• Journal of Chest Surgery
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• v.57 no.3
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• pp.263-271
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• 2024

Background: Delirium is a recognized neurological complication following cardiac surgery and is associated with adverse clinical outcomes, including elevated mortality and prolonged hospitalization. While several clinical risk factors for post-cardiac surgery delirium have been identified, the pathophysiology related to the immune response remains unexamined. This study was conducted to investigate the immunological factors contributing to delirium in patients after thoracic aortic surgery. Methods: We retrospectively evaluated 43 consecutive patients who underwent thoracic aortic surgery between July 2017 and June 2018. These patients were categorized into 2 groups: those with delirium and those without it. All clinical characteristics were compared between groups. Blood samples were collected and tested on the day of admission, as well as on postoperative days 1, 3, 7, and 30. Levels of helper T cells (CD4), cytotoxic T cells (CD8), B cells (CD19), natural killer cells (CD56+CD16++), and monocytes (CD14+CD16-) were measured using flow cytometry. Results: The median patient age was 71 years (interquartile range, 56.7 to 79.0 years), and 21 of the patients (48.8%) were male. Preoperatively, most immune cell counts did not differ significantly between groups. However, the patients with delirium exhibited significantly higher levels of interleukin-6 and lower levels of tumor necrosis factor-alpha (TNF-α) than those without delirium (p<0.05). Multivariate analysis revealed that lower TNF-α levels were associated with an increased risk of postoperative delirium (p<0.05). Conclusion: Postoperative delirium may be linked to perioperative changes in immune cells and preoperative cytokine levels. Additional research is required to elucidate the pathophysiological mechanisms underlying delirium.

• Journal of Korean Clinical Health Science
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• v.4 no.2
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• pp.593-602
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• 2016

Purpose. The purpose of this study was to investigate knowledge, stress and nursing performance about care for delirium in geriatric hospital nurses. Methods. For this study, data were collected from 242 nurses employed at geriatric hospitals with the capacity of more than 100 beds which were located in A, P and Y cites. Frequency analysis, t-test and one-way ANOVA were utilized to analyze the data and Scheffe test was used to conduct post-hoc tests. Results. Nurses showed significant differences in the level of Knowledge, as well as terminal care performance by marital status, nursing experience. A significant relationship was found between knowledge, stress and Delirium care performance. Conclusion. This study found nurses perform delirium care with a high level of stress but with insuffiecient understanding, and thus, showed great needs for related training. Such findings can be useful to develop educational programs to improve knowledge on delirium and plans to reduce stress from delirium for geriatric hospital nurses.

• Journal of Oriental Neuropsychiatry
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• v.18 no.3
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• pp.289-298
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• 2007

Delirium is a acute syndrome of disorientation caused by disfunction of brain tissue and has a variety of symptomes. It is characterized by disturbance of consciousness and attention, cognition, and perception for a brief period of time and tends to fluctuate during the course of the day. We experienced a 56 year-old woman who had a hypertension as well as Delirium caused by cranial contusion and whose condition was improved by Oriental medical treatment. this case study illustrates what the manifestation of Delirium caused by cranial contusion. This study shows more objective mecical pregress by grading Korean version of Delirium Rating Scale(K-DRS) and Korean version of Mini-Mental State Examination(K-MMSE). After our treatments, Delirium and some other symptoms were improved.

• Journal of muscle and joint health
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• v.20 no.1
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• pp.72-80
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• 2013

Purpose: This study was conducted to investigate the correlation among nurses' knowledge, performance, and stress about care for delirium. Methods: The data were collected using the instruments for knowledge about nursing care (50 items), performance (23 items), and stress (20 items). Descriptive statistics and Pearson's correlation coefficient were used to analyze the data of 222 participants. Results: Nursing knowledge were different by clinical experience (F=3.12, p=.016), position at work (t=-2.54, p=.012), experience in caring patients with delirium (t=3.90, p<.001), and conflicts with other disciplines on matters related to delirium (t=4.00, p=.001). The difference in performance were associated with age (F=4.19, p=.001), clinical experience (F=2.67, p=.003), and whether there was a guideline for managing the patients with delirium (t=2.30, p=.022). Stress of nurses was different by whether they had a religion or not (t=-2.41, p=.017). The knowledge of care for delirium had the positive relationship with performance (r=.21, p=.001) and negative relationship with stress (r=-.29, p=.001). Conclusion: It is necessary to develop educational program and guideline for improving the knowledge and performance in care for delirium among nurses working at orthopedic hospitals.

• Journal of Korean Medicine Rehabilitation
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• v.19 no.2
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• pp.303-313
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• 2009

Objectives : The purpose of this study is to report the effect of oriental medical treatments on the patients with delirium. Methods : Four patients diagnosed with delirium by DSM-$IV^{TM}$ was treated Onbaek-won(Wenbai-yuan), Jugeo-hwan(Zhouju-wan) and herb medicine. The severity of delirium was assessed by using MMSE-K. And then, we investigated and analyzed the clinical symptoms of the patients. Results : After oriental medical treatments, the symptoms of delirium were disappeared and MMSE-K score was improved. Conclusions : It could be suggested that oriental medical treatments were effective on delirium. Further study of the effect of oriental medical treatments on delirium is needed in the near future.

