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Year 2012, , 101 - 107, 13.07.2012

Tülin Akarsu Ayazoğlu , Hülya Tür Cihan Bolat , İsmail Özkaynak Mehmet Akif Candan

https://doi.org/10.5835/jecm.omu.29.02.004

Abstract

References

  • American Psychiatric Association (APA), 1994. Diagnostic and Statistical Manual of Mental Disorders. 4th ed.Washington DC, 136-143.
  • American Psychiatric Association (APA), 2000. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text Revision (DSM-IV-TR), 1-26.
  • Bergeron, N., Dubois, M.J., Dumont, M., Dial, S., Skrobik, Y., 2001. Intensive care delirium screening checklist: Evaluation of a new screening tool. Intens. Care Med. 27, 859-864.
  • Dubois, M.J., Bergeron, N., Dumont, M., Dial, S., Skrobik, Y., 2001. Delirium in an intensive care unit: A study of risk factors. Intens. Care Med. 27, 1297-1304.
  • Ely, E.W., Inouye, S.K., Bernard, G.R. 2001. Delirium in mechanically ventilated patients: Validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU) JAMA. 286, 2703-2710.
  • Ely, E.W., Shintani, A., Truman, B., Speroff, T., Gordon, S.M., Harrell, F.E. Jr., Inouye, S.K., Bernard, G.R., Dittus, R.S., 2004. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 291, 1753-1762.
  • Ely, E.W., Girard, T.D., Shintani, A.K., Jackson, J.C., Gordon, S.M., Thomason, J.W., Pun, B.T., Canonico, A.E., Light, R.W., Pandharipande, P., 2007. Apolipoprotein E4 polymorphism as a genetic predisposition to delirium in critically ill patients. Crit. Care Med. 35, 112-117.
  • Ely, E.W., Margolin, R., Francis, J., 2001. Evaluation of delirium in critically ill patients: Validation of Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit. Care Med. 29, 1370-1379.
  • Ely, E.W., Stephens, R.K., Jackson, J.C., Thomason, J.W., Truman, B., Gordon, S., Dittus, R.S., Bernard, G.R., 2004. Current opinions regarding the importance, diagnosis, and management of delirium in the intensive care unit: A survey of 912 healthcare professionals. Crit. Care Med. 32, 106-112.
  • Engel, G.L., Romano, J., 1959. Delirium, a syndrome of cerebral insufficiency. J. Chronic Dis. 9, 260-277. Fink, M.P., Evans, T.W., 2002. Mechanisms of organ dysfunction in critical illness: Report from a round table conference held in Brussels. Intens. Care Med. 28, 369-375.
  • Granberg, A.I.R., Malmros, C.W., Lundberg, D.B.A., 2002. Intensive care unit syndrome/delirium is associated with anemia, drug therapy and duration of ventilation treatment. Acta Anaesth. Scand. 46, 726-731.
  • Inouye, S.K., Rushing, J.T., Foreman, M.D., 1998. Does delirium contribute to poor hospital outcomes? A three site epidemiologic study. J. Gen. Intern. Med. 13, 234-242.
  • Inouye, S.K., Schlesinger, M.J., Lydon, T.J., 1999. Delirium: A symptom of how hospital care is failing older persons and a window to improve quality of hospital care. Am. J. Med. 106, 565-573.
  • Jackson, J.C., Gordon, S.M., Hart, R.P., Hopkins, R.O., Ely, E.W., 2004. The association between delirium and cognitive decline: A review of the empirical literature. Neuropsychol. Rev. 14, 87-98.
  • Justic, M., 2000. Does ‘ICU psychosis’ really exist? Crit. Care Nurse. 20, 28-37.
  • Marcantonio, E.R., Simon, S.E., Bergman, M.S., 2003. Delirium symptoms in post- acute care: Prevalent, persistent, and associated with poor functional recovery. J. Am. Geriatr. Soc. 51, 4-9.
  • McCusker, J., Cole, M., Abrahamowicz M., Primeau, F., Belzile, E., 2002. Delirium predicts 12 month mortality. Arch. Intern. Med. 162, 457-463.
