However, in nonintubated verbally communicative patients, the original CAM may be superior in detecting subtle cases of delirium [ 18].
For example, pain, depression, and delirium are subtle, rather complex problems to detect, particularly in populations with substantial impairments in cognition or communication.
21 More recent studies have used delirium as a subtle indicator of higher morbidity and mortality in patients who have advanced to AIDS.
However, the GCS requires observation of a verbal score (which is often unavailable in the ICU), must be interpreted in cases of concurrent sedation, and is insensitive to more subtle derangements of consciousness (such as delirium).
A significant number of patients, especially the elderly, develop peri-operative neurological complications ranging from subtle cognitive dysfunction and mild confusion to frank delirium, and occasionally permanent stroke.
On the other hand, in patients with high susceptibility to cerebral disturbance, an even more subtle set of changes in oxygenation might lead to postoperative delirium.
Sniffing the scented candles on display, she quickly chose a couple of favorites: the neroli candle by Malin+Goetz, which had subtle green notes she liked, and the pear and violet candle from Delirium & Co., which was "not too fruity or sweet," despite its name.
Unlike delirium — an acute, sudden-onset disorder that affects consciousness and attention — POCD can involve subtle, difficult-to-recognize symptoms that develop days to weeks after surgery.
However, it is difficult to understand how alleged age effects, expected to be subtle over a period of 4 years only, could obscure effects of processes driving the risk for delirium, which can be hypothesized to be quite strong operators.
