Margaret R Puelle

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BACKGROUND Quantifying the severity of delirium is essential to advancing clinical care by improved understanding of delirium effect, prognosis, pathophysiology, and response to treatment. OBJECTIVE To develop and validate a new delirium severity measure (CAM-S) based on the Confusion Assessment Method. DESIGN Validation analysis in 2 independent(More)
The National Institute for Health and Clinical Excellence (NICE) in the United Kingdom developed guidelines for the diagnosis, prevention, and management of delirium in July 2010 that included 10 recommendations for delirium prevention. The Hospital Elder Life Program (HELP) is a targeted multicomponent strategy that has proven effective and cost-effective(More)
IMPORTANCE Delirium, an acute disorder with high morbidity and mortality, is often preventable through multicomponent nonpharmacological strategies. The efficacy of these strategies for preventing subsequent adverse outcomes has been limited to small studies to date. OBJECTIVE To evaluate available evidence on multicomponent nonpharmacological delirium(More)
Methods We enrolled 459 people without dementia, who were aged 70 years or older and were scheduled for elective orthopaedic surgery between June, 2010, and August, 2013. At baseline, participants reported their current pain and the average and worst pain in the previous 7 days, on a scale of 0–10. Depressive symptoms before surgery were assessed with the(More)
BACKGROUND Preoperative pain and depression predispose patients to delirium. Our goal was to determine whether pain and depressive symptoms interact to increase delirium risk. METHODS We enrolled 459 persons without dementia aged ≥70 years scheduled for elective orthopedic surgery. At baseline, participants reported their worst and average pain within(More)
Electronic medical records (EMRs) offer the opportunity to streamline the search for patients with possible delirium. The purpose of the current study was to identify words and phrases commonly noted in charts of patients with delirium. The current study included 67 patients (nested within a cohort study of 300 patients) ages 70 and older undergoing major(More)
OBJECTIVES To examine baseline (preoperative) neuropsychological test performance in a cohort of elderly individuals undergoing elective surgery and the association between specific neuropsychological domains and postoperative delirium. DESIGN Ongoing prospective cohort study. SETTING Successful Aging after Elective Surgery Study. PARTICIPANTS Elderly(More)
OBJECTIVES To compare chart- and interview-based methods for identification of delirium. DESIGN Prospective cohort study. SETTING Two academic medical centers. PARTICIPANTS Individuals aged 70 and older undergoing major elective surgery (N = 300) (majority orthopedic surgery). MEASUREMENTS Participants were interviewed daily during hospitalization(More)
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