The predisposing and precipitating risk factors for delirium in neurosurgery : a prospective cohort study of 949 patients

Zipser, Carl Moritz; Deuel, Jeremy; Ernst, Jutta; Schubert, Maria; von Känel, Roland; Böttger, Sönke

doi:10.1007/s00701-019-03927-z

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	The predisposing and precipitating risk factors for delirium in neurosurgery : a prospective cohort study of 949 patients
Authors:	Zipser, Carl Moritz Deuel, Jeremy Ernst, Jutta Schubert, Maria von Känel, Roland Böttger, Sönke
et. al:	No
DOI:	10.1007/s00701-019-03927-z
Published in:	Acta Neurochirurgica
Volume(Issue):	161
Issue:	7
Page(s):	1307
Pages to:	1315
Issue Date:	2019
Publisher / Ed. Institution:	Springer
ISSN:	0001-6268 0942-0940
Language:	English
Subjects:	Delirium; Impact; Interaction; Neurosurgery; Precipitating factor; Predisposing factor; Risk factor
Subject (DDC):	617: Surgery
Abstract:	Background: Delirium is the most common neuropsychiatric presentation during hospitalization. In neurosurgery, studies on predisposing and precipitating risk factors for the development of delirium are rare but required for the individual risk estimation. Methods: Prospective cohort study in a tertiary university center. In total, 949 neurosurgical patients, 307 with and 642 without delirium, were included. Demographic factors, neurosurgery-related, neurological, and medical clusters were tested as predictors of delirium in multiple logistic regression analyses. Results: The incidence of delirium in this cohort of neurosurgical patients was 32.4%. Compared to patients without delirium, those with delirium were significantly older, more cognitively and neurologically impaired, transferred from hospitals and nursing homes, admitted as emergencies, longer hospitalized (16.2 vs. 9.5 days; p < 0.001), in greater need of intensive care management, and more frequently transferred to rehabilitation. Predisposing factors of delirium were stroke (OR 5.45, CI 2.12–14.0, p < 0.001), cardiac insufficiency (OR 4.59, CI 1.09–19.26, p = 0.038), cerebral neoplasm (OR 1.53, CI 0.92–2.54, p = 0.019), and age ≥ 65 years (OR 1.47, CI 1.03–2.09, p = 0.030). Precipitating factors of delirium were acute cerebral injury (OR 3.91, CI 2.24–6.83, p < 0.001), hydrocephalus (OR 3.10, CI 1.98–4.87, p < 0.001), and intracranial hemorrhage (OR 1.90, CI 1.23–2.94, p = 0.004). Conclusions: Delirium in acute neurosurgical patients was associated with longer hospitalization. Whereas common etiologies of delirium like infections and dementia, did not predict delirium, preexisting neurovascular and traumatic diseases, as well as surgery-related events seem important risk factors contributing to delirium in neurosurgery.
URI:	https://digitalcollection.zhaw.ch/handle/11475/17507
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Health Sciences
Organisational Unit:	Institute of Nursing (IPF)
Appears in collections:	Publikationen Gesundheit

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Zipser, C. M., Deuel, J., Ernst, J., Schubert, M., von Känel, R., & Böttger, S. (2019). The predisposing and precipitating risk factors for delirium in neurosurgery : a prospective cohort study of 949 patients. Acta Neurochirurgica, 161(7), 1307–1315. https://doi.org/10.1007/s00701-019-03927-z

Zipser, C.M. et al. (2019) ‘The predisposing and precipitating risk factors for delirium in neurosurgery : a prospective cohort study of 949 patients’, Acta Neurochirurgica, 161(7), pp. 1307–1315. Available at: https://doi.org/10.1007/s00701-019-03927-z.

C. M. Zipser, J. Deuel, J. Ernst, M. Schubert, R. von Känel, and S. Böttger, “The predisposing and precipitating risk factors for delirium in neurosurgery : a prospective cohort study of 949 patients,” Acta Neurochirurgica, vol. 161, no. 7, pp. 1307–1315, 2019, doi: 10.1007/s00701-019-03927-z.

ZIPSER, Carl Moritz, Jeremy DEUEL, Jutta ERNST, Maria SCHUBERT, Roland VON KÄNEL und Sönke BÖTTGER, 2019. The predisposing and precipitating risk factors for delirium in neurosurgery : a prospective cohort study of 949 patients. Acta Neurochirurgica. 2019. Bd. 161, Nr. 7, S. 1307–1315. DOI 10.1007/s00701-019-03927-z

Zipser, Carl Moritz, Jeremy Deuel, Jutta Ernst, Maria Schubert, Roland von Känel, and Sönke Böttger. 2019. “The Predisposing and Precipitating Risk Factors for Delirium in Neurosurgery : A Prospective Cohort Study of 949 Patients.” Acta Neurochirurgica 161 (7): 1307–15. https://doi.org/10.1007/s00701-019-03927-z.

Zipser, Carl Moritz, et al. “The Predisposing and Precipitating Risk Factors for Delirium in Neurosurgery : A Prospective Cohort Study of 949 Patients.” Acta Neurochirurgica, vol. 161, no. 7, 2019, pp. 1307–15, https://doi.org/10.1007/s00701-019-03927-z.