scholarly journals Incidence and risk factors of post operative delirium in elderly patients who underwent spinal anesthesia in Orotta, Halibet and Sembel Hospitals: A Cross sectional analytic study in ERITREA

2019 ◽  
Author(s):  
Michael Beraki Mengistu ◽  
Yonatan Mehari Andemeskel ◽  
Ariam Tsegay Emehatsion ◽  
Habtom Tareke Wrieta ◽  
Natsnet Yacob Gebreyessus

Abstract BackgroundDelirium is a common but often underdiagnosed set of transient symptomin the elderly patients following surgeries under spinal anesthesia. Delirium can be improved with early recognition and diagnosis based on the established standard criteria. The identification of the possible contributing factors and magnitude of the burden will help in the management of the fragile elderly patients. Managing delirium with environmental, supportive and pharmacological interventions will possibly reduce the incidence, and complication associated with postoperative delirium. The aim of this study is to determine the incidence of postoperative delirium and associated risk factors in elderly patients who did surgery under spinal anesthesia. MethodThis cross sectional study was conducted in the National Referral Hospitals in Eritrea (Orotta and Halibet), including Sembel hospital from February to May, 2019. The study participants were elderly patients (age ≥65 years) having no mental disorder, no history of acute cerebrovascular disease, no known history of delirium and/or dementia. Basic background and clinical characteristics of the patients was collected. To assess the status of cognitive impairment level, the Mini Mental State Examination and Confusion Assessment Method tools were used. Data was collected through an interview method. After the data was entered into SPSS version 22 software, it was conducted with frequency, percentage, bivariate and multivariate logistic regression analysis method as appropriate. P value at<0.05 was considered as statistically significant. ConclusionPostoperative delirium occurred in 14 out of 129 case (10.9%). The multivariate analysis showed that only age was significantly associated with postoperative delirium. The other variables did not significantly influence the occurrence of POD. Therefore, t he incidence of postoperative delirium after spinal anesthesia was relatively high (10.9%). Similarly, old age was found as the risk factor for the development of delirium in those elderly patients who underwent spinal anesthesia. This findings might help to develop preventive strategies to decrease POD through targeted factors.

2021 ◽  
pp. 1-8
Author(s):  
Michael Beraki Mengistu ◽  
◽  
Yonatan Mehari Andemeske ◽  
AriamTsegay Emhatsion ◽  
HabtomTareke Wrieta ◽  
...  

Background: Delirium is a common but often underdiagnosed set of transient symptoms often seen in elderly patients following surgeries under spinal anesthesia. With early recognition and diagnosis based on the established standard criteria delirium can be improved. Early identification of the possible contributingfactors and the magnitude of the burden will help in the management of the fragile elderly patients. The aim of this study is to determine the incidence of postoperative delirium and associated risk factors in elderly patients who have done surgery under spinal anesthesia. Method: This cross sectional study was conducted in the National Referral Hospitals and Sembel PrivateHospital, in Asmara, Eritrea from February to May, 2019. The study participants were elderly patients (age ≥65 years) having no known history of dementia or delirium or no mental disorder, no history of acute cerebrovascular disease. Basic background and clinical characteristics of the patients was collected. To assess the status of cognitive impairment level, the Mini Mental State Examination and Confusion Assessment Method tools were used. Data was collected through an interview method. After the data was entered into SPSS version 22 software, data was analyzed with frequency, percentage, bivariate and multivariate logistic regression analysis method as appropriate. P value <0.05 was considered as statistically significant. Results: The mean age of the participants was 74 ±6.62 and 102 (79.1%) of the participants were males. POD occurred in 14 (10.9%) of the patients. Adjusting all the potential factors, age was identified as arisk factor for developing POD. Conclusion: Age was determined to be a significant risk factor of delirium. Elderly patients require more attention and care and the findings might help to develop preventive strategies to the occurrence of POD


2021 ◽  
Author(s):  
Chunwen Yan ◽  
Min Yang ◽  
Nasha Niu ◽  
Linmei Li ◽  
Li Pan

