Delirium in trauma patients: a 1-year prospective cohort study of 2026 patients.
Background: Delirium in trauma surgery is common, especially post-operatively, but medical characteristics, risk factors and residence post-discharge have not comprehensively been investigated in all trauma patients. Methods: Over 1 year, 2026 trauma patients were prospectively screened for delirium...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 48; no. 2; pp. 1017 - 1025 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Apr2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156244324&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156244324 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Apr2022 vid: 48 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 156244324 148492863 156244324 156244324 10.1007/s00068-021-01603-5 156244324 ppf: 1017 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Delirium in trauma patients: a 1-year prospective cohort study of 2026 patients. aug: au: Marquetand, Justus Gehrke, Samuel Bode, Leonie Fuchs, Simon Hildenbrand, Florian Ernst, Jutta von Känel, Roland Boettger, Soenke affil: Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland sug: subj: Trauma Surgery Emergency Patients Psychosocial Factors Delirium Risk Factors Postoperative Complications Risk Assessment Human Prospective Studies DSM Multiple Regression Odds Ratio Confidence Intervals Checklists Scales ab: Background: Delirium in trauma surgery is common, especially post-operatively, but medical characteristics, risk factors and residence post-discharge have not comprehensively been investigated in all trauma patients. Methods: Over 1 year, 2026 trauma patients were prospectively screened for delirium with the following tools: Delirium Observation screening scale (DOS), Intensive Care Delirium Screening Checklist (ICDSC) and a DSM (Diagnostic and Statistical Manual)-5, nursing tool (ePA-AC) construct. Risk factors—predisposing und precipitating—for delirium were assessed via multiple regression analysis. Results: Of 2026 trauma patients, 440 (21.7%) developed delirium, which was associated with an increased risk of assisted living (OR 6.42, CI 3.92–10.49), transfer to nursing home (OR 4.66, CI 3.29–6.6), rehabilitation (OR 3.96, CI 3.1–5.1), or death (OR 70.72, CI 22–227.64). Intensive care management (OR 18.62, CI 14.04–24.68), requirement of ventilation (OR 32.21, CI 21.27–48.78), or its duration (OR 67.22, CI 33.8–133.71) all increased the risk for developing delirium. Relevant predisposing risk factors were dementia (OR 50.92, CI 15.12–171.45), cardiac insufficiency (OR 11.76, CI 3.6–38.36), and polypharmacy (OR 5.9, CI 4.01–8.68).Relevant precipitating risk factors were brain edema (OR 40.53, CI 4.81–341.31), pneumonia (OR 39.66, CI 8.89–176.93) and cerebral inflammation (OR 21.74, CI 2.34–202.07). Conclusion: Delirium in trauma patients is associated with poor outcome as well as with intensive care management and various predisposing and/or precipitating factors. Three quarters of patients who had undergone delirium were not able to live independently at home any more. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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