confusion

Summary

Summary: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation.

Top Publications

  1. Laplante J, Cole M, McCusker J, Singh S, Ouimet M. [Confusion Assessment Method. Validation of a French-language version]. Perspect Infirm. 2005;3:12-4, 16-8, 20-2 pubmed
    ..The Confusion Assessment Method (CAM) is the only valid and reliable clinical tool for detecting symptoms of delirium easily ..
  2. Sands M, Dantoc B, Hartshorn A, Ryan C, Lujic S. Single Question in Delirium (SQiD): testing its efficacy against psychiatrist interview, the Confusion Assessment Method and the Memorial Delirium Assessment Scale. Palliat Med. 2010;24:561-5 pubmed publisher
    ..The Confusion Assessment Method (CAM) and two other tools were also applied...
  3. Hardy J, Brennan N. Computerized tomography of the brain for elderly patients presenting to the emergency department with acute confusion. Emerg Med Australas. 2008;20:420-4 pubmed publisher
    b>Confusion is a common reason for presentation of elderly patients to the ED. There are many potential causes of confusion, which include acute neurological events...
  4. Kratz A. Use of the acute confusion protocol: a research utilization project. J Nurs Care Qual. 2008;23:331-7 pubmed publisher
    ..implement research-based preventive protocols to decrease the negative outcomes associated with delirium/acute confusion. After implementation, the medical-surgical unit experienced a 62% reduction in falls and a 100% decrease in ..
  5. Mapstone M, Duffy C. Approaching objects cause confusion in patients with Alzheimer's disease regarding their direction of self-movement. Brain. 2010;133:2690-701 pubmed publisher
    ..In particular, the presence of independently moving objects in naturalistic environments limits the capacity of patients with Alzheimer's disease to judge their heading of self-movement...
  6. Hestermann U, Backenstrass M, Gekle I, Hack M, Mundt C, Oster P, et al. Validation of a German version of the Confusion Assessment Method for delirium detection in a sample of acute geriatric patients with a high prevalence of dementia. Psychopathology. 2009;42:270-6 pubmed publisher
    To assess validity and interrater reliability of an operationalized German version of the Confusion Assessment Method (CAM) in geriatric patients with comorbid dementia and high delirium risk.
  7. Filik R, Price J, Darker I, Gerrett D, Purdy K, Gale A. The influence of tall man lettering on drug name confusion: a laboratory-based investigation in the UK using younger and older adults and healthcare practitioners. Drug Saf. 2010;33:677-87 pubmed publisher
    Medication errors commonly involve confusion between drugs with similar names. One possible method of reducing error is to emphasize differences between the names using 'Tall Man' (uppercase) letters (e.g. cefTAZidime vs cefUROxime)...
  8. Nakase Richardson R, Yablon S, Sherer M, Nick T, Evans C. Emergence from minimally conscious state: insights from evaluation of posttraumatic confusion. Neurology. 2009;73:1120-6 pubmed publisher
    ..Guidelines were developed by consensus because of lack of empirical data...
  9. Turner M, Cipolotti L, Shallice T. Spontaneous confabulation, temporal context confusion and reality monitoring: a study of three patients with anterior communicating artery aneurysms. J Int Neuropsychol Soc. 2010;16:984-94 pubmed publisher
    ..had a tendency to misidentify imagined events as real, a result that cannot be explained in terms of temporal confusion. This error was specific to confabulating patients and was not shared by non-confabulating ACoA patients...

Scientific Experts

More Information

Publications62

  1. Smith H, Boyd J, Fuchs D, Melvin K, Berry P, Shintani A, et al. Diagnosing delirium in critically ill children: Validity and reliability of the Pediatric Confusion Assessment Method for the Intensive Care Unit. Crit Care Med. 2011;39:150-7 pubmed publisher
    ..To validate a diagnostic instrument for pediatric delirium in critically ill children, both ventilated and nonventilated, that uses standardized, developmentally appropriate measurements...
  2. Kauffman M, Pereira de Silva N, Consalvo D, Kochen S. ApoE epsilon4 is not associated with posictal confusion in patients with mesial temporal lobe epilepsy with hippocampal sclerosis. Epilepsy Res. 2009;85:311-3 pubmed publisher
    A previous report found an association between ApoE isoforms and postictal confusion in medically intractable temporal lobe epilepsy (TLE). We performed a molecular epidemiology study in an independent sample of 77 TLE patients...