Abstract Background: The postoperative delirium is a common yet serious complication in elderly patients with hip fracture, it’s necessary to evaluate the potential risk factors of delirium in patients with hip fracture, to provide reliable evidence to the clinical management of hip fracture.Methods: Elderly patients who underwent hip fracture surgery in our hospital from June 1, 2019 to May 31, 2021 were selected. The characteristics and treatment data of delirium and no delirium patients were collected and compared. Multivariate logistic regression analysis was conducted to analyze the influencing factors affecting postoperative delirium in elderly patients with hip fracture.Results: A total of 245 patients with hip fracture were included, the incidence of postoperative delirium in patients with hip fracture was 13.06%. There were significant differences in the age, BMI, history of delirium, estimated blood loss and duration of surgery (all p<0.05). There were significant differences in the albumin and TSH between delirium and no delirium group(all p<0.05), Logistics analyses indicated that ge≥75y(OR3.112,95%CI1.527~5.742), BMI ≥24 kg/m2(OR2.127,95%CI1.144~3.598), history of delirium(OR1.754,95%CI1.173~2.347), estimated blood loss≥400ml(OR1.698,95%CI1.427~1.946), duration of surgery≥120min(OR2.138,95%CI1.126~3.085), preoperative albumin≤40g/L(OR1.845,95%CI1.102~2.835) and TSH≤2mU/L(OR2.226, 95%CI1.329~4.011) were the independent risk factors of postoperative delirium in patients with hip fracture(all p<0.05).Conclusions: Postoperative delirium is very common in elderly patients with hip fracture, and it was associated with many risk factors, clinical preventions targeted on those risk factors are needed to reduce the postoperative delirium.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Q.L Gou ◽  
R.F Shi ◽  
X Zhang ◽  
Q.T Meng ◽  
X.R Li ◽  
...  

Abstract Background High-altitude pulmonary hypertension (HAPH) remains a concern due to its high mortality, however, studies evaluating its prevalence and risk factors are lacking. Objective To determine the prevalence of HAPH and its correlated factors among the highlanders living at 3200 metres above sea level in Ganzi Tibetan Automous Prefecture, Sichuan Province, China. Methods This was a single-center cross-sectional study involved 1129 subjects (mean age 46.6±14 years, 39% men). Native Tibetans with HAPH were defined as mean pulmonary artery pressure &gt;30mmHg achieved from transthoracic echocardiography. Results The crude prevalence of HAPH was 6.2%, and was more prevalent in men compared to women (8.6% vs 4.6%, P=0.005). The elder was more likely to develop HAPH (OR: 5.308, 95% CI: 2.562–10.993). Highlanders with HAPH had more severe metabolic abnormalities (including elevated blood pressure, blood glucose, blood lipids, BMI, etc. P value&lt;0.05) and significantly increased hemoglobin level (P=0.001). On multivariate logistic regression analysis, independent risk factors for HAPH were metabolic syndrome (OR: 3.128, 95% CI: 1.110–8.818), age (&gt;60 years vs &lt;40 years) (OR: 2.924, 95% CI: 1.282–6.669), and decreased SpO2 (OR: 1.072 per 1-unit decrease; 95% CI: 1.010–1.136). Conclusion It could be concluded that HAPH was prevalent among 6.2% native Tibetans in Sichuan Province, China. Increasing age, metabolic syndrome and decreased SpO2 were independent predisposing factors for HAPH Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): This study was funded by one Science and Technology Pillar Programs in Sichuan Province (Grant no. 2017SZ0008).


Author(s):  
Pedro Santos-Moreno ◽  
Carlos Alberto Castro ◽  
Laura Villarreal ◽  
Guillermo Sánchez-Vanegas

