Preventing Delirium: identification of risk groups in elderly patients with acute medical condition

Detalhes bibliográficos
Autor(a) principal: Jorge, Ana Patrícia da Cruz Balhau
Data de Publicação: 2015
Tipo de documento: Dissertação
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10316/30485
Resumo: Trabalho final de mestrado integrado em Medicina, apresentado à Faculdade de Medicina da Universidade de Coimbra.
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spelling Preventing Delirium: identification of risk groups in elderly patients with acute medical conditiondeliriumagingacute medical conditiondementiarisk factorsTrabalho final de mestrado integrado em Medicina, apresentado à Faculdade de Medicina da Universidade de Coimbra.Background: Delirium is a frequent neuropsychiatric syndrome associated with serious outcomes affecting mainly elderly subjects with acute medical disorders. Although it is widely accepted that delirium is the result of an interplay between predisposing and precipitating factors, the specific role of a particular risk factor remains largely unknown. Exploring how the etiological factors interact with each other can facilitate the early diagnosis of delirium and clarify the pathophysiological mechanisms involved in this condition. Objectives: Explore how risk factors of delirium co-occur in medically-ill elderly patients with this syndrome and identify sub-groups of those risk factors. Materials and Methods: Sociodemographic characteristics, acute medical conditions and chronic medical comorbidities were characterized in a group of 82 acutely-ill medical elderly patients diagnosed with delirium (CAM and DSM-IV-TR). A hierarchical cluster analysis of all risk factors was carried out using SPSS 22. Results: With the hierarchical cluster analysis the cases could be grouped into two main clusters. Patients included in cluster 1 [45 cases] had higher rates of osteoarthropathy, cancer, urinary tract infection and hyponatraemia, while cluster 2 [36 cases] was characterized by valvulopathy, atrial fibrillation, heart failure, acute pulmonary insufficiency and pneumonia. Discussion and Conclusion: Based on clinical characteristics, we identified two subgroups of delirious patients with different pattern of risk factors. Cluster 1 reflects deregulation states of different physiological mechanisms during delirium since patients in this cluster seem to have disorders affecting multiple organs/systems. Common pathophysiological pathways are likely to include systemic inflammation, pain and electrolyte imbalance. Cluster 2 was constituted by cardiopulmonary symptoms that are associated with both chronic and acute reduction of blood flow and/or oxygenation to the brain which can lead to cerebral hypoperfusion and a 2 neurovascular unit energy crisis. Known predisposing factors of delirium, such as age and pre-existing dementia, were similar between groups.2015info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesishttp://hdl.handle.net/10316/30485http://hdl.handle.net/10316/30485TID:201628406engJorge, Ana Patrícia da Cruz Balhauinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-01-20T17:48:46Zoai:estudogeral.uc.pt:10316/30485Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:44:24.149643Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Preventing Delirium: identification of risk groups in elderly patients with acute medical condition
title Preventing Delirium: identification of risk groups in elderly patients with acute medical condition
spellingShingle Preventing Delirium: identification of risk groups in elderly patients with acute medical condition
Jorge, Ana Patrícia da Cruz Balhau
delirium
aging
acute medical condition
dementia
risk factors
title_short Preventing Delirium: identification of risk groups in elderly patients with acute medical condition
title_full Preventing Delirium: identification of risk groups in elderly patients with acute medical condition
title_fullStr Preventing Delirium: identification of risk groups in elderly patients with acute medical condition
title_full_unstemmed Preventing Delirium: identification of risk groups in elderly patients with acute medical condition
title_sort Preventing Delirium: identification of risk groups in elderly patients with acute medical condition
author Jorge, Ana Patrícia da Cruz Balhau
author_facet Jorge, Ana Patrícia da Cruz Balhau
author_role author
dc.contributor.author.fl_str_mv Jorge, Ana Patrícia da Cruz Balhau
dc.subject.por.fl_str_mv delirium
aging
acute medical condition
dementia
risk factors
topic delirium
aging
acute medical condition
dementia
risk factors
description Trabalho final de mestrado integrado em Medicina, apresentado à Faculdade de Medicina da Universidade de Coimbra.
publishDate 2015
dc.date.none.fl_str_mv 2015
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10316/30485
http://hdl.handle.net/10316/30485
TID:201628406
url http://hdl.handle.net/10316/30485
identifier_str_mv TID:201628406
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
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