  • McGuire, B.E., Basten, C.J., Ryan, C.J., Gallagher, J., 2000. Intensive care unit syndrome: A dangerous misnomer. Arch Intern. Med.160, 906-909.
  • McNicoll, L., Pisani, M.A., Zhang, Y., Ely, E.W., Siegel, M.D., Inouye, S.K., 2003. Delirium in the intensive care unit: Occurrence and clinical course in older patients. J. Am. Geriatr. Soc. 51, 591-598.
  • Newman, M.F., Kirchner, J.L., Phillips-Bute, B., Gaver, V., Grocott, H., Jones, R.H., Mark, D.B., Reves, J.G., Blumenthal, J.A., 2001. Longitudinal assessment of neurocognitive function after cardiac surgery: Perioperative decline predicts long-term (5-year) neurocognitive deterioration. New Engl. J. Med. 344, 395-402.
  • Lin, S.M., Liu, C.Y., Wang, C.H., Lin, H.C., Huang, C.D., Huang, P.Y., Fang, Y.F., Shieh, M.H., Kuo, H.P., 2004. The impact of delirium on the survival of mechanically ventilated patients. Crit. Care Med. 32, 2254-2259.
  • Lipowski, Z.J., 1990. Delirium: Acute confusional states. Oxford University Press, NewYork, 47-53.
  • Pandharipande, P., Cotton, B.A., Shintani, A., Thompson, J., Pun, B.T., Morris, J.A., Dittus, R., Ely, E.W., 2008. Prevalence and risk factors for development of delirium in surgical and trauma ICU patients. J. Trauma. 65, 34-41.
  • Peterson, J.F., Pun, B.T., Dittus, R.S., Thomason, J.W., Jackson, J.C., Shintani, A.K., Ely, E.W. 2006. Delirium and its motoric subtypes: A study of 614 critically ill patients. J. Am. Geriatr. Soc. 54, 479-484.
  • Pratico, C., Quattrone, D., Lucanto, T., Amato, A., Pena, O., Roscitano, C., Fodale, V., 2005. Drugs of anesthesia acting on central cholinergic system may cause postoperative cognitive dysfunction and delirium. Med. Hypotheses. 65, 972-982.
  • Rabinowitz, T., 2002. Delirium: An important (but often unrecognized) clinical syndrome. Curr. Psychiatry Rep. 202-208.
  • Rapp, C.G., Mentes, J.C., Titler, M.G., 2001. Acute confusion/ delirium protocol. J. Gerontol. Nurs. 27, 21-33.
  • Rudolph, J.L., Babikian, V.L., Birjiniuk, V., 2005. Atherosclerosis is associated with delirium after coronary artery bypass graft surgery. J. Am. Geriatr. Soc. 53, 462-466.
  • Rudberg, M.A., Pompei, P., Foreman, M.D., 1997. The natural history of delirium in older hospitalised patients: A syndrome of heterogeneity. Age Ageing. 26, 169-174.
  • Salam, A., Tilluckdharry, L., Amoateng-Adjepong, Y., Manthous, C.A. 2004. Neurologic status, cough, secretions and extubation outcomes. Intens. Care Med. 30, 1334-1339.
  • Samuels, S.C., Evers, M., 2002. Delirium, pragmatic guidance for managing a common, confounding, and sometimes lethal condition. Geriatrics. 57, 33-38.
  • Schuurmans, M.J., Duursma, S.A., Shortridge-Baggett, L.M., 2001. Early recognition of delirium: Review of the literature. J. Clin. Nurs. 10, 721-729.
  • Thomason, J.W., Shintani, A., Peterson, J.F., Pun, B.T., Jackson, J.C., Ely, E.W., 2005. Intensive care unit delirium is an independent predictor of longer hospital stay:A prospective analysis of 261 non-ventilated patients. Crit. Care. 9, 375-381.
  • Trzepacz, P.T., 1996. Delirium: Advances in diagnosis, pathophysiology and treatment. Psychiatr. Clin. North Am. 19, 429-448.
  • Tuğlu, C., Yıldırım, E., 2002. Hastanede yatarak tedavi gören hastalarda sık karşılaşılan psikiyatrik bir sendrom: Deliryum. Balkan Med. J. 19, 55-64.
  • Türkcan, A., 2001. Deliryum. Psikiyatri Dünyası. 5, 15-23.
  • Wise, M.G., Trzepacz, P.T., 1996, Delirium (confusional states). Textbook of consultation-liaison psychiatry, cilt 2. Rundell, J. R., Wise, M.G. (ed). The American Psychiatric Press. 259-274.

