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Prevention and Treatment of Delirium
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Prevention and Treatment of Delirium

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 January 2021) | Viewed by 6725

Special Issue Editor

Dr. Aleksandra Klimkowicz-Mrowiec

E-Mail Website
Guest Editor
Jagiellonian University, School of Medicine, Krakow, Poland
Interests: cognitive disorders; neuropsychology; degenerative diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Delirium is a transient condition characterized by a disturbance of consciousness, decreased attention, disorganized thinking, and psychomotor and sleep disturbances that develop over a short period of time and fluctuate during the course of the day. Delirium in hospitalized patients is associated with longer hospital stays, worse functional outcomes, and higher mortality. The cause of delirium is likely to be multifactorial and, therefore, this very common neurobehavioral syndrome is a subject of interest both for neurologists and for internists, psychiatrists, surgeons, and other specialists taking care of patients suffering from somatic disorders. The diagnosis of delirium should be a part of clinical neuropsychological assessment. Numerous studies have been published on delirium in different hospital settings but, still, many details of the underlying neural mechanisms that give rise to cognitive dysfunctions in this disorder remain poorly understood.

Therefore, this Special Issue of the Journal of Clinical Medicine aims to focus on very up-to-date achievements on delirium characteristics, diagnosis, monitoring, prevention, and treatment in different clinical settings.

Dr. Aleksandra Klimkowicz-Mrowiec
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • delirium
  • risk factors
  • diagnosis
  • prevention
  • treatment
  • prognosis
  • cognitive deficit

Published Papers (2 papers)

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Research

11 pages, 522 KiB  
Article
Delirium Post-Stroke: Short- and Long-Term Effect on Depression, Anxiety, Apathy and Aggression (Research Study—Part of PROPOLIS Study)
by Katarzyna Kowalska, Jakub Droś, Małgorzata Mazurek, Paulina Pasińska, Agnieszka Gorzkowska and Aleksandra Klimkowicz-Mrowiec
J. Clin. Med. 2020, 9(7), 2232; https://doi.org/10.3390/jcm9072232 - 14 Jul 2020
Cited by 16 | Viewed by 3131
Abstract
Background: Stroke patients are particularly vulnerable to delirium episodes, but very little is known about its subsequent adverse mental health outcomes. The author’s objective was to explore the association between in-hospital delirium and depression, anxiety, anger and apathy after stroke. Methods: A total [...] Read more.
Background: Stroke patients are particularly vulnerable to delirium episodes, but very little is known about its subsequent adverse mental health outcomes. The author’s objective was to explore the association between in-hospital delirium and depression, anxiety, anger and apathy after stroke. Methods: A total of 750 consecutive patients with acute stroke or transient ischemic attack, were screened for delirium during hospitalization. Patients underwent mental health evaluation in hospital, 3 and 12 months post-stroke; depression, apathy, anxiety and anger were the outcomes measured at all evaluation check points. Results: Delirium was an independent risk factor for depression (OR = 2.28, 95%CI 1.15–4.51, p = 0.017) and aggression (OR = 3.39, 95%CI 1.48–7.73, p = 0.004) at the hospital, for anxiety 3 months post-stroke (OR = 2.83, 95%CI 1.25–6.39, p = 0.012), and for apathy at the hospital (OR = 4.82, 95%CI 2.25–10.47, p < 0.001), after 3 (OR = 3.84, 95%CI 1.31–11.21, p = 0.014) and 12 months (OR = 4.95, 95%CI 1.68–14.54, p = 0.004) post stroke. Conclusions: The results of this study confirm, that mental health problems are very frequent complications of stroke. Delirium in the acute phase of stroke influences mental health of patients. This effect is especially significant in the first months post-stroke and vanishes with time, which suggests that in-hospital delirium might not be a damaging occurrence in most measures of mental health problems from a long-term perspective. Full article
(This article belongs to the Special Issue Prevention and Treatment of Delirium)
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15 pages, 471 KiB  
Article
Delirium Post-Stroke—Influence on Post-Stroke Dementia (Research Study—Part of the PROPOLIS Study)
by Jakub Droś, Katarzyna Kowalska, Paulina Pasińska, Aleksandra Szyper-Maciejowska, Agnieszka Gorzkowska and Aleksandra Klimkowicz-Mrowiec
J. Clin. Med. 2020, 9(7), 2165; https://doi.org/10.3390/jcm9072165 - 9 Jul 2020
Cited by 11 | Viewed by 3160
Abstract
Background: Previous research confirmed association between delirium and subsequent dementia in different clinical settings, but the impact of post-stroke delirium on cognitive functioning is still under-investigated. Therefore, we aimed to assess the risk of dementia among patients with stroke and in-hospital delirium. Methods: [...] Read more.
Background: Previous research confirmed association between delirium and subsequent dementia in different clinical settings, but the impact of post-stroke delirium on cognitive functioning is still under-investigated. Therefore, we aimed to assess the risk of dementia among patients with stroke and in-hospital delirium. Methods: A total of 750 consecutive patients admitted to the stroke unit with acute stroke or transient ischemic attacks were screened for delirium, during the first seven days after admission. At the three- and twelve-month follow-up, patients underwent cognitive evaluation. The DSM-5 definition for dementia was used. Cases with pre-stroke dementia were excluded from the analysis. Results: Out of 691 included cases, 423 (61.22%) and 451 (65.27%) underwent cognitive evaluation, three and twelve months after stroke; 121 (28.61%) and 151 (33.48%) patients were diagnosed with dementia, respectively. Six (4.96%) patients with dementia, three months post-stroke did not meet the diagnostic criteria for dementia nine months later. After twelve months, 37 (24.50%) patients were diagnosed with dementia, first time after stroke. Delirium in hospital was an independent risk factor for dementia after three months (OR = 7.267, 95%CI 2.182–24.207, p = 0.001) but not twelve months after the stroke. Conclusions: Patients with stroke complicated by in-hospital delirium are at a higher risk for dementia at three but not twelve months post-stroke. Full article
(This article belongs to the Special Issue Prevention and Treatment of Delirium)
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