Background: Delirium is an acute change in cognition and concentration that complicates the postoperative course.\nPatients who suffer delirium after surgery have an increased risk of persistent cognitive impairment, functional decline,\nand death. Postoperative delirium is also associated with an increased length of hospital stay and higher costs. With the\ngoal of preventing delirium in postoperative patients, we organized a medical team from the Delirium Management\nand Assessment Center (D-mac) at Okayama University Hospital in January 2012. The team members consisted of\nphysicians, pharmacists, nurses, and clinical psychologists.\nMethods: We retrospectively reviewed the medical records of patients with delirium to examine risk factors related to\nthe patients� background.\nResults: Fifty-nine postoperative patients with lung or esophageal cancer were investigated; 25% exhibited delirium\nduring hospitalization. Multiple logistic regression analysis showed significant associations between the presence of\ndelirium and a past history of delirium (odds ratio, 4.22; 95% CI, 1.10-16.2; p = 0.09) and use of benzodiazepine\nreceptor agonists (odds ratio, 3.97; 95% CI, 1.09-14.5; p = 0.03). Intervention by the D-mac significantly reduced the\nrate of delirium episodes in lung cancer patients (p =0.01). Notably, prior to intervention, the incidence of delirium\nwas 100% when three high-risk factors for delirium were present. In contrast, the incidence of delirium in patients\nwith three high-risk factors decreased following implementation of the D-mac intervention.\nConclusions: These findings suggest that active participation by various staff in the medical team managing delirium\nhad a marked therapeutic impact.
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