The Incidence and Impact of Abdominal Surgery on Delirium in Abdominal Trauma Patients

Abstract

Purpose: The occurrence of trauma-related delirium following postoperative abdominal surgery is associated with a poor prognosis. The purpose of this study was to identify predictive risk factors for trauma-related delirium. Methods: Trauma patient data from a regional trauma center were retrospectively collected from August 2015 to December 2016. The primary inclusion criteria were patients diagnosed with traumarelated delirium following abdominal trauma surgery. Head trauma patients and those under 18 years of age were excluded from this study. A multivariate logistic regression analysis was performed to identify the risk factors associated with trauma-related delirium. Results: Of the 255 trauma patients who met the inclusion criteria, 32 (12.5%) were diagnosed with delirium. The mean values for the age of the patients, Injury Severity Score, Glasgow Coma Scale score, and length of intensive care unit stay were 52.1 ± 17.8 years, 16.9, 14, and 7.1 days, respectively. Among the measured parameters, age [odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01-1.06; p = 0.022)], sex (OR, 0.125; 0.03-0.55; p = 0.006), hemoglobin level (OR, 0.875; CI, 0.68-0.98; p = 0.03), length of stay in the intensive care unit (OR, 1.12; CI, 1.03-1.22; p = 0.01), and having an abdominal operation (OR, 2.92; CI, 1.10-7.23; p = 0.011) showed strong correlations with trauma-related delirium Conclusion: This study showed that abdominal surgery was strongly associated with delirium in patients with traumatic abdominal injury. Thus, changes in consciousness should be carefully monitored following surgery.

A Descriptive Cross-Sectional Study on Clinical Profile and Outcome of Delirium in Trauma Patients in the Semi-Closed Intensive Care Unit of a Medical College

“…This study showed that age was a risk factor for delirium in trauma pa ents which is similar to the study by a Roh et al and Bryczkowsko et al This is because advancing age pa ents have co-morbidi es, physiological changes, metabolic disturbances, and altera on in the level of the neurotransmi er in the brain which predisposes the pa ent to delirium. 2,7 Long standing hypertension was iden fied as a risk factor in our study which is similar to the study by a Kim et al Hypertension can be associated with a decline in cogni ve performance. The vascular damage exposes hypertensive pa ents to cerebral hypo perfusion and cerebral hypoxia and makes them at risk for delirium when admi ed in the ICU.…”

“…Delirium is an acute brain dysfunc on and studies have shown that the incidence of delirium in the trauma pa ents in the intensive care unit (ICU) is between12.5% to 67%depending upon the type, the severity of the trauma, and a diagnos c method used. [2][3][4][5] Seda on management and delirium assessment is a rou ne procedure in our ICU by trea ng physicians and ICU staff. The nurse performs and records the result of seda on and delirium by using Richmond Agita on-Seda on Scale (RASS) and confusional assessment method (CAM-ICU) for every pa ent admi ed in the intensive care unit twice a day and whenever a pa ent experiences a change in mental status.…”

“…Studies have shown that the acute phase of trauma is a risk factor for delirium in the ICU but there are limited studies on incidence, risk factors, and outcomes of delirium in trauma pa ents in developing country. 2,6,7 This study was conducted to determine the risk factorsand outcome of delirium in trauma pa ents in a mixed semiclosed intensive care unit. All pa ents 18 years or older with a history of road traffic accidents, falls, drowning, physical assaults, and selfinflicted violence admi ed to the mixed intensive care unit of a ter ary care hospital for more than 24 hours were included in this study.…”

A Descriptive Cross-Sectional Study on the Incidence, Risk Factor and Outcome of Delirium in Surgical Patients in the Semi-Closed Intensive Care Unit

“…This study showed that the length of stay in the ICU was higher in delirious patients that is similar to other studies. 4,5,9,10 Length of stay causes more economic burden to patients and family members can cause more hospital-acquired infections and psycho-social problems.…”

“…1 Delirium is an acute brain dysfunction and studies have shown that an incidence of delirium in the surgical intensive care unit (ICU) is between3.6% to 73% depending upon the severity of the illness, type of surgery, and the diagnostic method used. [2][3][4][5][6][7][8] The onset is usually over 1-2 days and can deteriorate further with poor prognosis if appropriate intervention is delayed.…”