Risk Factors for Delirium During Acute and Subacute Stages of Various Disorders in Patients Admitted to Rehabilitation Units

Abstract

ObjectiveTo assess the risk factors for delirium in patients admitted to a rehabilitation unit for acute or subacute neurological or musculoskeletal disorders.MethodsWe reviewed the medical records of 537 patients admitted to a rehabilitation unit and selected 398 patients in the acute or subacute stage of various neurological or musculoskeletal disorders. Among them, patients who had suffered from delirium were categorized into the delirium group (n=65), and the other patients were categorized into the non-delirium group (n=333). As potential risk factors for delirium, the patients' diagnosis, underlying disease, demographic data, hospital stay duration, surgery, and laboratory findings were reviewed, and the differences between the two groups with respect to independent risk factors were analyzed.ResultsThe average age in the delirium group was higher; the hospital stay and pre-transfer periods were longer. A large proportion of the patients were admitted for musculoskeletal disorders, and many patients had diabetes mellitus, dementia, and depression as underlying diseases. Laboratory tests revealed increases in the white blood cells (WBC), glucose, blood urea nitrogen (BUN), total bilirubin, aspartate transaminase (AST), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels in the delirium group, while the hemoglobin, calcium, phosphorus, protein, albumin, and potassium levels were decreased. Depression, musculoskeletal disorders, traumatic brain injury, elevated WBC, BUN, AST, and CRP levels, and decreased potassium and phosphorus levels were identified as independent risk factors for delirium.ConclusionRisk factors treatable before delirium onset were identified in rehabilitation patients in acute and subacute stages of various disorders. Early diagnosis and prevention of these risk factors could decrease delirium occurrence and increase rehabilitation effectiveness.

Saturday allied health services for geriatric evaluation and management: A controlled before‐and‐after trial

“…However, fidelity audits confirmed that allied health service events increased by 27%‐36% on the experimental ward during the intervention. Another concern with ward changes in a setting with high rates of delirium is the disorientating effect that these changes can have on patients with a high risk of delirium . Clinical practice guidelines recommend against the practice of changing rooms and wards for patients with delirium .…”

“…Another concern with ward changes in a setting with high rates of delirium 20 is the disorientating effect that these changes can have on patients with a high risk of delirium. 21 Clinical practice guidelines recommend against T A B L E 3 Discharge destination: number of participants (%) at each ward pre-and postintervention and odds ratio (95% CI) between wards the practice of changing rooms and wards for patients with delirium. 22 However, a sensitivity analysis excluding patients who changed wards during their GEM admission did not change our results.…”

Risk Factors for Postoperative Delirium after Cardiac Surgery

“…In prior research, Jang reported that a decreased potassium concentration is independently associated with delirium in patients admitted to rehabilitation wards (OR = 0.144 [95% CI = 0.064-0.327], p < 0.001) [36]. In addition, disturbance of the balance of electrolytes such as sodium and potassium or glucose increases the risk of delirium after surgery [37,38].…”

The Role of Musicon the Delirium in Traumatic Patients: A Case Study in the ICU of Peymanieh Hospital of Jahrom, Fars Province, Iran

“…In a study, the mean age of patients with delirium (69.3±13.9 years) was signif icantly higher than in patients without delirium (63.5±16.5 years). In addition, there was no signif icant difference between the two groups in terms of gender (Jang ., 2016). Based on the results of the present study, although the incidence of delirium in patients aged over 65 years (50%) was higher than those aged under 65 years (38.15%), there was no signif icant relationship between…”