W., Deyne, C. D., Genbrugge, C., Marcus, B., Bouneb, S., Beran, M., Fret, T., Gutermann, H., Boer, W., Laenen, M. V., et al. (2019) · British Journal of Anaesthesia · doi:10.1016/j.bja.2019.09.042 · Cited by 91 · see citing works
Gusmao-Flores, D., Salluh, J. I., Dal‐Pizzol, F., Ritter, C., Tomasi, C. D., Lima, M. A., Santana, L. R., Lins, R. M. P., Lemos, P. P., Serpa, G., et al. (2011) · PubMed Central · doi:10.1590/s1807-59322011001100011 · Cited by 94 · see citing works
Delirium in Critically Ill Patients
Jackson, P., & Khan, A. (2015) · Critical Care Clinics · doi:10.1016/j.ccc.2015.03.011 · Cited by 89 · see citing works
Prediction of delirium in critically ill patients with elevated C-reactive protein
Zhang, Z., Pan, L., Deng, H., Ni, H., & Xu, X. (2013) · Journal of Critical Care · doi:10.1016/j.jcrc.2013.09.002 · Cited by 87 · see citing works
Delirium: An emerging frontier in the management of critically ill children
Smith, H. A. B., Fuchs, D. C., Pandharipande, P. P., Barr, F. E., & Ely, E. W. (2009) · Critical Care Clinics · doi:10.1016/j.ccc.2009.05.002 · Cited by 87 · see citing works
Self-citation
- Authors
- Peterson, J. F., Pun, B. T., Dittus, R. S., Thomason, J. W. W., Jackson, J. C., Shintani, A. K., & Ely, E. W.
- Affiliations
- Vanderbilt University Medical Center (US)
- VA Tennessee Valley Healthcare System (US)
- Corresponding author
- Peterson, Josh F.
- Ely, E. Wesley
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2006-03
- Volume
- 54
- Issue
- 3
- Pages
- 479-484
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W1505808688
- Cited by
- 660
- References
- 31
- Citations by year
- 2026: 11 · 2025: 17 · 2024: 32 · 2023: 37 · 2022: 21 · 2021: 33 · 2020: 32 · 2019: 45 · 2018: 44 · 2017: 41 · 2016: 48 · 2015: 37 · 2014: 29 · 2013: 42 · 2012: 44
- FWCI
- 27.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Pfizer
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Health Sciences › Medicine › Neurology › Alcoholism and Thiamine Deficiency
- Keywords
- delirium, hypoactive delirium, hyperactive delirium, mixed delirium, critically ill patients, older adults, intensive care unit, age as predictor, sedation, level of consciousness, delirium monitoring
- MeSH terms
- Age Factors, Aged, Critical Care, Delirium, Female, Follow-Up Studies, Humans, Male, Motor Activity, Prognosis, Prospective Studies, Severity of Illness Index, Incidence, Prevalence, Critical Illness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