Abstract Background: Rheumatoid arthritis (RA) is an autoimmune chronic pathology, present in between 0.5% and 1% of adults. This disease is accompanied by comorbidities such as sleep disorders (SD) that occur in between 54% and 70% of the population with RA. The objective of this study was to identify the associated risk factors and the prevalence of sleep disorders in a group of patients with rheumatoid arthritis in a referral center for the management of autoimmune diseases in Bogotá, Colombia.Methods: An analytical cross-sectional study was carried out on a population of patients with Rheumatoid Arthritis (RA) evaluated with the DSM-V. The factors related to sleep disorders and disease activity of were explored. The prevalence of sleep disorders was determined, and a multivariate logistic regression analysis was conducted.Results: the study analyzed a total of 1436 patients, with a median age of 56 years. The prevalence of sleep disorders was 31.1%. There was an association between the presence of sleep disorders and Disease Activity Score 28 (DAS28) (OR: 3.8 CI 95%: 3-5), Health Assessment Questionnaire (HAQ) (OR: 3.2 CI 95%: 2.5-4.1), self-care activities (OR: 0.6 CI 95%: 0.4-0.9), and somatic symptom disorder (OR: 1.8, CI 95%: 1.3-2.6). Conclusions: An association (p-value <0.05) was found between SDs and disease activity (DAS28), functional capacity (HAQ), scholarship level, smoking, sedentary lifestyle, metabolic diseases, and leisure and self-care activities. In one third of patients SD were prevalent. It is suggested that patients be approached comprehensively carrying out behavioral and cognitive activities.


2020 ◽  
Author(s):  
Shunpeng Xing ◽  
Shaolin Ma ◽  
Yuxi Zhou ◽  
Ming Lei ◽  
Gang Feng ◽  
...  

Abstract Objective: To study the incidence and risk factors of postoperative clinical delirium in critically ill elderly patients in order to devise strategies for prevention and treatment.Methods: We collected clinical data from 451 critically ill patients in the intensive care unit from four hospitals in Shanghai Pudong New Area. Postoperative delirium was measured using the Confusion Assessment Method for the ICU (CAM-ICU), and then the incidence of postoperative delirium was calculated. We used univariate analysis and multivariate logistic regression analysis to determine the risk factors associated with postoperative delirium in critically ill elderly patients.Results: Among the 451 critically ill patients, 56 had delirium after operation. The incidence of postoperative delirium was 12.4%. Univariate analysis showed that the incidence of postoperative delirium was significantly higher (P <0.05) in patients who had a past history of chronic obstructive pulmonary disease (COPD), underwent emergency surgery, were not administered intraoperative Propofol, had postoperative hypertension, were administered postoperative methylprednisolone, and did not have postoperative analgesia. Multivariate logistic regression analysis showed that age (OR=1.111, 95% CI, 1.056-1.168), surgical timing (OR=1.154, 95% CI, 1.058-7.200), and use of methylprednisolone postoperatively (OR=8.030, 95% CI, 1.050-61.408) were risk factors. Use of Propofol intraoperatively (OR=0.315, 95%CI, 0.124-0.800) was protective factors for postoperative delirium in elderly critically ill patients.Conclusion: Adavanced age, COPD history, emergency surgery, postoperative hypertension, use of methylprednisolone, and no postoperative analgesia are risk factors for postoperative delirium in critically ill elderly patients. Medical staff should be educated in evaluating delirium in postoperative patients and conducting risk assessment in order to prevent and treat the disease earlier, and reduce the incidence of delirium.


2019 ◽  
Vol 7 (4) ◽  
pp. 79
Author(s):  
Hasri Yulia Sasmita ◽  
Irma Prasetyowati ◽  
Pudjo Wahjudi

Tuberculosis (TB) is one of cause of death in infectious disease domain. The control of TB is complicated because the inclination of case numbers people with Diabetes Mellitus. Diabetes Mellitus (DM) is an important risk factor for TB development, with prove that more than ten percent of TB patient is DM patient. People with DM have risk three times more likely to suffer from TB than people without DM. The results of TB treatment with comorbid DM will be easier to be failed. Puskesmas Patrang have the highest bacteriologically confirmed BTA TB cases and DM cases in Jember during 2014 until 2016. The aim of this research is to know the DM prevalence in TB patients and to analyze the correlation between DM risk factors in TB patient to TB-DM incidence at Puskesmas Patrang Jember in 2017. The research uses observasional analytic with cross sectional approach. The sampling technique uses simple random sampling with 47 samples. The independent variables include respondent characteristics (age, sex, type of TB, medication category, and family history of DM), central obesity and smoking behavior. While the dependent variable is the DM status. The result shows that the prevelance of DM in TB patients at Puskesmas Patrang Jember regency is 23,4%. Factors associated with TB-DM are age (p-value = 0,012), family history of DM (p-value = 0,003), and smoking status (p-value = 0,035). Factors that do not associated with TB-DM are sex (p-value = 0,731), type of TB (p-value = 0,170), treatment category of TB (p-value = 0,560), central obesity (p-value = 0,435), the number of cigarette (p-value = 1,000) and smoking duration (p-value = 1,000). The most important factor of TB-DM is family history of DM that 10,850 times higher of getting TB-DM than patients without family history of DM.


