A personality trait contributes to the occurrence of postoperative delirium: a prospective study

BMC Psychiatry

Research Article

Jong-Seok Lee¹  Kyu Hyun Yang²  Woo Suk Lee³  Jae-Jin Kim⁴  Jin Young Park⁵  Jung Eun Shin⁶  Sunghyon Kyeong⁷ 

[1] Department of Anesthesia and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea;Department of Orthopedic Surgery, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, 06273, Seoul, Republic of Korea;Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea;Department of Psychiatry, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, 06273, Seoul, Republic of Korea;Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea;Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea;Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea;

关键词: Delirium;    Risk factor;    Personality;    Logistic regression;    Topological data analysis;   

DOI  :  10.1186/s12888-016-1079-z

 received in 2016-04-22, accepted in 2016-10-17,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAlthough various physical risk factors for delirium have been identified, the effect of psychological aspects is currently unknown. This study aimed to examine psychological risk factors for postoperative delirium and to identify hidden subgroups of delirium in clinical and psychological feature space.MethodsAmong 200 patients with hip fracture, 78 elderly patients were prospectively evaluated for clinical and psychological assessments before surgery. As delirium was assessed from the next day to the 7th day after surgery, postoperative delirium was found in 40 patients, but not in 38 patients. Univariate and multivariate logistic regression analyses were used to explore risk factors for postoperative delirium. Phenotypic subgroups of delirium were assessed using Topological Data Analysis, in which the significant risk factors were used for evaluating filter and distance metrics.ResultsMini-Mental State Examination, neuroticism, conscientiousness, and regional anesthesia were identified as a predictive risk factor for postoperative delirium. The filter metric showed significant negative correlations with nutrition-related factors such as total protein and albumin. When filter metric and Euclidean distances were entered, delirious patients were bifurcated as a function of personality traits and anesthesia method in the patient-patient network.ConclusionsA personality trait of neuroticism and conscientiousness may predispose elderly patients to postoperative delirium and this influence may be amplified by regional anesthesia. This study verifies the contribution of psychological risk factors to delirium and provides new insight for complex etiologies of delirium by mapping various clinical variables in the topological space.

【 授权许可】

CC BY   
© The Author(s). 2016