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"Neurology"

Original Articles
The Incidence and Related Risk Factors of Delirium in the Older Inpatients with Neurological Disorders in a Tertiary Hospital
Mi Sun Kim, Ji Yoon Jun, Hyun Ju Chun, Yun Ok Kim
Korean J Adult Nurs 2018;30(3):255-265.   Published online June 30, 2018
DOI: https://doi.org/10.7475/kjan.2018.30.3.255
PURPOSE
Although there is a high incidence of delirium with increased age, the risk factors have been too various. We investigated the incidence and risk factors in the older inpatient with neurological disorders.
METHODS
We reviewed the Electronic Medical Records (EMR) of older patients admitted to a neurology unit from August 2016 to January 2017. We analyzed the incidence and risk factors of delirium in 382 patients in a tertiary hospital. Delirium was determined daily using the Nursing Delirium Screening Scale (Nu-DESC). Demographic, disease, and environmental characteristics were obtained by using structured EMR data.
RESULTS
The incidence rate of delirium was 6.0% (n=23). Delirium was prevalent in patients who were older, had a lower serum hemoglobin, had hypertension or had diabetes mellitus. Delirium was also observed in patients on antibiotics, having a higher number of drugs or catheters, or receiving mechanical monitoring. A longer hospital stay, being admitted to a sub-intensive care unit, and sleep deprivation were significantly associated with delirium. Multiple logistic regression analysis found older age, having sleep deprivation, a higher number of catheters placed, and having diabetes mellitus to be significant predictors of delirium.
CONCLUSION
This study shows that age, sleep deprivation, number of catheters, and comorbidity of diabetes mellitus were identified as a risk factor for delirium. And it will guide the development of algorithms through its possible applications for the future in hospitalized older adults.

Citations

Citations to this article as recorded by  
  • Relationship between Barriers and Performance for Delirium Care among Hospital Nurses: The Mediating Effect of Self-confidence
    Hee Yeon Kim, Hye-Ja Park
    Journal of Health Informatics and Statistics.2025; 50(1): 81.     CrossRef
  • The evaluation of frequency and predictors of delirium and its short-term and long-term outcomes in hospitalized older adults’
    Yamini Ajmera, Karandeep Paul, Maroof Ahmad Khan, Bharti Kumari, Nand Kumar, Prasun Chatterjee, Aparajit Ballav Dey, Avinash Chakrawarty
    Asian Journal of Psychiatry.2024; 94: 103990.     CrossRef
  • Patterns of Symptoms and Symptom-related Factors of Patients in the Intensive Care Unit: A Secondary Data Analysis of Electronic Medical Records
    Moonjung Kwak, Yeon-Hwan Park
    Korean Journal of Adult Nursing.2024; 36(2): 146.     CrossRef
  • Leptin as a Predictor of Delirium in Geriatric Inpatients
    Yamini Ajmera, Avinash Chakrawarty, Masroor Anwar, Maroof Ahmad Khan, Prasun Chatterjee, Sharmistha Dey
    Journal of the Indian Academy of Geriatrics.2022; 18(4): 157.     CrossRef
  • Effectiveness of Delirium Education Programs for Nurses in Acute Hospitals: A Systematic Review and Meta-Analysis
    Jungyeon Roh, Sujin Shin, Eunmin Hong
    Korean Journal of Adult Nursing.2022; 34(5): 435.     CrossRef
  • 56 View
  • 5 Download
  • 5 Crossref
  • 4 Scopus
Comparison of the Reliability and Validity of Fall Risk Assessment Tools in Patients with Acute Neurological Disorders
Sung Reul Kim, Sung Hee Yoo, Young Sun Shin, Ji Yoon Jeon, Jun Yoo Kim, Su Jung Kang, Hea Sook Choi, Hea Lim Lee, Young Hee An
Korean J Adult Nurs 2013;25(1):24-32.   Published online February 28, 2013
DOI: https://doi.org/10.7475/kjan.2013.25.1.24
PURPOSE
The aim of the study was to identify the most appropriate fall-risk assessment tool for neurological patients in an acute care setting.
METHODS
This descriptive study compared the reliability and validity of three fall-risk assessment tools (Morse Fall Scale, MFS; St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, STRATIFY; Hendrich II Fall Risk Model, HFRM II). We assessed patients who were admitted to the Department of Neurology, Neurosurgery, and Rehabilitation at Asan Medical Center between July 1 and October 31, 2011, using a constructive questionnaire including general and clinical characteristics, and each item from the three tools. We analyzed inter-rater reliability with the kappa value, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools.
RESULTS
The analysis included 1,026 patients, and 32 falls occurred during this study. Inter-rater reliability was above 80% in all three tools. and the sensitivity was 50.0% (MFS), 84.4%(STRATIFY), and 59.4%(HFRM II). The AUC of the STRATIFY was 82.8. However, when the cutoff point was regulated as not 50 but 40 points, the AUC of the MFS was higher at 83.7.
CONCLUSION
These results suggest that the STRATIFY may be the best tool for predicting falls for acute neurological patients.