2020 ◽  
Author(s):  
Anna Kupiec ◽  
Barbara Adamik ◽  
Natalia Kozera ◽  
Waldemar Gozdzik

Abstract Background One of the most common complications after cardiac surgery is delirium. Determining the origin of this complication from possible pathomechanisms is difficult. The activation of an inflammatory response during surgery has been suggested as one possible mechanism of delirium. The usefulness of the inflammatory marker procalcitonin (PCT) as a predictor of delirium after cardiac surgery with cardiopulmonary bypass (CBP) has not yet been investigated. Methods The purpose of this study was to prospectively investigate the risk of developing postoperative delirium in a group of elderly patients using a multivariate assessment of preoperative (PCT, comorbidities, functional decline, depression) and intraoperative risk factors. 149 elderly patients were included. Delirium was assessed using the Confusion Assessment Method for the ICU. Results Thirty patients (20%) developed post-operative delirium: hypoactive in 50%, hyperactive in 33%, mixed in 17%. Preoperative PCT above the reference range (> 0.05 ng/mL) was recorded more often in patients who postoperatively developed delirium than in the non-delirium group (50% vs. 27%, p=0.019). After surgery, PCT was significantly higher in the delirium than the non-delirium group: ICU admission after surgery: 0.08 ng/mL, IQR 0.03-0.15 vs. 0.05 ng/mL, IQR 0.02-0.09, p=0.011), and for consecutive days (day 1: 0.59 ng/mL, IQR 0.25-1.55 vs. 0.25 ng/mL, IQR 0.14-0.54, p=0.003; day 2: 1.21 ng/mL, IQR 0.24-3.29 vs. 0.36 ng/mL, IQR 0.16-0.76, p=0.006; day 3: 0.76 ng/mL, IQR 0.48-2.34 vs. 0.34 ng/mL, IQR 0.14-0.66, p=0.001). Patients with delirium were older (74 years, IQR 70 – 76 vs. 69 years, IQR 67 – 74; p=0.038) and more often had functional decline (47% vs. 28%, p=0.041). There was no difference in comorbidities with the exception of anaemia (43% vs. 19%, p=0.006). Depression was detected in 40% of patients with delirium and in 17% without delirium (p=0.005). In a multivariable logistic regression model of preoperative procalcitonin (OR= 3.05; IQR 1.02-9.19), depression (OR=5.02, IQR 1.67-15.10), age (OR=1.14; IQR 1.02-1.26), functional decline (OR=0.76; IQR 0.63-0.91) along with CPB time (OR=1.04; IQR 1.02-1.06) were significant predictors of postoperative delirium. Conclusion A preoperative PCT test and assessment of functional decline and depression may help identify patients at risk for developing delirium after cardiac surgery.


