| 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 |
| Pages: | 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: | Health Professions |
| Organisational Unit: | Institute of Nursing (IPF) |
| Appears in Collections: | Publikationen Gesundheit |
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