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Acute confusional state in elderly orthopaedic patients: factors of importance for detection in nursing care

Andersson, Edith LU ; Gustafson, Lars LU and Rahm Hallberg, Ingalill LU (2001) In International Journal of Geriatric Psychiatry 16(1). p.7-17
Abstract
OBJECTIVES: The aims of this study were to identify factors of significance in the development of acute confusional state (ACS) and the differences between patients who developed ACS and those who did not. METHOD AND RESULTS: Assessment, observations and interviews with 505 patients admitted to an orthopaedic clinic revealed that 51 patients developed ACS during their in-hospital stay. Patients admitted for hip fracture had a higher incidence of ACS (20.2%) than patients admitted for elective surgery for coxarthros or gonarthros (3.6%). The highest hazard ratio for ACS was several other physical diseases 15.94 (CI: 4.60-55.31 and p-value <0.00001) and the lowest was age 1.10 (CI: 1.04-1.15 and p-value <0.0002). The ACS lasted from 1... (More)
OBJECTIVES: The aims of this study were to identify factors of significance in the development of acute confusional state (ACS) and the differences between patients who developed ACS and those who did not. METHOD AND RESULTS: Assessment, observations and interviews with 505 patients admitted to an orthopaedic clinic revealed that 51 patients developed ACS during their in-hospital stay. Patients admitted for hip fracture had a higher incidence of ACS (20.2%) than patients admitted for elective surgery for coxarthros or gonarthros (3.6%). The highest hazard ratio for ACS was several other physical diseases 15.94 (CI: 4.60-55.31 and p-value <0.00001) and the lowest was age 1.10 (CI: 1.04-1.15 and p-value <0.0002). The ACS lasted from 1 to 9 days, and patients had one (N=42), two (N=8) or three episodes (N=1) of confusion during their stay on the ward. More patients who developed ACS before surgery had two or more confusional episodes and emergency patients developed ACS more rapidly. The ACS lasted longer in patients with a higher score on the OBS scale at admittance and with rapid development of ACS. CONCLUSIONS: Acuteness in the situation seems an important risk indication for ACS in the elderly. Awareness of factors associated with the development of ACS makes it possible to more systematically identify those at risk, for instance by systematic assessment in the first interview with the patient on admission to hospital. (Less)
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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
acute confusional state, delirium, risk factors, nursing care, hip fracture, elderly, postoperative confusion, confusional episodes, Organic Brain Syndrome scale
in
International Journal of Geriatric Psychiatry
volume
16
issue
1
pages
7 - 17
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:11180480
  • scopus:0035143437
ISSN
1099-1166
DOI
10.1002/1099-1166(200101)16:1<7::AID-GPS261>3.0.CO;2-W
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Department of Psychogeriatrics (013304000), The Vårdal Institute (016540000)
id
a4f09318-e9b7-4991-b115-4474c9968e42 (old id 1120878)
date added to LUP
2016-04-01 11:41:18
date last changed
2022-03-28 01:36:56
@article{a4f09318-e9b7-4991-b115-4474c9968e42,
  abstract     = {{OBJECTIVES: The aims of this study were to identify factors of significance in the development of acute confusional state (ACS) and the differences between patients who developed ACS and those who did not. METHOD AND RESULTS: Assessment, observations and interviews with 505 patients admitted to an orthopaedic clinic revealed that 51 patients developed ACS during their in-hospital stay. Patients admitted for hip fracture had a higher incidence of ACS (20.2%) than patients admitted for elective surgery for coxarthros or gonarthros (3.6%). The highest hazard ratio for ACS was several other physical diseases 15.94 (CI: 4.60-55.31 and p-value &lt;0.00001) and the lowest was age 1.10 (CI: 1.04-1.15 and p-value &lt;0.0002). The ACS lasted from 1 to 9 days, and patients had one (N=42), two (N=8) or three episodes (N=1) of confusion during their stay on the ward. More patients who developed ACS before surgery had two or more confusional episodes and emergency patients developed ACS more rapidly. The ACS lasted longer in patients with a higher score on the OBS scale at admittance and with rapid development of ACS. CONCLUSIONS: Acuteness in the situation seems an important risk indication for ACS in the elderly. Awareness of factors associated with the development of ACS makes it possible to more systematically identify those at risk, for instance by systematic assessment in the first interview with the patient on admission to hospital.}},
  author       = {{Andersson, Edith and Gustafson, Lars and Rahm Hallberg, Ingalill}},
  issn         = {{1099-1166}},
  keywords     = {{acute confusional state; delirium; risk factors; nursing care; hip fracture; elderly; postoperative confusion; confusional episodes; Organic Brain Syndrome scale}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{7--17}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{International Journal of Geriatric Psychiatry}},
  title        = {{Acute confusional state in elderly orthopaedic patients: factors of importance for detection in nursing care}},
  url          = {{http://dx.doi.org/10.1002/1099-1166(200101)16:1<7::AID-GPS261>3.0.CO;2-W}},
  doi          = {{10.1002/1099-1166(200101)16:1<7::AID-GPS261>3.0.CO;2-W}},
  volume       = {{16}},
  year         = {{2001}},
}