Delirium Risk Score in Elderly Patients with Cervical Spinal Cord Injury and/or Cervical Fracture-Reference-Cited by-同舟云学术

Delirium Risk Score in Elderly Patients with Cervical Spinal Cord Injury and/or Cervical Fracture

Published:2023-03-20 Issue:6 Volume:12 Page:2387
ISSN:2077-0383
Container-title:Journal of Clinical Medicine
language:en
Short-container-title:JCM

Author:

Tamai Koji¹^ORCID,Terai Hidetomi¹^ORCID,Nakamura Hiroaki¹,Yokogawa Noriaki²^ORCID,Sasagawa Takeshi²³,Nakashima Hiroaki⁴^ORCID,Segi Naoki⁴^ORCID,Ito Sadayuki⁴,Funayama Toru⁵^ORCID,Eto Fumihiko⁶,Yamaji Akihiro⁷,Watanabe Kota⁸^ORCID,Yamane Junichi⁸,Takeda Kazuki⁸⁹,Furuya Takeo¹⁰^ORCID,Yunde Atsushi¹⁰^ORCID,Nakajima Hideaki¹¹^ORCID,Yamada Tomohiro¹²¹³,Hasegawa Tomohiko¹²,Terashima Yoshinori¹⁴¹⁵,Hirota Ryosuke¹⁴,Suzuki Hidenori¹⁶^ORCID,Imajo Yasuaki¹⁶,Ikegami Shota¹⁷,Uehara Masashi¹⁷^ORCID,Tonomura Hitoshi¹⁸^ORCID,Sakata Munehiro¹⁸¹⁹,Hashimoto Ko²⁰^ORCID,Onoda Yoshito²⁰,Kawaguchi Kenichi²¹,Haruta Yohei²¹,Suzuki Nobuyuki²²,Kato Kenji²²,Uei Hiroshi²³²⁴^ORCID,Sawada Hirokatsu²⁴,Nakanishi Kazuo²⁵^ORCID,Misaki Kosuke²⁵,Kuroda Akiyoshi²⁶,Inoue Gen²⁶^ORCID,Kakutani Kenichiro²⁷^ORCID,Kakiuchi Yuji²⁷,Kiyasu Katsuhito²⁸,Tominaga Hiroyuki²⁹,Tokumoto Hiroto²⁹,Iizuka Yoichi³⁰,Takasawa Eiji³⁰,Akeda Koji³¹^ORCID,Takegami Norihiko³¹,Funao Haruki³²³³³⁴^ORCID,Oshima Yasushi³⁵,Kaito Takashi³⁶,Sakai Daisuke³⁷^ORCID,Yoshii Toshitaka³⁸,Ohba Tetsuro³⁹,Otsuki Bungo⁴⁰,Seki Shoji⁴¹^ORCID,Miyazaki Masashi⁴²^ORCID,Ishihara Masayuki⁴³^ORCID,Okada Seiji³⁶,Imagama Shiro⁴,Kato Satoshi²^ORCID

Affiliation:

1. Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka-City, Osaka 545-8585, Japan

2. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan

3. Department of Orthopedics Surgery, Toyama Prefectural Central Hospital, 2-2-78 Nishinagae, Toyama, Toyama 930-8550, Japan

4. Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan

5. Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan

6. Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan

7. Department of Orthopaedic Surgery, Ibaraki Seinan Medical Center Hospital, 2190, Sakaimachi, Sashima, Ibaraki 306-0433, Japan

8. Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan

9. Department of Orthopaedic Surgery, Japanese Red Cross Shizuoka Hospital, 8-2 Otemachi, Aoi-ku, Shizuoka 420-0853, Japan

10. Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8670, Japan

11. Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan

12. Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu City, Shizuoka 431-3192, Japan

13. Department of Orthopaedic Surgery, Nagoya Kyoritsu Hospital, 1-172 Hokke, Nakagawa-ku, Nagoya-shi, Aichi 454-0933, Japan

14. Department of Orthopaedic Surgery, Sapporo Medical University, South 1-West 16-291, Chuo-ku, Sapporo 060-8543, Japan

15. Department of Orthopaedic Surgery, Matsuda Orthopedic Memorial Hospital, North 18-East 4-1 Kita-ku, Sapporo 001-0018, Japan

16. Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube City, Yamaguchi 755-8505, Japan

17. Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan

18. Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan

19. Department of Orthopaedics, Saiseikai Shiga Hospital, 2-4-1 Ohashi Ritto, Shiga 520-3046, Japan

20. Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan

21. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan

22. Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan

23. Department of Orthopaedic Surgery, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8393, Japan

24. Department of Orthopaedic Surgery, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo 173-8610, Japan

25. Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School, 577, Matsushima, Kurashiki, Okayama 701-0192, Japan

26. Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1, Kitazato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan

27. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan

28. Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku 783-8505, Japan

29. Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan

30. Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan

31. Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie 514-8507, Japan

32. Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 852 Hatakeda, Narita, Chiba 286-0124, Japan

33. Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba 286-0124, Japan

34. Department of Orthopaedic Surgery and Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan

35. Department of Orthopaedic Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan

36. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan

37. Department of Orthopedics Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan

38. Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-Ku, Tokyo 113-8519, Japan

39. Department of Orthopaedic Surgery, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan

40. Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Kyoto 606-8507, Japan

41. Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan

42. Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan

43. Department of Orthopaedic Surgery, Kansai Medical University Hospital, 2-3-1 Shinmachi, Hirakata, Osaka 573-1191, Japan

Abstract

The number of elderly patients with cervical trauma is increasing. Such patients are considered to be at high risk for delirium, which is an acute neuropsychological disorder that reduces the patient’s capacity to interact with their environment due to impairments in cognition. This study aimed to establish a risk score that predicts delirium in elderly patients with cervical SCI and/or cervical fracture regardless of treatment type. This retrospective cohort study included 1512 patients aged ≥65 years with cervical SCI and/or cervical fracture. The risk factors for delirium according to treatment type (surgical or conservative) were calculated using multivariate logistic regression. A delirium risk score was established as the simple arithmetic sum of points assigned to variables that were significant in the multivariate analyses. Based on the statistical results, the delirium risk score was defined using six factors: old age (≥80 years), hypoalbuminemia, cervical fracture, major organ injury, dependence on pre-injury mobility, and comorbid diabetes. The score’s area under the curve for the prediction of delirium was 0.66 (p < 0.001). Although the current scoring system must be validated with an independent dataset, the system remains beneficial because it can be used after screening examinations upon hospitalization and before deciding the treatment strategy.

Publisher

MDPI AG

Subject

General Medicine

Link

https://www.mdpi.com/2077-0383/12/6/2387/pdf

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