Laboratorial parameters as predictors of Delirium in elderly subjects hospitalized with acute medical conditions

Detalhes bibliográficos
Autor(a) principal: Barbosa, Catarina de Fátima
Data de Publicação: 2017
Tipo de documento: Dissertação
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10316/82735
Resumo: Trabalho de Projeto do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina
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spelling Laboratorial parameters as predictors of Delirium in elderly subjects hospitalized with acute medical conditionsParâmetros laboratoriais como preditores de Delirium em idosos hospitalizados com doenças médicas agudasDeliriumconsciênciaenvelhecimentodoença agudabiomarcadoresdeliriumconsciousnessagingacute diseasebiomarkersTrabalho de Projeto do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaBackground: Delirium is a neuropsychiatric syndrome common in acute medically ill elderly patients during hospitalization. It is frequently unrecognized and leads to bad outcomes. Development of biomarkers to be used in conjunction with clinical assessment could allow delirium prevention. The aim of this study was to correlate commonly used laboratorial blood parameters (LP) with the presence of delirium and to determine whether these tests can predict a delirium episode in elderly patients with acute medical conditions.Methods: The study was prospective and observational. We screened 269 elderly male individuals admitted to a general medical ward with acute medical conditions. During four days of hospitalization, each patient was periodically assessed for the level of consciousness with the Richmond Agitation-Sedation Scale and for the presence of Delirium with the Confusion Assessment Method and Diagnostic and Statistical Manual of Mental Disorders-V criteria. The most recent LP before each mental status assessment were obtained from clinical records. Changes in LP during hospitalization were analyzed and compared between patients according to the presence of delirium. LP measures were compared between subjects according to the presence of delirium or considerable sedation at different times during hospitalization. LP were also analyzed according to the presence of altered arousal. Statistical analysis was performed using IBM SPSS Statistics 24.0.Results: On admission, 15,4% of the participants had delirium. Leukocytes (Lc), glucose, creatinine, blood urea nitrogen, creatine kinase (CK), C-reactive protein, sodium (Na), potassium (K) and gamma glutamyl transferase changed significantly during hospitalization. During the first half of hospital stay, delirious patients tended to present decreasing aspartate transaminase (AST) and alkaline phosphatase, while these LP varied in narrower ranges than those observed in subjects without delirium. Changes in LP during the second half of hospitalization didn´t differ according to the presence of delirium. In terms of mean LP, delirium was associated with higher AST and Na levels as well as lower Lc, platelet and K values, considering different assessments during hospital stay. Also, altered arousal was associated with elevated CK levels.Discussion and Conclusions: Changes in some LP during hospitalization reflected different physiological reactions to regain homeostasis following an acute medical condition. And our results suggest that liver function particularly influences brain failure during the early stages of this altered homeostasis. We couldn´t find enough evidence to determine commonly used laboratory tests as predictors of a delirium episode in elderly patients with acute medical conditions.Background: Delirium is a neuropsychiatric syndrome common in acute medically ill elderly patients during hospitalization. It is frequently unrecognized and leads to bad outcomes. Development of biomarkers to be used in conjunction with clinical assessment could allow delirium prevention. The aim of this study was to correlate commonly used laboratorial blood parameters (LP) with the presence of delirium and to determine whether these tests can predict a delirium episode in elderly patients with acute medical conditions.Methods: The study was prospective and observational. We screened 269 elderly male individuals admitted to a general medical ward with acute medical conditions. During four days of hospitalization, each patient was periodically assessed for the level of consciousness with the Richmond Agitation-Sedation Scale and for the presence of Delirium with the Confusion Assessment Method and Diagnostic and Statistical Manual of Mental Disorders-V criteria. The most recent LP before each mental status assessment were obtained from clinical records. Changes in LP during hospitalization were analyzed and compared between patients according to the presence of delirium. LP measures were compared between subjects according to the presence of delirium or considerable sedation at different times during hospitalization. LP were also analyzed according to the presence of altered arousal. Statistical analysis was performed using IBM SPSS Statistics 24.0.Results: On admission, 15,4% of the participants had delirium. Leukocytes (Lc), glucose, creatinine, blood urea nitrogen, creatine kinase (CK), C-reactive protein, sodium (Na), potassium (K) and gamma glutamyl transferase changed significantly during hospitalization. During the first half of hospital stay, delirious patients tended to present decreasing aspartate transaminase (AST) and alkaline phosphatase, while these LP varied in narrower ranges than those observed in subjects without delirium. Changes in LP during the second half of hospitalization didn´t differ according to the presence of delirium. In terms of mean LP, delirium was associated with higher AST and Na levels as well as lower Lc, platelet and K values, considering different assessments during hospital stay. Also, altered arousal was associated with elevated CK levels.Discussion and Conclusions: Changes in some LP during hospitalization reflected different physiological reactions to regain homeostasis following an acute medical condition. And our results suggest that liver function particularly influences brain failure during the early stages of this altered homeostasis. We couldn´t find enough evidence to determine commonly used laboratory tests as predictors of a delirium episode in elderly patients with acute medical conditions.2017-06-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesishttp://hdl.handle.net/10316/82735http://hdl.handle.net/10316/82735TID:202046095engBarbosa, Catarina de Fátimainfo: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:RCAAP2019-06-02T14:18:37Zoai:estudogeral.uc.pt:10316/82735Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:04:37.391489Repositório 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 Laboratorial parameters as predictors of Delirium in elderly subjects hospitalized with acute medical conditions
Parâmetros laboratoriais como preditores de Delirium em idosos hospitalizados com doenças médicas agudas
title Laboratorial parameters as predictors of Delirium in elderly subjects hospitalized with acute medical conditions
spellingShingle Laboratorial parameters as predictors of Delirium in elderly subjects hospitalized with acute medical conditions
Barbosa, Catarina de Fátima
Delirium
consciência
envelhecimento
doença aguda
biomarcadores
delirium
consciousness
aging
acute disease
biomarkers
title_short Laboratorial parameters as predictors of Delirium in elderly subjects hospitalized with acute medical conditions
title_full Laboratorial parameters as predictors of Delirium in elderly subjects hospitalized with acute medical conditions
title_fullStr Laboratorial parameters as predictors of Delirium in elderly subjects hospitalized with acute medical conditions
title_full_unstemmed Laboratorial parameters as predictors of Delirium in elderly subjects hospitalized with acute medical conditions
title_sort Laboratorial parameters as predictors of Delirium in elderly subjects hospitalized with acute medical conditions
author Barbosa, Catarina de Fátima
author_facet Barbosa, Catarina de Fátima
author_role author
dc.contributor.author.fl_str_mv Barbosa, Catarina de Fátima
dc.subject.por.fl_str_mv Delirium
consciência
envelhecimento
doença aguda
biomarcadores
delirium
consciousness
aging
acute disease
biomarkers
topic Delirium
consciência
envelhecimento
doença aguda
biomarcadores
delirium
consciousness
aging
acute disease
biomarkers
description Trabalho de Projeto do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina
publishDate 2017
dc.date.none.fl_str_mv 2017-06-02
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/10316/82735
http://hdl.handle.net/10316/82735
TID:202046095
url http://hdl.handle.net/10316/82735
identifier_str_mv TID:202046095
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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