DELIRIUM IN PATIENTS WITH HIP FRACTURE AND ITS IMPACT
Abstract
Acute Confusion Syndrome (ACS) or Delirium is a frequent mental disorder with serious adverse results in hospitalized patients who are also affected by, among other things, aspects of their daily care and hospital environment.
Because it is related to an increase in mortality, the duration of hospital stay and the following institutionalization of patients that suffer from this, it is considered important to quantify how many elderly patients with hip fractures, a very common pathology in the hospitalization unit of Traumatology Surgery and Orthopedics of the hospital, were suffering from this syndrome.
Objective: To know the impact of ACS in patients over 65 years of age, admitted to hospital due to proximal femur fracture, during 2008 in the C.O.T. hospitalization unit in the Hospital Nuestra Señora de Sonsoles del Complejo Asistencial, Ávila, Spain. Also to identify the day of hospital admittance in which ACS appeared.
Methodology: Observational, descriptive, retrospective study. The total population is 240, that corresponds to the total number of patients admitted due to hip fracture in 2008, for a confidence rate or of 3%, the sample size is 213. The sample was obtained randomly and grouped and is made up of patients admitted in the Traumatology unit in 2008, over 65 years of age, with a diagnosis of hip fracture.
Independent Variables: Gender and age, the day of admittance and surgical intervention and dementia type when admitted. The dependant variables are the appearance of ACS and the day of hospital stay in which it appeared, identifying if it is anterior or posterior to the surgical intervention of fracture osteosynthesis.
Results: High percentage of women vs. men, 166 women (78%) with an average age of 84 years, 41.78% being over 85 years old.
ACS Incidence: 32.4%, 69 of the total cases (n=213). Dementia previous to admittance: 38 cases of which in 31.57% alterations in the sleep cycle were detected along with wakefulness and verbal and nocturnal motor hyperactivity. ACS shows up in a high percentage in the second and third day after admittance making up 43.46%. In 25 patients that did not show signs of delirium after their hospital admittance, 64% developed signs or ACS in the second or third day after surgical intervention.
Conclusions: An impact of ACS or delirium was discovered within the average of the reviewed studies in the bibliography. The quick identification, by the nurses, and the application of adequate therapeutic measures in order to minimize the effects of ACS and avoid greater medical complications is important.
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