gykwak03/KISS_delirium_papaers huggingface dataset:
Title: 노인 입원 환자에서 섬망 발생과 결과에 대한 후향적 연구

Objectives：This study was aimed to examine the development and outcome of delirium in elderly inpatients retrospectively. Methods：We reviewed medical records of 2,570 patients, who were referred to consultation of psychiatry between January 2007 and December 2011. We found 916 patients(35.6%) who were confirmed as delirium by psychiatrists with DSM-IV-TR diagnostic criteria. The epidemiologic and clinical information were obtained and the factors affecting on recovery and recurrence of delirium were explored. All statistical analyses were conducted by using Pearson Chi-Square test, Student`s t-test, Binary logistic regression analysis with SPSS 17.0. Results：916 patients presented delirium. 577 patients(63.0%) were men and 339 patients(37.0%) were women. The mean of age was 74.6 years. The most frequently prescribed medicine was risperidone(52.7%), and followed by quetiapine(26.8%), olanzapine (9.9%). We found significant differences in Sex, Age, Ambulation state and Treatment in recovered and unchanged patients group. Additionally we also found that male sex can be a risk factor of recurrent delirium(OR 1.914, CI 1.102-3.323). Conclusion：These results suggest that female, advanced age, ambulation and antipsychotic medication can be associated with positive outcome of delirium, whereas male can increase the risk of recurrence of delirium.
Objectives：This study was aimed to examine the development and outcome of delirium in elderly inpatients retrospectively. Methods：We reviewed medical records of 2,570 patients, who were referred to consultation of psychiatry between January 2007 and December 2011. We found 916 patients(35.6%) who were confirmed as delirium by psychiatrists with DSM-IV-TR diagnostic criteria. The epidemiologic and clinical information were obtained and the factors affecting on recovery and recurrence of delirium were explored. All statistical analyses were conducted by using Pearson Chi-Square test, Student`s t-test, Binary logistic regression analysis with SPSS 17.0. Results：916 patients presented delirium. 577 patients(63.0%) were men and 339 patients(37.0%) were women. The mean of age was 74.6 years. The most frequently prescribed medicine was risperidone(52.7%), and followed by quetiapine(26.8%), olanzapine (9.9%). We found significant differences in Sex, Age, Ambulation state and Treatment in recovered and unchanged patients group. Additionally we also found that male sex can be a risk factor of recurrent delirium(OR 1.914, CI 1.102-3.323). Conclusion：These results suggest that female, advanced age, ambulation and antipsychotic medication can be associated with positive outcome of delirium, whereas male can increase the risk of recurrence of delirium.
Title: 응급실에서의 노인환자의 섬망

Objectives：It is known that delirium is common among elder patients and is associated poor clinical outcomes. As elderly patients are increasing in emergency department(ED), the prevalence of delirium should be on the rise. However delirium has been under-recognized by medical team. Our study was designated to evaluate the frequency, the clinical effect and risk factors of delirium of hospitalized elder patients in ED. Methods：We retrospectively reviewed elderly patients admitted to general ward after over 24 hours hospitalization in ED between January 2008 and December 2008. examined the frequency and assessed the clinical effect and risk factors. Results：Among 414 patients, 42 patients(10.1%) developed delirium in ED over 12 month period studied. The development of delirium in ED was associated with significant poor outcomes ; increased hospital mortality and prolonged hospital stays. Independent risk factors of delirium were stroke, metabolic derangements, dementia, hemodynamic instability, depression. Conclusion：ED environment can be important risk factors of delirium, thus ED physician should try to recognize and correct the possible risk factors of delirium earlier and in particular, should try to reduce exposure time to the ED environment in elderly patients.
Title: 인공관절치환수술 노인의 섬망 발생 영향요인

