The major risk factors for delirium in a clinical setting

Kim, Harin; Chung, Seockhoon; Joo, Yeon Ho; Lee, Jung Sun

doi:10.2147/ndt.s112017

Cited by 32 publications

(11 citation statements)

References 42 publications

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“…This finding is consistent with recent pooled evidence on the risk factors for PODE [16]. Patients with cranial nerve disorders who have hypertension usually receive treatment with multiple drugs, such as antihypertensive and antipsychotic drugs, and this has been associated with delirium in the clinical setting [17]. In addition, among hypertensive patients, blood pressure may rise above the optimal mean arterial pressure during the perioperative period, and this has been associated with both the incidence and severity of PODE [18].…”

Section: Discussionsupporting

confidence: 89%

Risk factors for postoperative delirium in patients undergoing microvascular decompression

Cheng

et al. 2019

PLoS ONE

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This study is to identify the risk factors for postoperative delirium (PODE) in patients undergoing microvascular decompression (MVD) for the treatment of primary cranial nerve disorders. We retrospectively reviewed the data of 912 patients (354 men, 558 women) with primary cranial nerve disorders (trigeminal neuralgia, 602 patients; hemifacial spasm, 296 patients; glossopharyngeal neuralgia, 14 patients) who underwent MVD in the Neurosurgery Department of Lanzhou University Second Hospital between July 2007 and June 2018. Potential risk factors for PODE were identified using univariate and multivariate stepwise logistic regression analysis.Of the 912 patients, 221 (24.2%) patients developed PODE. Patients with PODE were significantly older and significantly more likely to be male than patients without PODE. A history of hypertension, preoperative carbamazepine therapy, and postoperative sleep disturbance and tension pneumocephalus were independently associated with PODE. Variables such as body-mass index, smoking and drinking habits, cardiac disease, diabetes mellitus, cerebrovascular disease, mean operative time, affected vessel, mean blood loss, postoperative intensive care unit stay, postoperative fever (>38°C), and routine laboratory results were not associated with PODE in our patients.PODE is a common complication after MVD, and is associated with multiple risk factors, including old age, male sex, hypertension, preoperative carbamazepine use, postoperative sleep disturbance, and tension pneumocephalus.

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Section: Discussionsupporting

confidence: 89%

Risk factors for postoperative delirium in patients undergoing microvascular decompression

Cheng

et al. 2019

PLoS ONE

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“…Yoğun bakımda deliryum gelişmesi açısından yaş, sigara, alkol, hipertansiyon, ciddi sistemik hastalık, sedatif ve analjezikler, temel bilişsel bozukluk, metabolik bozukluklar, hipoalbüminemi, anemi, preoperatif uyarıcı olabilecek önemli risk faktörleridir [10,26] . Çalışmamızda, delirium gurubunda yaş ortalaması diğer gruba göre daha yüksekti ve preoperative hipertansiyon bir risk faktörü olarak belirlendi.…”

Section: Discussionunclassified

The Prevalance Of Delirium After Open Heart Surgery And The Efficacy Of Dexmedetomidine

Aslankurt¹,

Yapıcı²,

Kudsioğlu³

et al. 2016

GKDA Derg

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Deliryum açık kalp cerrahisi sonrası en çok rastlanan nörolojik komplikasyonlardan biridir. Çalışmalarda deliryumu belirleme aracı ve tanı kriterlerinin değişik olması gibi nedenlerle farklı prevalans sonuçları bildirilmiştir. Çalışmamızda açık kalp cerrahisi geçiren hastalarda deliryum sıklığını, hangi predispozan faktörlerle ilişkili olduğunu ve tedavide deksmedetomidin etkinliğini araştırmak istedik.

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“…Characteristics potentially associated with delirium during the ICU stay and neuropsychiatric disorders at a 1-year follow-up were identified a priori [ 37 , 38 ] . Characteristics included age, sex, ICU admission reason (medical, surgical, neurological, trauma), Acute Physiology and Chronic Health Evaluation (APACHE) II score, Charlson Comorbidity Index (CCI), Glasgow Coma Scale (GCS), transfer delay ≥ 24 h, invasive mechanical ventilation (yes/no), non-invasive mechanical ventilation (yes/no), continuous renal replacement therapy (yes/no), vasoactive medications (yes/no), ICU size (categorized as < 20 beds vs. ≥ 20 beds), teaching hospital (yes/no), ICU length of stay (categorized as < 7 days vs. ≥ 7 days), and last Sequential Organ Failure Assessment (SOFA) score.…”

Section: Methodsmentioning

confidence: 99%

Association between delirium in the intensive care unit and subsequent neuropsychiatric disorders

et al. 2020

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Background: Patients in the intensive care unit (ICU) are known to be at increased risk of developing delirium, but the risk of subsequent neuropsychiatric disorders is unclear. We therefore sought to examine the association between the presence of delirium in the ICU and incident neuropsychiatric disorders (including depressive, anxiety, trauma-and-stressor-related, and neurocognitive disorders) post-ICU stay among adult medical-surgical ICU patients. Methods: Retrospective cohort study utilizing clinical and administrative data from both inpatient and outpatient healthcare visits to identify the ICU cohort and diagnostic information 5 years prior to and 1 year post-ICU stay. Patients ≥ 18 years of age admitted to one of 14 medical-surgical ICUs across Alberta, Canada, January 1, 2014-June 30, 2016, and survived to hospital discharge were included. The main outcome of interest was a new diagnosis of any neuropsychiatric disorder 1 year post-ICU stay. The exposure variable was delirium during the ICU stay identified through any positive delirium screen by the Intensive Care Unit Delirium Screening Checklist (ICDSC) during the ICU stay. Results: Of 16,005 unique patients with at least one ICU admission, 4033 patients were included in the study of which 1792 (44%) experienced delirium during their ICU stay. The overall cumulative incidence of any neuropsychiatric disorder during the subsequent year was 19.7% for ICU patients. After adjusting for hospital characteristics using log-binomial regression, patients with delirium during the ICU stay had a risk ratio (RR) of 1.14 (95% confidence interval [CI] 0.98-1.33) of developing any neuropsychiatric disorder within 1 year post-ICU compared to those who did not experience delirium. Delirium was significantly associated with neurocognitive disorders (RR 1.59, 95% CI 1.08-2.35), but not depressive disorders (RR 1.16, 95% CI 0.92-1.45), anxiety (RR 1.16, 95% CI 0.92-1.47), and trauma-and-stressor-related (RR 0.82, 95% CI 0.53-1.28) disorders. Conclusions: The diagnosis of new onset of neurocognitive disorders is associated with ICU-acquired delirium. In this study, significant associations were not observed for depressive, anxiety, and trauma-and-stressor-related disorders.

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The major risk factors for delirium in a clinical setting

Cited by 32 publications

References 42 publications

Risk factors for postoperative delirium in patients undergoing microvascular decompression

Risk factors for postoperative delirium in patients undergoing microvascular decompression

The Prevalance Of Delirium After Open Heart Surgery And The Efficacy Of Dexmedetomidine

Association between delirium in the intensive care unit and subsequent neuropsychiatric disorders

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