Environmental and Clinical Risk Factors for Delirium in a Neurosurgical Center: A Prospective Study.
World Neurosurg. 2017 Apr 12;:
Authors: Matano F, Mizunari T, Yamada K, Kobayashi S, Murai Y, Morita A
Abstract
INTRODUCTION: Few reports of delirium-related risk factors have focused on environmental risk factors and clinical risk factors, such as white matter signal abnormalities on magnetic resonance imaging (MRI) FLAIR images.
MATERIAL & METHODS: We prospectively enrolled 253 patients admitted to our neurosurgical center between December 2014 and June 2015 and analyzed a total of 220 patients (100 males; mean age, 64.1 years; age range, 17-92 years). The upper 4 points of the Intensive Care Delirium Screening Checklist (ICDSC) indicated delirium. We evaluated patient factors consisting of baseline characteristics and related factors, such as white matter lesions (WMLs), and we also evaluated the surrounding environment.
RESULTS: Delirium occurred in 29/220 cases (13.2%) in the present study. Regarding the baseline characteristics, there were significant statistical correlations between delirium and age (P = 0.0187), Hasegawa Dementia Scale-Revised score (P = 0.0022) on admission, and WMLs (P <0.0001). WMLs were related to age (P < 0.0001) and atherosclerotic disease (P = 0.004). Regarding related factors, there were significant statistical correlations between delirium and staying at a neurosurgical care unit (NCU; P = 0.0245). Multivariate logistic regression analyses showed statistically significant correlations of delirium with WMLs (P <0.0001) and surrounding delirium patients (P = 0.026).
CONCLUSION: WMLs in patients and the environmental situation are risk factors for delirium in a neurosurgical center. Therefore, to prevent delirium, we must recognize risk factors, such as high grade WMLs, and manage environmental factors, such as the surrounding situation.
PMID: 28412481 [PubMed - as supplied by publisher]
http://ift.tt/2oFn8aE
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου