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New-onset Delirium Among Elderly Acu...

Maher, Susan Schindler.

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New-onset Delirium Among Elderly Acute Care Orthopedic Trauma Patients: Sleep Disturbance and Nutritional Status as Modifiable Risk Factors.

Record Type:	Electronic resources : Monograph/item
Title/Author:	New-onset Delirium Among Elderly Acute Care Orthopedic Trauma Patients: Sleep Disturbance and Nutritional Status as Modifiable Risk Factors./
Author:	Maher, Susan Schindler.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2020,
Description:	82 p.
Notes:	Source: Dissertations Abstracts International, Volume: 81-10, Section: B.
Contained By:	Dissertations Abstracts International81-10B.
Subject:	Health sciences. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=27955152
ISBN:	9798641803661

New-onset Delirium Among Elderly Acute Care Orthopedic Trauma Patients: Sleep Disturbance and Nutritional Status as Modifiable Risk Factors.
Maher, Susan Schindler.

New-onset Delirium Among Elderly Acute Care Orthopedic Trauma Patients: Sleep Disturbance and Nutritional Status as Modifiable Risk Factors. - Ann Arbor : ProQuest Dissertations & Theses, 2020 - 82 p.

Source: Dissertations Abstracts International, Volume: 81-10, Section: B.

Thesis (Ph.D.)--Northeastern University, 2020.

This item must not be sold to any third party vendors.

Background: Among elderly orthopedic trauma patients, the prevalence of delirium during acute care hospitalization may be as high as 60%. Recent evidence suggests that a history of sleep disturbance may increase the risk of delirium in elective surgery patients; however, such an association remains underexplored in trauma patients.Objective: To investigate the relationship between pre-admission history of sleep disturbance and new-onset delirium (NOD) among elderly orthopedic trauma patients.Design: We conducted a retrospective, cross-sectional study.Setting: Data was abstracted from the Massachusetts General Hospital Geriatric Inpatient Fracture Trauma Service (GIFTS) research repository.Participants: The analytical cohort was composed of 467 individuals, all >65 years of age, who were hospitalized between 01/01/2017 and 08/31/2018 for an extremity fracture.Intervention: All patients received GIFTS consultation within 24 hours of admission.Measurements: Patients were considered to have a history of sleep disturbance if it was documented in the medical record before hospitalization or if they self-reported a history of chronic sleep disturbance. Delirium was assessed daily using the Confusion Assessment Method. To investigate whether a history of sleep disturbance is associated with NOD, we performed a multiple variable logistic regression, controlling for several biologically relevant covariates known to be associated with sleep disturbance and risk of delirium.Results: Incidence of NOD was 20% (n = 91). Multiple variable regression analysis demonstrated that patients with a history of sleep disturbance were 75% more likely to develop NOD compared to patients with no history of sleep disturbance (OR 1.75; 95% CI 1.08-3.12).Conclusion: Our results suggest that a history of sleep disturbance increases the risk of NOD in hospitalized, elderly orthopedic trauma patients. Future studies are needed to determine whether perioperative interventions focused on improving sleep can reduce the risk of NOD and improve outcomes in this rapidly growing cohort of patients.

ISBN: 9798641803661Subjects--Topical Terms:

3168359
Health sciences.
Subjects--Index Terms:

Delirium

New-onset Delirium Among Elderly Acute Care Orthopedic Trauma Patients: Sleep Disturbance and Nutritional Status as Modifiable Risk Factors.
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245 1 0 $a New-onset Delirium Among Elderly Acute Care Orthopedic Trauma Patients: Sleep Disturbance and Nutritional Status as Modifiable Risk Factors.
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300 $a 82 p.
500 $a Source: Dissertations Abstracts International, Volume: 81-10, Section: B.
500 $a Advisor: Van Pelt, Maria.
502 $a Thesis (Ph.D.)--Northeastern University, 2020.
506 $a This item must not be sold to any third party vendors.
520 $a Background: Among elderly orthopedic trauma patients, the prevalence of delirium during acute care hospitalization may be as high as 60%. Recent evidence suggests that a history of sleep disturbance may increase the risk of delirium in elective surgery patients; however, such an association remains underexplored in trauma patients.Objective: To investigate the relationship between pre-admission history of sleep disturbance and new-onset delirium (NOD) among elderly orthopedic trauma patients.Design: We conducted a retrospective, cross-sectional study.Setting: Data was abstracted from the Massachusetts General Hospital Geriatric Inpatient Fracture Trauma Service (GIFTS) research repository.Participants: The analytical cohort was composed of 467 individuals, all >65 years of age, who were hospitalized between 01/01/2017 and 08/31/2018 for an extremity fracture.Intervention: All patients received GIFTS consultation within 24 hours of admission.Measurements: Patients were considered to have a history of sleep disturbance if it was documented in the medical record before hospitalization or if they self-reported a history of chronic sleep disturbance. Delirium was assessed daily using the Confusion Assessment Method. To investigate whether a history of sleep disturbance is associated with NOD, we performed a multiple variable logistic regression, controlling for several biologically relevant covariates known to be associated with sleep disturbance and risk of delirium.Results: Incidence of NOD was 20% (n = 91). Multiple variable regression analysis demonstrated that patients with a history of sleep disturbance were 75% more likely to develop NOD compared to patients with no history of sleep disturbance (OR 1.75; 95% CI 1.08-3.12).Conclusion: Our results suggest that a history of sleep disturbance increases the risk of NOD in hospitalized, elderly orthopedic trauma patients. Future studies are needed to determine whether perioperative interventions focused on improving sleep can reduce the risk of NOD and improve outcomes in this rapidly growing cohort of patients.
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