Ann Rehabil Med.  2016 Dec;40(6):1082-1091. 10.5535/arm.2016.40.6.1082.

Risk Factors for Delirium During Acute and Subacute Stages of Various Disorders in Patients Admitted to Rehabilitation Units

• Jang S
• Jung KI
• Yoo WK
• Jung MH
• Ohn SH

• KMID: 2371341
• DOI: http://doi.org/10.5535/arm.2016.40.6.1082

Abstract

OBJECTIVE
To assess the risk factors for delirium in patients admitted to a rehabilitation unit for acute or subacute neurological or musculoskeletal disorders.
METHODS
We reviewed the medical records of 537 patients admitted to a rehabilitation unit and selected 398 patients in the acute or subacute stage of various neurological or musculoskeletal disorders. Among them, patients who had suffered from delirium were categorized into the delirium group (n=65), and the other patients were categorized into the non-delirium group (n=333). As potential risk factors for delirium, the patients' diagnosis, underlying disease, demographic data, hospital stay duration, surgery, and laboratory findings were reviewed, and the differences between the two groups with respect to independent risk factors were analyzed.
RESULTS
The average age in the delirium group was higher; the hospital stay and pre-transfer periods were longer. A large proportion of the patients were admitted for musculoskeletal disorders, and many patients had diabetes mellitus, dementia, and depression as underlying diseases. Laboratory tests revealed increases in the white blood cells (WBC), glucose, blood urea nitrogen (BUN), total bilirubin, aspartate transaminase (AST), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels in the delirium group, while the hemoglobin, calcium, phosphorus, protein, albumin, and potassium levels were decreased. Depression, musculoskeletal disorders, traumatic brain injury, elevated WBC, BUN, AST, and CRP levels, and decreased potassium and phosphorus levels were identified as independent risk factors for delirium.
CONCLUSION
Risk factors treatable before delirium onset were identified in rehabilitation patients in acute and subacute stages of various disorders. Early diagnosis and prevention of these risk factors could decrease delirium occurrence and increase rehabilitation effectiveness.

Keyword

Delirium; Risk factors; Rehabilitation

MeSH Terms

Aspartate Aminotransferases
Bilirubin
Blood Glucose
Blood Sedimentation
Brain Injuries
C-Reactive Protein
Calcium
Delirium*
Dementia
Depression
Diabetes Mellitus
Diagnosis
Early Diagnosis
Humans
Length of Stay
Leukocytes
Medical Records
Nitrogen
Phosphorus
Potassium
Rehabilitation*
Risk Factors*
Urea
Aspartate Aminotransferases
Bilirubin
Blood Glucose
C-Reactive Protein
Calcium
Nitrogen
Phosphorus
Potassium
Urea

Figure

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  Fig. 1 Participant flow chart. Flow chart describes the progress of patients belonging to the delirium group or the non-delirium group.

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