Delirium is a common and serious syndrome in elderly patients.The hypoactive type of delirium is known to have\ndifferent characteristics, but further studies are needed to define the specificities of these characteristics.Our study aims at finding\nspecific risk factors, especially estimated blood loss during operations of hyper- and hypoactive delirium in orthopedic elderly\npatients. Methods. One hundred and seventy-five elderly patients were evaluated using the Confusion AssessmentMethod (CAM)\nand the 4\nth edition text revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Trained psychiatrists\ninterviewed the subjects directly at pre- and postoperative time points. We reviewed medical records after the patients were\ndischarged. Results. Thirty-nine patients (22.3%) were diagnosed with multiple types of delirium, which included 17 hyperactive\ntypes (65.9%), 13 hypoactive types (33.3%), and 9 mixed types (23.1%). Although the mean estimated blood loss in patients with\neither hyper- or hypoactive symptoms was larger than in patients lacking these symptoms, the odds ratio was only significant in\npatients with hyperactive symptoms. In addition, age, preoperative daily function, and preoperative hyponatremia were found to be\nrisk factors for hyperactive but not hypoactive symptoms. Conclusion. Patients with hypoactive symptoms had different risk factors\nthan patients with hyperactive symptoms of delirium. The estimated blood loss, well-known risk factors for delirium,might be risk\nfactors for only hyperactive delirium.The acute precipitating factors seemed to show stronger correlation with the hyperactive type\nof delirium than with the hypoactive type.
Loading....