2010 ◽  
Vol 25 (5) ◽  
pp. 236-240 ◽  
Author(s):  
A Clark ◽  
I Harvey ◽  
F G R Fowkes

Background There are many hypotheses concerning risk factors for the development of varicose veins based mostly on pathophysiological plausibility. Population studies have been carried out mostly on the middle aged with relatively few on elderly populations. Objectives To investigate epidemiological risk factors for varicose veins in an elderly population in the UK. Methods The South Wales Skin Cancer study – an examination survey undertaken between 1988 and 1991 of a random sample ( n = 792) drawn from all patients aged 60 and over registered with a general practitioner in South Glamorgan. Exposure variables were obtained from a structured administered questionnaire combined with clinical examination. Unadjusted and adjusted odds ratios were estimated using logistic regression. Results The response rate was 71% with an average age of 71 years (range 60–97). The age-adjusted prevalence of trunk varices was 63.2% (95% confidence interval [CI] 57.9–68.4%) in men and 57.0% (95% CI 50.6–63.4%) in women. In a multiple logistic regression the significant risk factors for varicose veins were increasing age ( P value = 0.001), obesity (odds ratio [OR] 3.28, 95% CI 1.25–8.63, P = 0.042), self-reported history of deep vein thrombosis (DVT) (OR 3.19, 1.16–8.78, P = 0.024) and history of hypertension (OR 0.58, 0.38–0.89, P = 0.013). The results for gender suggested that women were at greater risk than men, but this was not statistically significant (OR 1.53, 0.99–2.38, P = 0.056). Conclusion Trunk varices occur very commonly in older age groups with increasing age, obesity and possibly female sex as risk factors. Associations found with DVT and hypertension were based on history alone and must be interpreted with caution.


2020 ◽  
Vol 27 (01) ◽  
pp. 205-209
Author(s):  
Subhan Shahid ◽  
Muhammad Umair Hashmi

Objectives: This study was conducted to determine risk factors of osteoporosis in women after menopause. Study Design: Cross Sectional study. Setting: Sir Ganga Ram Hospital located in Lahore, a city of Pakistan. Period: 1st January 2018 to 31st July 2018 comprising on seven months duration. Material & Methods: An inclusion and exclusion criteria was formed. Patients diagnosed cases of osteoporosis presenting in out-patient door of the study institution during study period and falling in inclusion criteria were selected for the study. Those not falling in criteria were excluded from the study. A questionnaire was formed containing all necessary questions such as age of patient, risk factors of osteoporosis and age of menopause. All data was documented properly. A well informed written consent was taken from all patients for including them in the study. Consent was taken from the ethical committee of the study institution for conducting study. Privacy of data of patients was maintained. Data was analyzed using statistical software and Microsoft office version 2017. Results were calculated in the form of frequencies and percentages and presented via tables and graphs. P-value less than 0.05 were considered significant. Results: Total 115 post-menopausal females with osteoporosis were studied. Their age range was 35-63 years with mean age 46.7 years. Age of menopause among study females was found to be less than 40 years in 4.3% cases, between 41-45 years in 20.9% cases, between 46-50 years in 9.6% and between 51-55 years in 25.2%. Common risk factors of osteoporosis reported in study females include low calcium diet in 60.8% cases, family history of osteoporosis positive at least in one close relative, overweight in 57.4% and history of steroid intake for prolong period was found a cause of osteoporosis in 21.7% cases, excessive intake of soft drinks (more than 400ml daily) in 34.8% and excessive coffee intake (more than 2 cups daily) reported in 33%. Other risk factors include thyroid disease, ongoing hormonal replacement therapy, and prolonged immobilization. Conclusion: Osteoporosis is a common problem among females particularly in post menopausal period. Most common risk factors of this disease are improper diet and lack of physical activity. By spreading awareness of this disease in community, encouraging proper intake of calcium containing diet and daily exercise can reduce incidence of this disease.


2020 ◽  
Vol 6 (3) ◽  
pp. 310-315
Author(s):  
Juniar Eka Budiyani ◽  
Susilawati Susilawati ◽  
Ledy Octaviani Iqmy

