정형외과에 입원한 노인 환자의 섬망 위험 요인 연구

The Risk Factors of Delirium in Orthopedic Elderly Patients

Objective：The aim of this study was to explore risk factors behind delirium in elderly inpatients with orthopedic problem. Methods：The subjects were 94 elderly patients (≥65 years old) who admitted to a department of orthopedic surgery. They were evaluated with Confusion Assessment Method (CAM) and were diagnosed by Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision through direct interview with psychiatrists. The demographic data, medical histories, and orthopedic chart were checked through medical records of patients. Results：20 subjects (21.3%) were diagnosed as delirium, and among them, 10 subjects had hyperactive type (50.0%), 6 had hypoactive type (30.0%) and 4 had mixed type (20.0%). Delirium group had high systolic blood pressure (p=0.007) and plasma glucose level (p=0.001) at the admission day. They had low hemoglobin (p=0.002) and potassium level (p=0.017) after surgery. Conclusion：In our study, there were many delirium patients, and even though there were many hypoactive type patients. It is assumed that delirium occurs more at the surgery or damage with larger loss of blood. It is important that we take care of management of past diseases rather than presence of past diseases. It is necessary to develop guidelines which would help to find out high risk patients for delirium.