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Acute confusional state in elderly orthopaedic patients: factors of importance for detection in nursing care

In English

Författare

Summary, in English

OBJECTIVES: The aims of this study were to identify factors of significance in the development of acute confusional state (ACS) and the differences between patients who developed ACS and those who did not. METHOD AND RESULTS: Assessment, observations and interviews with 505 patients admitted to an orthopaedic clinic revealed that 51 patients developed ACS during their in-hospital stay. Patients admitted for hip fracture had a higher incidence of ACS (20.2%) than patients admitted for elective surgery for coxarthros or gonarthros (3.6%). The highest hazard ratio for ACS was several other physical diseases 15.94 (CI: 4.60-55.31 and p-value <0.00001) and the lowest was age 1.10 (CI: 1.04-1.15 and p-value <0.0002). The ACS lasted from 1 to 9 days, and patients had one (N=42), two (N=8) or three episodes (N=1) of confusion during their stay on the ward. More patients who developed ACS before surgery had two or more confusional episodes and emergency patients developed ACS more rapidly. The ACS lasted longer in patients with a higher score on the OBS scale at admittance and with rapid development of ACS. CONCLUSIONS: Acuteness in the situation seems an important risk indication for ACS in the elderly. Awareness of factors associated with the development of ACS makes it possible to more systematically identify those at risk, for instance by systematic assessment in the first interview with the patient on admission to hospital.

Publiceringsår

2001

Språk

Engelska

Sidor

7-17

Publikation/Tidskrift/Serie

International Journal of Geriatric Psychiatry

Volym

16

Issue

1

Dokumenttyp

Artikel i tidskrift

Förlag

John Wiley & Sons Inc.

Ämne

  • Psychiatry
  • Geriatrics

Nyckelord

  • acute confusional state
  • delirium
  • risk factors
  • nursing care
  • hip fracture
  • elderly
  • postoperative confusion
  • confusional episodes
  • Organic Brain Syndrome scale

Status

Published

ISBN/ISSN/Övrigt

  • ISSN: 1099-1166