  3. Shindo Y, Sato S, Maruyama E, Ohashi T, Ogawa M, Imaizumi K, et al. Comparison of severity scoring systems A-DROP and CURB-65 for community-acquired pneumonia. Respirology. 2008;13:731-5 pubmed publisher
    ..mg/L); (iii) Respiratory failure (SaO(2) <or= 90% or PaO(2) <or= 60 mm Hg); (iv) Orientation disturbance (confusion); and (v) low blood Pressure (systolic blood pressure <or= 90 mm Hg)...
  4. Reade M, Eastwood G, Peck L, Bellomo R, Baldwin I. Routine use of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) by bedside nurses may underdiagnose delirium. Crit Care Resusc. 2011;13:217-24 pubmed
    The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is emerging as the most frequently used tool for identifying delirium among critically ill patients.
  5. Veran O, Kahane P, Thomas P, Hamelin S, Sabourdy C, Vercueil L. De novo epileptic confusion in the elderly: a 1-year prospective study. Epilepsia. 2010;51:1030-5 pubmed publisher
    ..Its incidence among elderly patients with confusion of unknown origin (CUO) remains undetermined.
  6. Harwood R, Goldberg S, Whittamore K, Russell C, Gladman J, Jones R, et al. Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Acronym: TEAM: Trial of an Elder. Trials. 2011;12:123 pubmed publisher
    ..We hypothesise that patients managed on this ward will have better outcomes than those receiving standard care, and that such care will be cost-effective...
  7. Xiao C, Mou W, McNamara T. Use of self-to-object and object-to-object spatial relations in locomotion. J Exp Psychol Learn Mem Cogn. 2009;35:1137-47 pubmed publisher
  8. Mitasova A, Kostálová M, Bednarik J, Michalcakova R, Kasparek T, Balabanova P, et al. Poststroke delirium incidence and outcomes: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2012;40:484-90 pubmed publisher
    ..To describe the epidemiology and time spectrum of delirium using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and to validate a tool for delirium assessment in patients in the acute poststroke period...
  9. Chapin J, Busch R, Janigro D, Dougherty M, Tilelli C, Lineweaver T, et al. APOE epsilon4 is associated with postictal confusion in patients with medically refractory temporal lobe epilepsy. Epilepsy Res. 2008;81:220-4 pubmed publisher
    This study examined the relationship between the APOE epsilon4 allele and postictal confusion in patients with medically intractable temporal lobe epilepsy (TLE)...
  10. Wang J, Mentes J. Factors determining nurses' clinical judgments about hospitalized elderly patients with acute confusion. Issues Ment Health Nurs. 2009;30:399-405 pubmed publisher
    Acute confusion(AC)/delirium is a common clinical phenomenon in hospitalized elders that is often overlooked or misdiagnosed by nurses of various cultural backgrounds...
  11. Bion J. Financial and intellectual conflicts of interest: confusion and clarity. Curr Opin Crit Care. 2009;15:583-90 pubmed publisher
    ..To examine the literature on competing interests for individuals and organizations involved in healthcare and to determine the nature and extent of the problem, and the most effective methods of management...
  12. Han J, Wilson A, Vasilevskis E, Shintani A, Schnelle J, Dittus R, et al. Diagnosing delirium in older emergency department patients: validity and reliability of the delirium triage screen and the brief confusion assessment method. Ann Emerg Med. 2013;62:457-465 pubmed publisher
    ..performed the Delirium Triage Screen (DTS), designed to be a highly sensitive rule-out test, and the Brief Confusion Assessment Method (bCAM), designed to be a highly specific rule-in test for delirium...
  13. Myint P, Musonda P, Sankaran P, Subramanian D, Ruffell H, Smith A, et al. Confusion, Urea, Respiratory Rate and Shock Index or Adjusted Shock Index (CURSI or CURASI) criteria predict mortality in community-acquired pneumonia. Eur J Intern Med. 2010;21:429-33 pubmed publisher
    ..Community-acquired pneumonia (CAP) is common and associated with a significant mortality. Shock index, heart rate divided by systolic blood pressure, has been shown to be associated with outcome in sepsis...
