Zusammenfassung
Das Delir zeigt bei hospitalisierten Patienten, je nach Patientenauswahl,
eine Prävalenz zwischen 20 und 50 %.
Ein Alter > 65 Jahre zählt hierbei
als prädisponierender Faktor, weshalb man beim Umgang mit
betagten Patienten häufig mit diesem Syndrom konfrontiert
wird. 2010 wurde zwei Leitlinien zum Thema Delir veröffentlicht: die „NICE
clinical guideline 103: Delirium. Diagnosis, prevention and management” und
die S3-Leitlinie „Analgesie, Sedierung und Delirmanagement
in der Intensivmedizin”. Der Artikel fasst für
die klinische Praxis relevante Neuerungen kurz zusammen.
Abstract
Delirium occurs in 20 – 50 % of
hospitalized elderly patients. An age > 65
years is one of the factors predisposing to the development of delirium, which
is a common syndrome in geriatric medicine. Two clinical guidelines
on this condition were published in 2010: NICE clinical guideline 103, „Delirium:
diagnosis, prevention, management” and the German guideline „S3-Leitlinie Analgesie,
Sedierung und Delirmanagement in der Intensivmedizin”.
The article gives an overview of new aspects of delirium in the
clinical context.
Schlüsselwörter
Delirium - Geriatrie - CAM-Score
Keywords
delirium - geriatrics - CAM-Score
Literatur
-
1
Clegg A, Young J B.
Which medications
to avoid in people at risk of delirium: a systematic review.
Age
and Ageing.
2011;
40
23-29
-
2
Devlin J W. et al .
Efficacy and safety of quetiapine in critically
ill patients with delirium: A prospective multicenter, randomized,
double-blind, placebo-controlled pilot study.
Crit Care
Med.
2010;
38
419-427
-
3
Ely E W. et al .
Current opinions regarding the importance,
diagnosis, and management of delirium in the intensive care unit:
a survey of 912 healthcare professionals.
Crit Care Med.
2004;
32
106-112
-
4
Inouye S K.
Delirium in older persons.
N Engl J Med.
2006;
354
1157-1165
-
5 Martin J, Heymann A, Bäsell K. et al .S3-Leitline Analgesie, Sedierung und Delirmanagement
in der Intensivmedizin. http://www.uni-duesseldorf.de/AWMF/11/001-0121.htm
(letzter Zugriff 12.1.2011)
-
6
McCusker J. et al .
Delirium predicts 12-month mortality.
Arch Intern Med.
2002;
162
457-463
-
7 NICE clinical guideline 103.
Delirium. diagnosis, prevention and management. Developed and published
by the National Clinical Guideline Centre for Acute and Chronic
Conditions. 2010 London; www.nice.org.uk/nicemedia/pdf/DeliriumDraftFullGuideline061109.pdf (letzter
Zugriff 17.1.2011)
-
8
Oldenbeuving A W. et al .
A pilot study of rivastigmine in the treatment
of delirium after stroke: a safe alternative.
BMC Neurol.
2008;
20
34
-
9
Pisani A. et
al .
Benzodiazepine and opioid use and the duration
of ICU delirium in older population.
Crit Care Med.
2009;
37
177-183
-
10
Schreier A M.
Nursing care, delirium, and pain management for the hospitalized
older adult.
Pain Manag Nurs.
2010;
11
177-185
-
11
Schweickert W D, Pohlman M C, Pohlman A S. et al .
Early physical and occupational
therapy in mechanically ventilated, critically ill patients: a randomised
controlled trial.
Lancet.
2009;
373
1874-1882
-
12
van Eijk M M, Roes K C, Honing M L. et al .
Effect of rivastigmine as
an adjunct to usual care with haloperidol on duration of delirium
and mortality in critically ill patients: a multicentre, double-blind,
placebo-controlled randomised trial.
Lancet.
2010;
376
1829-1837
-
13
Wei L A, Fearing M A, Sternberg E J, Inouye S K.
The
Confusion Assessment Method: a systematic review of current usage.
J Am Geriatr Soc.
2008;
56
823-830
-
14
Wong C L. et al .
Does this patient have delirium? Value
of bedside instruments.
JAMA.
2010;
304
779-86
-
15 www.hospitalelderlifeprogramm.org (letzter Zugriff
4.3.2011)
Dr. K. Singler
Medizinische Klinik 2, Geriatrie
Klinikum Nürnberg
Prof.-E.-Nathan-Str. 1
90419 Nürnberg
Phone: 0911/398 2434
Email: katrin.singler@klinikum-nuernberg.de