Yaşlılarda kardiyak cerrahi sonrası yoğun bakımda deliryumun prevalansı ve risk faktörleri

Year 2012, , 101 - 107, 13.07.2012

Tülin Akarsu Ayazoğlu , Hülya Tür Cihan Bolat , İsmail Özkaynak Mehmet Akif Candan

https://doi.org/10.5835/jecm.omu.29.02.004

Abstract

Deliryum kardiyak cerrahi sonrası sık görülen geçici nöropsikiyatrik bir sendromdur. Yaşlılarda ve yoğun bakımda yüksek prevalansına rağmen klinisyenler tarafından sıklıkla tanınmamakta ya da depresyon, yoğun bakım sendromu, demans gibi kritik hastalıkların beklenen önemsiz komplikasyonları olarak görülmektedir. Çalışmamızın amacı, açık kalp cerrahisi sonrasında yoğun bakım ünitesinde, 65 yaş ve üzeri hastalarda, prevalans ve deliryum ile ilişkili risk faktörlerini belirlemektir. Çalışmaya 65 yaş ve üzeri 217 hasta dahil edildi. Veriler yoğun bakım ünitesinde konfüzyonu değerlendirme ölçeği (YBÜ-KDÖ) [The Confusion Assesment Method for the In-tensive Care Unit (CAMICU)] ve deliryumun tanımında altın standart olan tüm diğer psikiyatrik tanıların da sınıflandırıldığı, uluslararası kılavuz olan, ''Diagnostic and Statistical Manual for Mental Disorders (DSM-IV)'' ile ölçülerek toplandı. Çalışmada deliryumun prevalansı % 29,5 olarak bulundu. İleri yaş, erkek cinsiyet, yüksek acute physiology and chronic health evaluation II (APACHE II) değeri, New York heart association functional classification (NYHA)>2, serebrovasküler hastalık, kötü fiziksel durum, aortik cerrahi, ameliyat süresi, iskemi süresi, hematokrit düşüklüğü (<30), kan laktat düzeyi artışı (>1,2mmol/L), hipoalbuminemi (<3g/dL), BUN/Kreatinin oranında artış (>18), immobilizasyon, postoperatif 48. saat medikasyonlar, uyku bozukluğu ve yoğun bakımda kalma süresi yaşlılarda deliryum gelişiminde risk faktörleri olarak tespit edildi. Açık kalp cerrahisi sonrası yaşlı hastalarda görülen deliryum multifaktöryel bir hastalıktır. Risk faktörlerinin belirlenip kontrol altına alınması hastanede yatış ve taburcu olma süresini, morbidite ve en önemlisi mortaliteyi azaltmaktadır. 