  14. Jones R, Vernon S, Woolf S. Is discussion of colorectal cancer screening options associated with heightened patient confusion?. Cancer Epidemiol Biomarkers Prev. 2010;19:2821-5 pubmed publisher
    ..screening, but the modalities vary by frequency, accuracy, preparations, discomfort, and cost, which may cause confusion and reduce screening rates...
  15. Mead M. Cadmium confusion: do consumers need protection?. Environ Health Perspect. 2010;118:a528-34 pubmed publisher
  16. Grabner R, Ansari D, Koschutnig K, Reishofer G, Ebner F. The function of the left angular gyrus in mental arithmetic: evidence from the associative confusion effect. Hum Brain Mapp. 2013;34:1013-24 pubmed publisher
    ..Using functional magnetic resonance imaging, we investigated the neural correlates of the associative confusion effect that allowed us to dissociate effects of task difficulty and task-related arithmetic processes on lAG ..
  17. Strasburger H, Malania M. Source confusion is a major cause of crowding. J Vis. 2013;13:24 pubmed publisher
    ..That rule shows a formal analogy to M scaling, from which the critical crowding distances on a cortical map can be derived as a logarithmic function. The perceptual results are visualized in a "doughnut" model...
  18. Meagher D. More attention, less confusion: time to lessen the burden of delirium. Int Rev Psychiatry. 2009;21:1-3 pubmed publisher
  19. Komatsu H, Nojiri H, Sogo T, Inui A, Sawa F, Fujisawa T. Sacroiliitis infected with group A streptococcus in a child presenting with confusion and combativeness. J Infect Chemother. 2009;15:328-30 pubmed publisher
    ..b>Confusion and combativeness are well known as the common symptoms of streptococcal toxic shock syndrome...
  20. Wang C, Wu Y, Yue P, Ely E, Huang J, Yang X, et al. Delirium assessment using Confusion Assessment Method for the Intensive Care Unit in Chinese critically ill patients. J Crit Care. 2013;28:223-9 pubmed publisher
    The aim of this study was to provide a method for delirium evaluation in simplified Chinese for patients speaking this language via validation of a translation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).
  21. Hughes C, Patel M, Pandharipande P. Pathophysiology of acute brain dysfunction: what's the cause of all this confusion?. Curr Opin Crit Care. 2012;18:518-26 pubmed publisher
    ..To survey the recent medical literature examining the pathophysiology of acute brain dysfunction (delirium and coma) in the ICU...
  22. Attebring M, Herlitz J, Ekman I. Intrusion and confusion--the impact of medication and health professionals after acute myocardial infarction. Eur J Cardiovasc Nurs. 2005;4:153-9 pubmed
    ..Secondary prevention is important in preventing new cardiovascular events after acute myocardial infarction (AMI)...
  23. Chuang W, Lin C, Hsu W, Ting Y, Lin K, Ma S. [Evaluation of the reliability and validity of the Chinese version of the confusion assessment method for the intensive care unit]. Hu Li Za Zhi. 2007;54:45-52 pubmed
    ..the Chinese version of the diagnostic and statistical manual (DSM) of mental disorders written by Ely et al as a confusion assessment method for the intensive care unit (CAM-ICU) for diagnosing delirium...
  24. Soja S, Pandharipande P, Fleming S, Cotton B, Miller L, Weaver S, et al. Implementation, reliability testing, and compliance monitoring of the Confusion Assessment Method for the Intensive Care Unit in trauma patients. Intensive Care Med. 2008;34:1263-8 pubmed publisher
    To implement delirium monitoring, test reliability, and monitor compliance of performing the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in trauma patients.
  25. Walker M, Ayre G, Cummings J, Wesnes K, McKeith I, O Brien J, et al. The Clinician Assessment of Fluctuation and the One Day Fluctuation Assessment Scale. Two methods to assess fluctuating confusion in dementia. Br J Psychiatry. 2000;177:252-6 pubmed
    The identification of fluctuating confusion is central to improving the differential diagnosis of the common dementias.
  26. Kudoh A, Takahira Y, Katagai H, Takazawa T. Schizophrenic patients who develop postoperative confusion have an increased norepinephrine and cortisol response to surgery. Neuropsychobiology. 2002;46:7-12 pubmed
    The purpose of this study was to investigate the relationship between postoperative confusion and the plasma norepinephrine (NE), adrenocorticotropin (ACTH) or cortisol response to surgery in schizophrenic patients...