Citations

Citations to this article as recorded by  
  • Effects of Forest Environment on Peak Cough Flow and Dyspnea in Patients with Neurological Disorders
    Jung Woo Shin, Jong Hwan Choi
    Journal of People, Plants, and Environment.2025; 28(2): 209.     CrossRef
  • Changes in Health Risks, Daily Activities and Antipsychotic Use After Humanitude Care for People With Dementia: A Retrospective Study
    Sungjun Kim, Jiyoung Kim, SungWoo Chung, Ju Young Sim
    Journal of Clinical Nursing.2025;[Epub]     CrossRef
  • Sensitivity of Fall Risk Perception and Associated Factors in Hospitalized Patients with Mental Disorders
    Ji Young Kim, Sung Reul Kim, Yusun Park, Jin Kyeong Ko, Eunmi Ra
    Asian Nursing Research.2024; 18(5): 443.     CrossRef
  • Congruency and its related factors between patients' fall risk perception and nurses' fall risk assessment in acute care hospitals
    Jieun Choi, Sujin Lee, Eunjin Park, Sangha Ku, Sunhwa Kim, Wonhye Yu, Eunmi Jeong, Sookhee Park, Yusun Park, Sung Reul Kim
    Journal of Nursing Scholarship.2024; 56(4): 507.     CrossRef
  • Falls in Patients of Medical Institutions in South Korea: A Literature Review
    Jongwon Choi, Woochol Joseph Choi
    Physical Therapy Korea.2023; 30(1): 1.     CrossRef
  • Development and validation of interpretable machine learning models for inpatient fall events and electronic medical record integration
    Soyun Shim, Jae Yong Yu, Seyong Jekal, Yee Jun Song, Ki Tae Moon, Ju Hee Lee, Kyung Mi Yeom, Sook Hyun Park, In Sook Cho, Mi Ra Song, Sejin Heo, Jeong Hee Hong
    Clinical and Experimental Emergency Medicine.2022; 9(4): 345.     CrossRef
  • Factors included in adult fall risk assessment tools (FRATs): a systematic review
    Hendrika de Clercq, Alida Naudé, Juan Bornman
    Ageing and Society.2021; 41(11): 2558.     CrossRef
  • Factors Influencing Falls in High- and Low-Risk Patients in a Tertiary Hospital in Korea
    Young-Shin Lee, Eun-Ju Choi, Yeon-Hee Kim, Hyeoun-Ae Park
    Journal of Patient Safety.2020; 16(4): e376.     CrossRef
  • Predictors of Health-related Quality of Life among Spouses of Older Adults with Dementia in the Community-dwelling
    Hye-Young Jang, Song Yi Han
    Journal of Korean Academy of Community Health Nursing.2019; 30(4): 518.     CrossRef
  • Effects of Fall Prevention Education Program on Attitudes, Prevention Behaviors, and Satisfaction among Elderly Inpatients
    Young Ok Kang, Rhayun Song
    Korean Journal of Adult Nursing.2018; 30(1): 49.     CrossRef
  • Risk factors of falling in patients with neurological diseases
    Michaela Miertová, Ivana Bóriková, Martina Tomagová, Katarína Žiaková
    Kontakt.2018; 20(3): e217.     CrossRef
  • Characteristics and Risk Factors for Falls in Tertiary Hospital Inpatients
    Eun-Ju Choi, Young-Shin Lee, Eun-Jung Yang, Ji-Hui Kim, Yeon-Hee Kim, Hyeoun-Ae Park
    Journal of Korean Academy of Nursing.2017; 47(3): 420.     CrossRef
  • A prediction model of falls for patients with neurological disorder in acute care hospital
    Sung-Hee Yoo, Sung Reul Kim, Yong Soon Shin
    Journal of the Neurological Sciences.2015; 356(1-2): 113.     CrossRef
  • Validation of Fall Risk Assessment Scales among Hospitalized Patients in South Korea using Retrospective Data Analysis
    Young Ok Kang, Rhayun Song
    Korean Journal of Adult Nursing.2015; 27(1): 29.     CrossRef
  • Evaluation of Clinical Usefulness of Delirium Assessment Tools for Elderly Patients after Neurosurgery
    Su-Jung Kim, Jun-Ah Song
    Journal of Korean Gerontological Nursing.2015; 17(1): 38.     CrossRef
  • 26 View
  • 0 Download
  • 15 Crossref
  • 11 Scopus
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