Keywords

Deliryum Prevalans Risk faktörleri Kalp cerrahisi Yoğun bakım ünitesi

References

  • American Psychiatric Association (APA), 1994. Diagnostic and Statistical Manual of Mental Disorders. 4th ed.Washington DC, 136-143.
  • American Psychiatric Association (APA), 2000. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text Revision (DSM-IV-TR), 1-26.
  • Bergeron, N., Dubois, M.J., Dumont, M., Dial, S., Skrobik, Y., 2001. Intensive care delirium screening checklist: Evaluation of a new screening tool. Intens. Care Med. 27, 859-864.
  • Dubois, M.J., Bergeron, N., Dumont, M., Dial, S., Skrobik, Y., 2001. Delirium in an intensive care unit: A study of risk factors. Intens. Care Med. 27, 1297-1304.
  • Ely, E.W., Inouye, S.K., Bernard, G.R. 2001. Delirium in mechanically ventilated patients: Validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU) JAMA. 286, 2703-2710.
  • Ely, E.W., Shintani, A., Truman, B., Speroff, T., Gordon, S.M., Harrell, F.E. Jr., Inouye, S.K., Bernard, G.R., Dittus, R.S., 2004. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 291, 1753-1762.
  • Ely, E.W., Girard, T.D., Shintani, A.K., Jackson, J.C., Gordon, S.M., Thomason, J.W., Pun, B.T., Canonico, A.E., Light, R.W., Pandharipande, P., 2007. Apolipoprotein E4 polymorphism as a genetic predisposition to delirium in critically ill patients. Crit. Care Med. 35, 112-117.
  • Ely, E.W., Margolin, R., Francis, J., 2001. Evaluation of delirium in critically ill patients: Validation of Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit. Care Med. 29, 1370-1379.
  • Ely, E.W., Stephens, R.K., Jackson, J.C., Thomason, J.W., Truman, B., Gordon, S., Dittus, R.S., Bernard, G.R., 2004. Current opinions regarding the importance, diagnosis, and management of delirium in the intensive care unit: A survey of 912 healthcare professionals. Crit. Care Med. 32, 106-112.
  • Engel, G.L., Romano, J., 1959. Delirium, a syndrome of cerebral insufficiency. J. Chronic Dis. 9, 260-277. Fink, M.P., Evans, T.W., 2002. Mechanisms of organ dysfunction in critical illness: Report from a round table conference held in Brussels. Intens. Care Med. 28, 369-375.
  • Granberg, A.I.R., Malmros, C.W., Lundberg, D.B.A., 2002. Intensive care unit syndrome/delirium is associated with anemia, drug therapy and duration of ventilation treatment. Acta Anaesth. Scand. 46, 726-731.
  • Inouye, S.K., Rushing, J.T., Foreman, M.D., 1998. Does delirium contribute to poor hospital outcomes? A three site epidemiologic study. J. Gen. Intern. Med. 13, 234-242.
  • Inouye, S.K., Schlesinger, M.J., Lydon, T.J., 1999. Delirium: A symptom of how hospital care is failing older persons and a window to improve quality of hospital care. Am. J. Med. 106, 565-573.
  • Jackson, J.C., Gordon, S.M., Hart, R.P., Hopkins, R.O., Ely, E.W., 2004. The association between delirium and cognitive decline: A review of the empirical literature. Neuropsychol. Rev. 14, 87-98.
  • Justic, M., 2000. Does ‘ICU psychosis’ really exist? Crit. Care Nurse. 20, 28-37.
  • Marcantonio, E.R., Simon, S.E., Bergman, M.S., 2003. Delirium symptoms in post- acute care: Prevalent, persistent, and associated with poor functional recovery. J. Am. Geriatr. Soc. 51, 4-9.
  • McCusker, J., Cole, M., Abrahamowicz M., Primeau, F., Belzile, E., 2002. Delirium predicts 12 month mortality. Arch. Intern. Med. 162, 457-463.
  • McGuire, B.E., Basten, C.J., Ryan, C.J., Gallagher, J., 2000. Intensive care unit syndrome: A dangerous misnomer. Arch Intern. Med.160, 906-909.