• Journal of Korean Clinical Nursing Research
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• v.14 no.1
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• pp.151-160
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• 2008

Purpose: The purpose of this study was to investigate factors related to delirium occurrence in the ICU patients. Method: The sample were 99 patients in the ICU in a university affiliated hospital located in Kyunggi-do. Data were collected from September $1^{st}$ to October $31^{st}$, 2006. The instrument, CAM-ICU developed by Ely et al.(2001) was utilized. Data were analyzed by SPSS 13.0 for descriptive statistics, t-test, chi-square and multiple regression. Results: The delirium in the ICU patients was occurred in 22 (22.2%) out of 99 patients. There were significant differences in factors related to delirium occurrence, such as past medical history, long hospitalization, long ICU hospitalization, restraints, intubation or tracheostomy experience, ventilator experience, high pain score, and high anxiety score. Duration of ICU hospitalization, level of anxiety and past medical history were the significant predictors of the delirium occurrence(${\ss}$=44.5%). Conclusion: This study results recommend that specific nursing strategies needed to be developed to increase the detection of delirium in the ICU patients. The ICU nurses should recognize the incidence of delirium and prevent it in ICU settings.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.16 no.3
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• pp.290-299
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• 2009

Purpose: The objectives of this study were to determine the prevalence, incidence, duration and risk factors for delirium following liver transplantation while the patients were in the acute stage and admitted to the intensive care unit. Method: A retrospective chart review of 106 patients who had liver transplantation was conducted. A delirium risk factor checklist was used, to collect preoperative and postoperative data. Descriptive analysis, t-test, x2-test, and logistic regression analyses were used for data analysis. Results: The post-transplantation incidence of delirium was 29.3% (n=31). Multivariate analysis revealed that risk factors were preoperative conditions in the patients including spontaneous bacterial peritonitis, hepatorenal syndrome, and postoperative laboratory test results, such as hyperbilirubinemia. Conclusion: Therefore, a daily delirium risk factor assessment should be conducted before liver transplantation as a way to identify risk of delirium after the liver transplantation and to effectively manage delirium when it occurs.

• The Journal of Internal Korean Medicine
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• v.45 no.2
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• pp.140-148
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• 2024

Objective: In this case study, we describe the use of Shihogayonggolmoryo-tang-gami to treat an in-patient with delirium. Methods: An in-patient with symptoms of delirium was treated with Korean medicine therapies, including the herbal medication Shihogagyonggolmoryo-tang-gami, for 7 days. To evaluate its therapeutic effect, we used the Nursing Delirium Screening Scale (Nu-DESC) and Memorial Delirium Assessment Scale (MDAS). Results: After the treatment, Nu-DESC and MDAS scores improved. Of note, instances of the patient calling out improved, in addition to the patient's sleeping pattern. Although all the symptoms of delirium did not disappear completely, Shihogayonggolmoryo-tang-gami had therapeutic effects. Conclusion: These results suggest that Shihogayonggolmoryo-tang-gami may have a beneficial effect on delirium, without using other antipsychotic medications.

• Korean Journal of Adult Nursing
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• v.24 no.4
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• pp.348-357
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• 2012

Purpose: This retrospective chart review study was carried out in order to examine the frequency of delirium, and to identify the risk factors associated with the development of delirium in elderly patients with arthroplasty. Methods: Data were collected from medical records of patients who received arthroplasty during one and half year in a hospital. Three hundred sixty five patients were selected for the study. The onset of delirium was reviewed based on the result of psychological doctor's consultation or nurse's assessment with Confusion Assessment Method and delirium onset risk factors were examined. Data were analyzed with descriptive statistics, t-test, $x_2$-test, Fisher's exact test and logistic regression analysis. Results: Delirium occurred with 31 patients (8.5%) out of 365 patients who underwent arthroplasty. There were statistically significant differences between incidence of delirium and gender ($x_2$=6.11, p=.025), age ($x_2$=32.81, p<.001), hearing difficulty ($x_2$=8.08, p=.012), albumin level of preoperational day (t=-3.43, p<.001), albumin (t=-2.20, p=.028) and hemoglobin level (t=-2.83, p=.005) of operational day. Age and gender were the most significant predictive factors with regard to the incidence of delirium. Conclusion: Through understanding of these results, nurses will be able to identify those patients who may be at risk for developing delirium in early stages.

• Korean Journal of Clinical Pharmacy
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• v.30 no.2
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• pp.92-101
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• 2020

Background: Delirium is a neuropsychiatric disorder characterized by sudden impairments in consciousness, attention, and perception. The evidence of successful pharmacological interventions for delirium is limited, and medication recommendations for managing delirium are not standardized. This study aimed to provide evidence of antipsychotics for symptomatic treatment of delirium in cancer patients receiving palliative care. Methods: We retrospectively reviewed adult cancer patients in palliative care who received antipsychotic delirium treatment at Severance Hospital between January 2016 and June 2019. The efficacy was evaluated primarily by resolution rates. The resolution of delirium was defined as neurological changes from drowsiness, confusion, stupor, sedation, or agitation to alertness or significant symptomatic improvements described in the medical records. The safety was studied primarily by adverse drug reaction incidence ratios. Results: Of the 63 enrolled patients, 60 patients were included in the statistical analysis and were divided into three groups based on which antipsychotic medication they were prescribed [quetiapine (n=27), haloperidol (n=25) and co-administration of quetiapine and haloperidol (n=8)]. The resolution ratio showed quetiapine to be more effective than haloperidol (p=0.001). No significant differences were seen in adverse drug reaction rates among the three groups (p=0.332). Conclusions: Quetiapine was considered the most effective medication for delirium, with no significant differences in adverse drug reaction rates. Therefore, quetiapine may be considered a first-line medication for treating delirium in cancer patients receiving palliative care. However, further studies comparing more diverse antipsychotics among larger populations are still needed.