2011 Volume 15 Issue 1 Pages 21-30
In the present study, we investigated the risk factors and course of postoperative delirium in 144 patients who underwent either carotid endarterectomy or superficial temporal artery to middle cerebral artery bypass for ischemic cerebrovascular disease. We collected information from medical records on 34 items related to the risk factors and course of postoperative delirium. The onset and severity of delirium were determined using the Japanese version of the NEECHAM Confusion Scale. The mean age of the subjects was 65.9±9.1 years, and the incidence of delirium was 33.1%. Analysis using the Akaike information criterion was performed with the onset and severity of delirium as dependent variables for 121 patients. The results suggested that effective explanatory variables for onset of delirium, were the effects of facilitating factors as well as the preoperative status of cerebral blood flow, which is a predisposing factor. On the basis of these findings, we think that nursing intervention can be effective for patients with brain diseases who are considered to have the precipitating factors of delirium physical restraint, the number of catheters, and sleeplessness after the operation. In addition, the effects of disease severity and the extent of surgical invasion were suggestive of the severity of delirium. Delirium is an indicator of somatic abnormalities, and postoperative management of physical health is important for preventing exacerbation of delirium.