  • McNicoll, L., Pisani, M.A., Zhang, Y., Ely, E.W., Siegel, M.D., Inouye, S.K., 2003. Delirium in the intensive care unit: Occurrence and clinical course in older patients. J. Am. Geriatr. Soc. 51, 591-598.
  • Newman, M.F., Kirchner, J.L., Phillips-Bute, B., Gaver, V., Grocott, H., Jones, R.H., Mark, D.B., Reves, J.G., Blumenthal, J.A., 2001. Longitudinal assessment of neurocognitive function after cardiac surgery: Perioperative decline predicts long-term (5-year) neurocognitive deterioration. New Engl. J. Med. 344, 395-402.
  • Lin, S.M., Liu, C.Y., Wang, C.H., Lin, H.C., Huang, C.D., Huang, P.Y., Fang, Y.F., Shieh, M.H., Kuo, H.P., 2004. The impact of delirium on the survival of mechanically ventilated patients. Crit. Care Med. 32, 2254-2259.
  • Lipowski, Z.J., 1990. Delirium: Acute confusional states. Oxford University Press, NewYork, 47-53.
  • Pandharipande, P., Cotton, B.A., Shintani, A., Thompson, J., Pun, B.T., Morris, J.A., Dittus, R., Ely, E.W., 2008. Prevalence and risk factors for development of delirium in surgical and trauma ICU patients. J. Trauma. 65, 34-41.
  • Peterson, J.F., Pun, B.T., Dittus, R.S., Thomason, J.W., Jackson, J.C., Shintani, A.K., Ely, E.W. 2006. Delirium and its motoric subtypes: A study of 614 critically ill patients. J. Am. Geriatr. Soc. 54, 479-484.
  • Pratico, C., Quattrone, D., Lucanto, T., Amato, A., Pena, O., Roscitano, C., Fodale, V., 2005. Drugs of anesthesia acting on central cholinergic system may cause postoperative cognitive dysfunction and delirium. Med. Hypotheses. 65, 972-982.
  • Rabinowitz, T., 2002. Delirium: An important (but often unrecognized) clinical syndrome. Curr. Psychiatry Rep. 202-208.
  • Rapp, C.G., Mentes, J.C., Titler, M.G., 2001. Acute confusion/ delirium protocol. J. Gerontol. Nurs. 27, 21-33.
  • Rudolph, J.L., Babikian, V.L., Birjiniuk, V., 2005. Atherosclerosis is associated with delirium after coronary artery bypass graft surgery. J. Am. Geriatr. Soc. 53, 462-466.
  • Rudberg, M.A., Pompei, P., Foreman, M.D., 1997. The natural history of delirium in older hospitalised patients: A syndrome of heterogeneity. Age Ageing. 26, 169-174.
  • Salam, A., Tilluckdharry, L., Amoateng-Adjepong, Y., Manthous, C.A. 2004. Neurologic status, cough, secretions and extubation outcomes. Intens. Care Med. 30, 1334-1339.
  • Samuels, S.C., Evers, M., 2002. Delirium, pragmatic guidance for managing a common, confounding, and sometimes lethal condition. Geriatrics. 57, 33-38.
  • Schuurmans, M.J., Duursma, S.A., Shortridge-Baggett, L.M., 2001. Early recognition of delirium: Review of the literature. J. Clin. Nurs. 10, 721-729.
  • Thomason, J.W., Shintani, A., Peterson, J.F., Pun, B.T., Jackson, J.C., Ely, E.W., 2005. Intensive care unit delirium is an independent predictor of longer hospital stay:A prospective analysis of 261 non-ventilated patients. Crit. Care. 9, 375-381.
  • Trzepacz, P.T., 1996. Delirium: Advances in diagnosis, pathophysiology and treatment. Psychiatr. Clin. North Am. 19, 429-448.
  • Tuğlu, C., Yıldırım, E., 2002. Hastanede yatarak tedavi gören hastalarda sık karşılaşılan psikiyatrik bir sendrom: Deliryum. Balkan Med. J. 19, 55-64.
  • Türkcan, A., 2001. Deliryum. Psikiyatri Dünyası. 5, 15-23.
  • Wise, M.G., Trzepacz, P.T., 1996, Delirium (confusional states). Textbook of consultation-liaison psychiatry, cilt 2. Rundell, J. R., Wise, M.G. (ed). The American Psychiatric Press. 259-274.
There are 37 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Surgery Medical Sciences
Authors

