Department of Nursing, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
Department of Healthcare Information Management, The University of Tokyo Hospital, Tokyo, Japan.
PLoS One. 2021 Aug 2;16(8):e0255607. doi: 10.1371/journal.pone.0255607. eCollection 2021.
Postoperative delirium (POD) and subsyndromal delirium (SSD) among older patients is a common, serious condition associated with a high incidence of negative outcomes. However, there are few accurate methods for the early detection of POD and SSD in surgical wards. This study aimed to identify risk factors of POD and SSD in older patients who were scheduled for surgery in a surgical ward. This was a prospective observational study. Study participants were older than 65 years, underwent urology surgery, and were hospitalized in the surgical ward between April and September 2019. Delirium symptoms were assessed using the Confusion Assessment Method (CAM) on the preoperative day, the day of surgery, and postoperative days 1-3 by the surgical ward nurses. SSD was defined as the presence of one or more CAM criteria and the absence of a diagnosis of delirium based on the CAM algorithm. Personal characteristics, clinical data, cognitive function, physical functions, laboratory test results, medication use, type of surgery and anesthesia, and use of physical restraint and bed sensor were collected from medical records. Multiple logistic regression analyses were conducted to identify the risk factors for both POD and SSD. A total of 101 participants (mean age 74.9 years) were enrolled; 19 (18.8%) developed POD (n = 4) and SSD (n = 15). The use of bed sensors (odds ratio 10.2, p = .001) was identified as a risk factor for both POD and SSD. Our findings suggest that the use of bed sensors might be related to the development of both POD and SSD among older patients in surgical wards.
术后谵妄（POD）和亚综合征谵妄（SSD）在老年患者中较为常见，是一种与高发生率的负面结果相关的严重情况。然而，在外科病房中，早期发现 POD 和 SSD 的准确方法很少。本研究旨在确定外科病房中拟行手术的老年患者发生 POD 和 SSD 的危险因素。这是一项前瞻性观察性研究。研究参与者年龄均大于 65 岁，行泌尿科手术，且于 2019 年 4 月至 9 月期间在外科病房住院。由外科病房护士在术前日、手术当天和术后第 1-3 天使用意识模糊评估法（CAM）评估谵妄症状。SSD 定义为存在一个或多个 CAM 标准且根据 CAM 算法未诊断为谵妄。从病历中收集个人特征、临床数据、认知功能、身体功能、实验室检查结果、用药情况、手术类型和麻醉方式、身体约束和床传感器使用情况。采用多因素逻辑回归分析来确定 POD 和 SSD 的危险因素。共纳入 101 名参与者（平均年龄 74.9 岁）；19 名（18.8%）患者发生 POD（n = 4）和 SSD（n = 15）。使用床传感器（比值比 10.2，p =.001）被确定为 POD 和 SSD 的危险因素。我们的研究结果表明，在外科病房中，床传感器的使用可能与老年患者 POD 和 SSD 的发生有关。