  27. Milstein A, Pollack A, Kleinman G, Barak Y. Confusion/delirium following cataract surgery: an incidence study of 1-year duration. Int Psychogeriatr. 2002;14:301-6 pubmed
    ..Delirium is frequently observed in clinical practice, particularly in medical and surgical wards and more so among patients at risk, especially elderly with preexisting central nervous system impairments...
  28. Kim P, Ashton D, Pollard J. Isolated hypoglycorrachia: leptomeningeal carcinomatosis causing subacute confusion. J Clin Neurosci. 2005;12:841-3 pubmed
    We report a 76-year-old caucasian man who presented with a 3-week history of progressive confusion. His past medical history included a left nephro-uretectomy for poorly differentiated transitional cell carcinoma 9 years previously...
  29. Myint P, Kamath A, Vowler S, Maisey D, Harrison B. The CURB (confusion, urea, respiratory rate and blood pressure) criteria in community-acquired pneumonia (CAP) in hospitalised elderly patients aged 65 years and over: a prospective observational cohort study. Age Ageing. 2005;34:75-7 pubmed
  30. McCaffrey R, Locsin R. The effect of music listening on acute confusion and delirium in elders undergoing elective hip and knee surgery. J Clin Nurs. 2004;13:91-6 pubmed
    ..to determine the effect of music on elders undergoing elective hip and knee surgery who experience acute confusion and delirium postoperatively...
  31. Milisen K, Foreman M, Hendrickx A, Godderis J, Abraham I, Broos P, et al. Psychometric properties of the Flemish translation of the NEECHAM Confusion Scale. BMC Psychiatry. 2005;5:16 pubmed
    ..This study determined the reliability, validity and diagnostic value of the Flemish translation of the NEECHAM Confusion Scale.
  32. Alink J, de Vries T. Unexplained seizures, confusion or hallucinations: think Hashimoto encephalopathy. Acta Paediatr. 2008;97:451-3 pubmed publisher
    ..We summarize and review all published cases to delineate the disease and to alert paediatricians so that they recognize the disease in children...
  33. Inouye S, van Dyck C, Alessi C, Balkin S, Siegal A, Horwitz R. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990;113:941-8 pubmed
    To develop and validate a new standardized confusion assessment method (CAM) that enables nonpsychiatric clinicians to detect delirium quickly in high-risk settings.
  34. Geschwind M, Josephs K, Parisi J, Keegan B. A 54-year-old man with slowness of movement and confusion. Neurology. 2007;69:1881-7 pubmed
  35. Shih H, Huang W, Liu C, Tsai T, Lu C, Lu M, et al. Confusion or delirium in patients with posterior cerebral arterial infarction. Acta Neurol Taiwan. 2007;16:136-42 pubmed
    To identify the possible anatomic sites and risk factors for the development of confusion or delirium in patients with posterior cerebral arterial (PCA) infarction.
  36. Saphyakhajon P, Greene G. Alternating acetaminophen and ibuprofen in children may cause parental confusion and is dangerous. Arch Pediatr Adolesc Med. 2006;160:757; author reply 757-8 pubmed
  37. Monette J, Galbaud du Fort G, Fung S, Massoud F, Moride Y, Arsenault L, et al. Evaluation of the Confusion Assessment Method (CAM) as a screening tool for delirium in the emergency room. Gen Hosp Psychiatry. 2001;23:20-5 pubmed
    The objective of this study was to compare the results of the Confusion Assessment Method (CAM) obtained by a trained non-physician interviewer to those obtained by a geriatrician, among a sample of elderly patients seen in an emergency ..
  38. Johansson I, Hamrin E, Larsson G. Psychometric testing of the NEECHAM Confusion Scale among patients with hip fracture. Res Nurs Health. 2002;25:203-11 pubmed
    The main aim of this study was to assess the reliability and validity of a Swedish translation of the NEECHAM Confusion Scale among 73 patients having surgery for hip fractures. Cronbach's alpha before and 7 days after surgery were...
  39. Laurila J, Pitkala K, Strandberg T, Tilvis R. Confusion assessment method in the diagnostics of delirium among aged hospital patients: would it serve better in screening than as a diagnostic instrument?. Int J Geriatr Psychiatry. 2002;17:1112-9 pubmed
    The Confusion Assessment Method (CAM) is an easy, four-step algorithmic diagnostic test developed to detect delirium.