Tülin Akarsu Ayazoğlu

Hülya Tür This is me

Cihan Bolat

İsmail Özkaynak This is me

Mehmet Akif Candan This is me

Publication Date July 13, 2012
Submission Date June 6, 2011
Published in Issue Year 2012

Cite

APA Akarsu Ayazoğlu, T., Tür, H., Bolat, C., Özkaynak, İ., et al. (2012). Yaşlılarda kardiyak cerrahi sonrası yoğun bakımda deliryumun prevalansı ve risk faktörleri. Journal of Experimental and Clinical Medicine, 29(2), 101-107. https://doi.org/10.5835/jecm.omu.29.02.004
AMA Akarsu Ayazoğlu T, Tür H, Bolat C, Özkaynak İ, Candan MA. Yaşlılarda kardiyak cerrahi sonrası yoğun bakımda deliryumun prevalansı ve risk faktörleri. J. Exp. Clin. Med. July 2012;29(2):101-107. doi:10.5835/jecm.omu.29.02.004
Chicago Akarsu Ayazoğlu, Tülin, Hülya Tür, Cihan Bolat, İsmail Özkaynak, and Mehmet Akif Candan. “Yaşlılarda Kardiyak Cerrahi Sonrası yoğun bakımda Deliryumun Prevalansı Ve Risk faktörleri”. Journal of Experimental and Clinical Medicine 29, no. 2 (July 2012): 101-7. https://doi.org/10.5835/jecm.omu.29.02.004.
EndNote Akarsu Ayazoğlu T, Tür H, Bolat C, Özkaynak İ, Candan MA (July 1, 2012) Yaşlılarda kardiyak cerrahi sonrası yoğun bakımda deliryumun prevalansı ve risk faktörleri. Journal of Experimental and Clinical Medicine 29 2 101–107.
IEEE T. Akarsu Ayazoğlu, H. Tür, C. Bolat, İ. Özkaynak, and M. A. Candan, “Yaşlılarda kardiyak cerrahi sonrası yoğun bakımda deliryumun prevalansı ve risk faktörleri”, J. Exp. Clin. Med., vol. 29, no. 2, pp. 101–107, 2012, doi: 10.5835/jecm.omu.29.02.004.
ISNAD Akarsu Ayazoğlu, Tülin et al. “Yaşlılarda Kardiyak Cerrahi Sonrası yoğun bakımda Deliryumun Prevalansı Ve Risk faktörleri”. Journal of Experimental and Clinical Medicine 29/2 (July 2012), 101-107. https://doi.org/10.5835/jecm.omu.29.02.004.
JAMA Akarsu Ayazoğlu T, Tür H, Bolat C, Özkaynak İ, Candan MA. Yaşlılarda kardiyak cerrahi sonrası yoğun bakımda deliryumun prevalansı ve risk faktörleri. J. Exp. Clin. Med. 2012;29:101–107.
MLA Akarsu Ayazoğlu, Tülin et al. “Yaşlılarda Kardiyak Cerrahi Sonrası yoğun bakımda Deliryumun Prevalansı Ve Risk faktörleri”. Journal of Experimental and Clinical Medicine, vol. 29, no. 2, 2012, pp. 101-7, doi:10.5835/jecm.omu.29.02.004.
Vancouver Akarsu Ayazoğlu T, Tür H, Bolat C, Özkaynak İ, Candan MA. Yaşlılarda kardiyak cerrahi sonrası yoğun bakımda deliryumun prevalansı ve risk faktörleri. J. Exp. Clin. Med. 2012;29(2):101-7.

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