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Kose G, Şirin K, Inel MB, Mertoglu S, Aksakal R, Kurucu Ş. Prevalence and Factors Affecting Postoperative Delirium in a Neurosurgical Intensive Care Unit. J Neurosci Nurs 2021; 53:177-182. [PMID: 34116558 DOI: 10.1097/jnn.0000000000000595] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT PURPOSE: The aim of this study was to identify the prevalence of, and factors affecting, postoperative delirium (POD) in patients in the neurosurgical intensive care unit. METHODS: A cross-sectional study of 127 Turkish neurosurgical intensive care unit patients admitted between May 2018 and May 2019 was conducted. Patients were assessed for the development of POD using the Intensive Care Delirium Screening Checklist. We collected other independent data variables daily. Data were analyzed using independent sample t test, χ2 test, and logistic regression. RESULTS: The prevalence rates of POD on the first and second postoperative days were 18.9% and 8.7%, respectively. Logistic regression analysis showed that the Glasgow Coma Scale score, albumin level, Spo2 level, hemoglobin values, undergoing cranial surgery, and having intra-arterial catheter were the independent risk factors for POD. CONCLUSION: These findings may contribute to identifying patients at risk for developing POD and developing strategies to improve patient outcomes.
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Belanger K, Grassia F, Kortz MW, Thompson JA, DeStefano S, Ojemann S. Management of post-operative delirium following stereoelectroencephalography electrode placement for drug resistant epilepsy: Lessons learned from two case reports. Epilepsy Behav Rep 2021; 16:100438. [PMID: 33997756 PMCID: PMC8093411 DOI: 10.1016/j.ebr.2021.100438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 12/02/2022] Open
Abstract
Post-operative delirium poses unique challenges in neurosurgical patients. Substance use is a modifiable risk factor for post-operative delirium after SEEG. SEEG patients have increased risk of harm when experiencing post-operative delirium.
Post-operative delirium (POD) represents a unique challenge in the care of any surgical patient but is especially challenging in neurosurgical inpatient management due to a host of potentially significant predisposing factors. Patients undergoing stereoencephalography (SEEG) for diagnosis of drug resistant epilepsy are at unique risk due to safety concerns, yet POD has been underdiscussed in this population. Patients should be counseled pre-operatively about their risk and subsequent steps be taken post-operatively. We present two cases of POD status-post SEEG and propose a mechanism by which future post-operative care be coordinated by the physician, patient, and patient’s family.
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Affiliation(s)
- Katherine Belanger
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80217, USA
| | - Fabio Grassia
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80217, USA.,Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80217, USA
| | - Michael W Kortz
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80217, USA
| | - John A Thompson
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80217, USA.,Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80217, USA.,Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO 80217, USA
| | - Sam DeStefano
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80217, USA.,Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO 80217, USA
| | - Steven Ojemann
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80217, USA.,Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, CO 80217, USA.,Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO 80217, USA
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