  40. O Connor K, Aardema F. Fusion or confusion in obsessive compulsive disorder. Psychol Rep. 2003;93:227-32 pubmed
    Inferential confusion occurs when a person mistakes an imagined possibility for a real probability and might account for some types of thought-action and other fusions reported in obsessive-compulsive disorder...
  41. Kushida C, Clerk A, Kirsch C, Hotson J, Guilleminault C. Prolonged confusion with nocturnal wandering arising from NREM and REM sleep: a case report. Sleep. 1995;18:757-64 pubmed
    A 51-year-old man with Machado-Joseph disease had a 3-year history of prolonged confusion following nightly nocturnal wandering...
  42. Brébion G, Ohlsen R, Pilowsky L, David A. Visual hallucinations in schizophrenia: confusion between imagination and perception. Neuropsychology. 2008;22:383-389 pubmed publisher
    ..The aim of this study was to investigate the association between visual hallucinations and a specific type of reality-monitoring deficit, namely confusion between imagined and perceived pictures.
  43. Ludwick R. Clinical decision making: recognition of confusion and application of restraints. Orthop Nurs. 1999;18:65-72 pubmed
    The purpose of this study was to test the effects of patients' social, behavioral and medical characteristics on nurses' clinical decision for patient confusion.
  44. Franck N, Rouby P, Daprati E, Dalery J, Marie Cardine M, Georgieff N. Confusion between silent and overt reading in schizophrenia. Schizophr Res. 2000;41:357-64 pubmed
    ..Our data favour the hypothesis that the inability to correctly discriminate between inner and overt speech may play a role in the onset of schizophrenic hallucinations...
  45. Andrade C. Confusion and dysphoria with low-dose topiramate in a patient with bipolar disorder. Bipolar Disord. 2001;3:211-2 pubmed
    ..Topiramate, a newer antiepileptic agent, may benefit several neurological and psychiatric states, including bipolar disorder...
  46. Doherty M, Jayadev S, Watson N, Konchada R, Hallam D. Clinical implications of splenium magnetic resonance imaging signal changes. Arch Neurol. 2005;62:433-7 pubmed
    ..Magnetic resonance imaging (MRI) may show discrete splenium abnormalities; however, the implications of this radiologic finding are unclear...
  47. Rottger S, Schroger E, Grube M, Grimm S, Rubsamen R. Mismatch negativity on the cone of confusion. Neurosci Lett. 2007;414:178-82 pubmed
    ..MMN latencies suggest that sound localization based on spectral cues is slower than ITD- or ILD-based localization...
  48. Gonzalez M, de Pablo J, Fuente E, Valdes M, Peri J, Nomdedeu M, et al. Instrument for detection of delirium in general hospitals: adaptation of the confusion assessment method. Psychosomatics. 2004;45:426-31 pubmed
    ..In this study, the authors present an adaptation of the Confusion Assessment Method in order to improve its psychometric properties...
  49. Mador J, Giles L, Whitehead C, Crotty M. A randomized controlled trial of a behavior advisory service for hospitalized older patients with confusion. Int J Geriatr Psychiatry. 2004;19:858-63 pubmed
    To determine whether individualized advice on non-pharmacological strategies for hospitalized older patients with confusion and behavioral problems can improve levels of agitation and reduce the use of psychotropic medication.
  50. Chan Tack K, Forrest G. A man with fever, headache, and confusion. Clin Infect Dis. 2004;39:1834, 1856-7 pubmed
  51. Lemiengre J, Nelis T, Joosten E, Braes T, Foreman M, Gastmans C, et al. Detection of delirium by bedside nurses using the confusion assessment method. J Am Geriatr Soc. 2006;54:685-9 pubmed
    A prospective, descriptive study was used to assess the diagnostic validity of the Confusion Assessment Method (CAM) administered at the bedside by nurses in daily practice...
  52. McCaffrey R, Locsin R. The effect of music on pain and acute confusion in older adults undergoing hip and knee surgery. Holist Nurs Pract. 2006;20:218-24; quiz 225-6 pubmed
    ..Acute confusion and pain after surgery can increase length of stay and reduce function...
  53. Mou W, McNamara T, Rump B, Xiao C. Roles of egocentric and allocentric spatial representations in locomotion and reorientation. J Exp Psychol Learn Mem Cogn. 2006;32:1274-90 pubmed
    ..Egocentric representations may be used to locate objects when allocentric representations are not of high fidelity...