Cerrahi Sonrası Deliryum Gelişen ve Ruh Sağlığı ve Hastalıkları Kliniğine Konsülte Edilen Hastalarda Deliryum Tablosunun Yönetimi: Tek Merkez Deneyimi

Year 2022, Volume: 11 Issue: 1, 11 - 21, 29.04.2022

Meltem Derya Şahin , Samet Şahin

https://doi.org/10.47493/abantmedj.1067988

Cited By: 1

Abstract

Amaç: Deliryum dikkat ve bilişsel işlevlerde ani başlangıçlı bozulma ile karakterize bir klinik tablodur. Deliryum kliniğinin altında birçok neden yatmakla beraber bazen sadece cerrahi bile kendi başına deliryum tablosu oluşturacak etkiye sahip olabilmektedir. Biz bu çalışmada genel cerrahi kliniğinde opere edilen ve postoperatif takip döneminde deliryum tablosu gelişmesi nedeniyle ruh sağlığı ve hastalıkları kliniğine konsülte edilen hastalarda tedavi yaklaşımlarının retrospektif analizini yapmayı amaçladık.

Yöntem ve Gereçler: Muğla Eğitim ve Araştırma Hastanesi Genel Cerrahi kliniğinde, Ocak 2019- Kasım 2021 tarihleri arasında opere edilen ve postoperatif dönemde deliryum tablosu geliştiği düşünülerek ruh sağlığı ve hastalıkları kliniğine konsülte edilen hastalar çalışmaya dahil edildi.

Bulgular: 38 hastadan 13 (%24,2) si kadın, 25’i (%65,8) erkek idi. Hastaların yaşları değerlendirildiğinde 61,5 (iqr: 45,5-79,25) idi. Operasyon süresi deliryum tablosunda semptomların devam ettiği süreyle ilişkili saptanmıştır (p:0,038). Yoğun bakımda yatış süresinin ve buna ek olarak toplam yatış süresinin uzaması yüksek korelasyon değerleri ile anlamlı olarak ilişkili saptanmıştır (sırasıyla rho:0,852, p<0,001 ve rho:0,866, p<0,001).

Sonuç: Çalışmamıza göre deliryum tablosu gelişen hastalarda semptom sürelerinin uzaması hastalarda yoğun bakım süreleri ve toplam yatış sürelerinin de uzamasıyla ilişkilidir. Yine uzamış operasyon süreleri deliryum tablosunun semptom süreleri ile ilişkili saptanmıştır. Ruh sağlığı ve hastalıkları profesyonellerinin bu hasta grubunu değerlendirmesi, mortalite ve morbidite üzerine önemli etkisi olan bu tablonun erken tanısında önemli rol oynamaktadır.

Keywords

deliryum, genel cerrahi, postoperatif dönem

Management of Delirium in Patients Developing Post-Surgical Delirium and Consulted to the Mental Health and Diseases Clinic: A Single Center Experience

Abstract

Objective: Delirium is a clinical picture characterized by sudden onset deterioration in attention and cognitive functions. There are many reasons underlying the delirium clinic; even just surgery can have the effect of creating delirium. In this study, we aimed to make a retrospective analysis of the treatment approaches in patients who were operated in the general surgery clinic and who were consulted to the psychiatry clinic due to the development of delirium during the postoperative follow-up period.

Materials and Methods: Patients who were operated in Muğla Training and Research Hospital General Surgery clinic between January 2019 and November 2021 and who were consulted to the psychiatry clinic considering that delirium developed in the postoperative period were included in the study.

Results: 13(24.2%) of 38 patients were female and 25(65.8%) were male. The median age was 61.5(iqr:45.5-79.25). The duration of the operation was found to be related to the duration of the symptoms in the delirium picture (p:0.038). Total length of stay in the intensive care unit and hospital was found to be associated with the duration of delirium.

Conclusion: The prolongation of the duration of symptoms in patients with delirium is associated with the prolongation of the duration of intensive care and total hospitalization in patients. Again, prolonged operation times were found to be associated with the symptom duration of the delirium. The evaluation of this patient group by psychiatry professionals plays an important role in the early diagnosis of this clinic, which has a significant impact on mortality and morbidity.

Keywords

delirium, general surgery, postoperative period

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