Screening Cognitive Changes and Delirium for the General Surgical Patients Aged Older Than 60

Monday, 12 July 2010: 3:05 PM

Meral Demiralp, PhD, RN1
Turgut Tufan, MD2
Ismail Hakki Ozerhan, MD2
Emine Iyigun, PhD, RN1
Derya Celik, RN2
Sevtap Simsek, RN2
Caglayan Ates, RN2
1School of Nursing, Gulhane Military Medical Academy, Ankara, Turkey
2General Surgical Department, Gulhane Military Medical Academy, Ankara, Turkey

Learning Objective 1: The learner will be able to know screening the preoperative cognitive changes is important for postoperative delirium in the patient aged 60 and older.

Learning Objective 2: The learner will be able to know screening age, marital status, smoking history, and comorbidite for the older patients

Purpose: This study carried out to examine preoperative cognitive changes and postoperative delirium signs in general-surgical patients aged 60 and older.
Methods: A prospective descriptive design was used. Participants were recruited at the intensive care unit of the general surgical department (ICU-GSD), Gulhane Military Medical Academy, Turkey. The sample of this study consisted of 147 patients were admitted to the ICU-GSD between December 01, 2007 and May 31, 2008. Data were collected from patients at the following four time; before the surgical operation, after the surgical operation on 1st, 3rd and 6th day An information form Mini Mental State Examination, and Delirium Rating Scale were used to collect data.
Results: The mean age of participants was 69.23±6.58 years between range of 60 and 93. We also found that the intermediate, negative, and significant relation was presence between preoperative cognitive changes and postoperative 1st day delirium signs (p<0.001). Age, marital status, smoking history, and comorbidite were found as significant variables in the cognitive state and delirium signs scores.

Conclusion: We believe that preoperative delirium risk assessment is important and recognizing patients who are at risk for delirium will help for developing treatment and prevention strategies in early term. Screening cognitive changes of the older patients before surgery and delirium monitoring should be introduced as standard of care within surgical clinics and surgical intensive care unit.