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The aim of our article was to give an overview of the current state of knowledge of delirium in the hospital. In particular, diagnosis, strategies for prevention of delirium, and delirium treatment are essential for the outcome of the patient (1). The statements in our article refer to both internal medicine patients and operative patients, regardless of patient age or pre-existing conditions, and are intended to raise awareness of the problem of delirium in the hospital (2).

We fully support the statements of Professors Kratz and Diefenbacher about postoperative delirium and postoperative cognitive deficits as well as about indications of patients with dementia. However, these patient groups are a special collective that does not reflect the full range of patients in a hospital. Our task must be to ensure targeted delirium prevention, early delirium detection, and rapid delirium treatment in an extensive manner. This is the only way to avoid delirium during hospitalization, or to treat it in a timely manner, for patients with and without cognitive impairment from all specialist disciplines, thereby avoiding a protracted or permanent cognitive impairment (3, 4).

DOI: 10.3238/arztebl.2019.0376b

PD Dr. med. Norbert Zoremba PhD
Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie
Sankt Elisabeth Hospital Gütersloh, Germany
norbert.zoremba@sankt-elisabeth-hospital.de

Prof. Dr. med. Mark Coburn
Klinik für Anästhesiologie, Universitätsklinikum RWTH Aachen, Germany

Conflict of interest statement

PD Dr. Zoremba and Prof. Coburn have received congress fee and travel cost reimbursement, as well as lecture honoraria, from Orion Phama and MD Horizonte GmbH

1.
Avelino-Silva TJ, Campora F, Curiati JAE, et al.: Prognostic effects of delirium motor subtypes in hospitalized older adults: a prospective cohort study. PLoS One 2018; 13: e0191092 CrossRef MEDLINE PubMed Central
2.
Zoremba N, Coburn M: Acute confusional states in hospital. Dtsch Arztebl Int 2019; 116: 101–6 VOLLTEXT
3.
Devlin JW, Skrobik Y, Gelinas C, et al.: Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med 2018; 46: e825–73.
4.
Aldecoa C, Bettelli G, Bilotta F, et al.: European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur J Anaesthesiol 2017; 34: 192–214 CrossRef MEDLINE
1.Avelino-Silva TJ, Campora F, Curiati JAE, et al.: Prognostic effects of delirium motor subtypes in hospitalized older adults: a prospective cohort study. PLoS One 2018; 13: e0191092 CrossRef MEDLINE PubMed Central
2.Zoremba N, Coburn M: Acute confusional states in hospital. Dtsch Arztebl Int 2019; 116: 101–6 VOLLTEXT
3.Devlin JW, Skrobik Y, Gelinas C, et al.: Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med 2018; 46: e825–73.
4.Aldecoa C, Bettelli G, Bilotta F, et al.: European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur J Anaesthesiol 2017; 34: 192–214 CrossRef MEDLINE

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