Journal of Korean Clinical Nursing Research (임상간호연구)

Hospital Nurses Association (병원간호사회)
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The Incidence and risk factors of delirium in elderly surgical patients

외과계 병동 노인 수술 환자의 섬망 발생률과 위험요인

  • Lee, Eun Ju (Department of Nursing, Seoul National University Hospital) ;
  • Jang, Mi (Department of Nursing, Seoul National University Hospital) ;
  • Kim, Myung Hwa (Department of Nursing, Seoul National University Hospital) ;
  • Yun, Hye Jun (Department of Nursing, Seoul National University Hospital) ;
  • Kim, Eun Mi (Department of Nursing, Seoul National University Hospital) ;
  • Chung, Young In (Department of Nursing, Seoul National University Hospital) ;
  • Kim, Bo Kyung (Department of Nursing, Seoul National University Hospital) ;
  • Im, Eun Su (Department of Nursing, Seoul National University Hospital) ;
  • Hong, Kyoung Soon (Department of Nursing, Seoul National University Hospital)
  • Received : 2022.02.15
  • Accepted : 2022.06.24
  • Published : 2022.08.31
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Abstract

Purpose: This retrospective chart review study was conducted to examine the frequency of delirium and to identify the risk factors of delirium in elderly surgical patients. Methods: The subjects of this study were 394 patients aged 65 years or older who underwent surgery. The diagnosis of delirium was based on the nursing assessment records with scores from the day of surgery to the 4th day after surgery. The collected data were analyzed by binary logistic regression analysis. Results: The incidence of delirium was 4.3%, and delirium occurred most frequently on the first day of surgery and lasted for 2.16 days on average. Of delirium patients, 76.5% underwent gastrointestinal surgery, and the most common delirium pattern was disorientation. In terms of the characteristics of the subjects, the occurrence of delirium was statistically different by age (𝝌2=10.79, p=.005), systemic-specific disease (𝝌2=9.63, p=.047), use of delirium-inducing drug(benzodiazepine) before surgery (𝝌2=15.90, p<.001), walking ability before surgery (𝝌2=7.65, p=.006), history of delirium (𝝌2=35.92, p<.001), and emergency surgery (𝝌2=16.40, p<.001). As risk factors of delirium, gastrointestinal surgery was found to increase the risk of delirium by 12.57 times (95% CI=2.45~64.46, p=.002), and the use of benzodiazepines before surgery was shown to increase delirium by 10.07 times (95% CI=2.21~45.87, p=.003). Conclusion: It is necessary for nurses to actively evaluate delirium using screening tools for early detection and prevention of delirium in elderly surgical patients with delirium risk factors.

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References

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