Acute Confusional Syndrome: a challenge for hospital nursing
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Del Campo Ugidos RM et al. Síndrome Confusional Agudo: un reto para la Enfermería hospitalaria. Metas de Enferm dic 2010/ene 2011; 13(10): 58-63
Authors
1Rosa María del Campo Ugidos, 2Esther Mata Peón, 3Manuel Amorín Díaz
Position
1Enfermera de la Unidad de Cirugía General. Fundación Hospital de Jove, Gijón. 2Enfermera del Servicio de Calidad. Fundación Hospital de Jove, Gijón. 3Médico de Neurología. Fundación Hospital de Jove, Gijón.
Contact address
Rosa María del Campo Ugidos. Unidad de Cirugía General. 1º Norte. Fundación Hospital de Jove. C/ Avenida de Eduardo Castro, s/n. 33290 Gijón (Asturias
Contact email: rosamariadelcampo@hotmail.com
Abstract
Material and method: longitudinal prospective descriptive study performed over the course of eight consecutive months (1/2/09-30/9/09) in patients admitted to the Hospital de Jove Foundation. In order to determine the occurrence of ACS, Confusion Assessment Method criteria were used. Study variables: age, sex, hospitalization days, admission service,
prior morbidity, presence of infection, time of onset since admission, clinical type, need for mechanical containment, substance and drug use. Bivariate and logistic regression analyses were performed.
Results: 69 of 3.877 patients (1,8%) developed ACS. Mean age: 81,13 years, predominantly males (59,4%), with admission to surgical services 63,8%, early onset (53,6; 100%
hyperactive) and nocturnal onset: 87,0%. In medical patients’ ACS, versus that of surgical patients, prior neurological pathology (OR = 5,83), early onset (OR = 6,35), use of corticoids (OR = 9,88) and use of anti-Parkinson’s drugs (OR = 1,19) were the most frequent features. Only the admission service (OR = 3,61 for Internal Medicine versus Surgical) and the presence of prior neurological pathology (OR = 3,11) remained in the regression model (dependent variable: early or delayed onset).
Conclusions: although the overall incidence of ACS in the Hospital de Jove Foundation was 1,8%, it ranged from 0,6 and 7,4% depending on the admission Unit, a rate that is lower than that found in published series. The hyperactive patient with nocturnal onset and a low incidence of hypoactive patients were predominant, suggesting that it is difficult to identify the latter. It is essential to promote Nursing training for this problem.
Keywords:
ACS; patients; bivariate analyses; hypercativehypoactive
Versión en Español
Título:
Síndrome Confusional Agudo: un reto para la Enfermería hospitalaria