ABSTRACT  Background Pre eclampsia is hypertension that occurs after 20 weeks of pregnancy accompanied by proteinuria. Based on Mangunang Kotaagung's Regional General Hospital, Mangunang Kota Agung itself obtained data from 1 January 2017 to 30 April 2019, there were 84 cases of preeclampsia from 677 cases who entered the Midwifery Hospital in Batin Mangunang, Agung City.  The Purpose of the study was the relationship between the risk factors of pregnant women and the incidence of preeclampsia and eclampsia in the Batin Mangunang Hospital in the Great City of Tanggamus Regency in 2019.  MethodsThis type of research is quantitative analytical research with a cross sectional approach. This population is all pregnant women who experienced preeclampsia as many as 54 cases for cases and 54 samples for control because this study uses a comparison of cases 1: 1. the sampling technique used is total sampling. Data collection using observation sheet and data analysis used is univariate and bivariate using the chi-square test.  The results showed that the frequency distribution of non-risk age was 66 people (61.1%), non-risky parity as many as 60 people (55.6%), respondents with a history of non-risky diseases as many as 81 people (75.0%), risky education (SD, SMP) as many as 54 people (50.0%), risk antenatal care as many as 55 people (50.9%), the incidence of preeclampsia cases as many as 54 people (50%), while respondents with preeclampsia control as many as 54 people (50%),  CoclusionThere is a relationship between risk factors for pregnant women based on age pvalue = 0.001, parity pvalue = 0.012 and antenatal service pvalue = 0.007 with the incidence of pre eclampsia, there is no relationship between risk factors for pregnant women based on maternal education p value = 0.847 and history of chronic disease 182, with the incidence of pre-eclampsia. Suggestion Can be used as knowledge, information, and references in subsequent studies related to factors related to the incidence of preeclampsia in labor by adding different variables and adding the number of samples with primary data.  Keywords: risk factors for preeclamptic events  ABSTRAK   Latar Belakang Pre eklampsia adalah hipertensi yang timbul setelah 20 minggu kehamilan disertai dengan proteinuria. Data Rumah Sakit Umum Daerah Batin Mangunang Kota Agung Periode 1 Januari 2017 sampai dengan 30 April 2019 terdapat  84 pasien dengan kasus preeklampsia dari 677 kasus yang masuk ke Ruang Kebidanan RSUD Batin Mangunang Kota Agung.  Tujuan penelitian untuk mengetahui  hubungan Antara Faktor Resiko Ibu Hamil dengan kejadian preeklamsi dan eklamsia Di RSUD Batin Mangunang  Kota Agung Kabupaten Tanggamus Tahun 2019.  Metode Jenis penelitian ini merupakan penelitian analitik kuantitatif dengan pendekatan cross sectional. Populasi ini adalah semua ibu hamil yang mengalami preeklampsi sebanyak 54 kasus untuk kasus dan 54 sampel untuk kontrol karena penelitian ini menggunakan perbandingan kasus 1:1.teknik sampling yang digunakan total sampling. Pengumpulan data dengan menggunakan lembar observasi dan analisa data yang digunakan adalah univariat dan bivariat dengan menggunakan uji chi-square. Hasil penelitian didapatkan bahwa Distribusi frekuensi usia tidak berisiko sebanyak 66 orang (61,1%), paritas yang tidak berisiko sebanyak 60 orang (55.6%), responden dengan riwayat penyakit yang tidak berisiko sebanyak 81 orang (75,0%), pendidikan berisisiko (SD, SMP) sebanyak 54 orang (50.0%), pelayanan antenatal berisiko sebanyak 55 orang (50,9%), kejadian preeklampsia kasus sebanyak 54 orang (50%), sedangkan responden dengan preeklampsia kontrol sebanyak 54 orang (50%),  Kesimpulan Ada hubungan antara Faktor resiko ibu hamil berdasarkan umur pvalue = 0,001, paritas pvalue = 0,012 dan pelayanan antenatal pvalue= 0,007 dengan Kejadian pre eklamsia, tidak ada hubungan antara Faktor resiko ibu hamil berdasarkan pendidikan ibu pvalue = 0,847 dan riwayat Penyakit kronik pada ibu  pvalue = 182, dengan Kejadian pre eklamsia.  Saran Dapat dijadikan sebagai pengetahuan, informasi, dan referensi dalam penelitian selanjutnya terkait faktor-faktor yang berhubungan dengan kejadian preeklampsia pada persalinan dengan menambahkan varibel yang berbeda dan menambahkan jumlah sampel dengan data primer.  Kata Kunci : Faktor Risiko kejadian preeklampsi  


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