Purpose: This retrospective chart review study was carried out in order to examine the frequency of delirium, and to identify the risk factors associated with the development of delirium in elderly patients with arthroplasty. Methods: Data were collected from medical records of patients who received arthroplasty during one and half year in a hospital. Three hundred sixty five patients were selected for the study. The onset of delirium was reviewed based on the result of psychological doctor's consultation or nurse's assessment with Confusion Assessment Method and delirium onset risk factors were examined. Data were analyzed with descriptive statistics, t-test, x2-test, Fisher's exact test and logistic regression analysis. Results: Delirium occurred with 31 patients (8.5%) out of 365 patients who underwent arthroplasty. There were statistically significant differences between incidence of delirium and gender (x2=6.11, p=.025), age (x2=32.81, p<.001), hearing difficulty (x2=8.08, p=.012), albumin level of preoperational day (t=-3.43, p<.001), albumin (t=-2.20, p=.028) and hemoglobin level (t=-2.83, p=.005)of operational day. Age and gender were the most significant predictive factors with regard to the incidence of delirium. Conclusion: Through understanding of these results, nurses will be able to identify those patients who may be at risk for developing delirium in early stages.
Purpose: This retrospective chart review study was carried out in order to examine the frequency of delirium, and to identify the risk factors associated with the development of delirium in elderly patients with arthroplasty. Methods: Data were collected from medical records of patients who received arthroplasty during one and half year in a hospital. Three hundred sixty five patients were selected for the study. The onset of delirium was reviewed based on the result of psychological doctor's consultation or nurse's assessment with Confusion Assessment Method and delirium onset risk factors were examined. Data were analyzed with descriptive statistics, t-test, x2-test, Fisher's exact test and logistic regression analysis. Results: Delirium occurred with 31 patients (8.5%) out of 365 patients who underwent arthroplasty. There were statistically significant differences between incidence of delirium and gender (x2=6.11, p=.025), age (x2=32.81, p<.001), hearing difficulty (x2=8.08, p=.012), albumin level of preoperational day (t=-3.43, p<.001), albumin (t=-2.20, p=.028) and hemoglobin level (t=-2.83, p=.005)of operational day. Age and gender were the most significant predictive factors with regard to the incidence of delirium. Conclusion: Through understanding of these results, nurses will be able to identify those patients who may be at risk for developing delirium in early stages.
Title: 한국의 노인환자에 대한 섬망 및 졸음 유발 약물의 사용평가

In Korea, elderly population aged 65 and older are about 5.0% and 10.7% in 1990 and 2009, respectively. Since elderly people may experience physiologic changes with aging and their pharmacodynamic and pharmcokinetic parameters also have been undergone changes, several adverse drug reactions can occur more frequently than young people. Especially,neuropsychiatric adverse drug reactions such as delirium and drowsiness endanger elderly patients more. The purpose of this study is to evaluate the outpatient prescriptions using drug causing delirium and drowsiness in elderly patients aged 65 and older. We retrospectively reviewed prescriptions for elderly patients collected from four community pharmacies from January 2nd to February 1st, 2010. One pharmacy was located closed to a general hospital, and others were located closed to a internal medicine or an ENT clinic. The each number of the collected prescriptions was followings; Group A (n=496) from internal medicine department of a general hospital; Group B (n=44) from ENT department of general hospital; Group C (n=144) from internal medicine clinic; Group D (n=110) from ENT clinic. In result, in Group A, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.38 In Group B, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.09 In Group C, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.51. In Group D, the average number of prescribed drugs causing delirium or drowsiness per Rx was 2.72. Especially, in Group D, the percentage of prescription that drugs causing delirium or drowsiness per Rx prescribed more than 3 is 52.73% In all the 4 groups, over the 60%of drugs causing delirium and/or drowsiness per prescription of elderly patients were prescribed. It means elderly patients take 2 drugs causing delirium and/or drowsiness among 3 drugs, which is very serious. Frequently prescribed drugs causing delirium and/or drowsiness were followings; GI agents, antitussives & expectorants, histamine H1 antagonist,analgesics, antibiotics. Among these drugs, GI agents was high raking in all the 4 groups, and pharmacists should caution elderly patients when counseling. In the internal medicine groups (Group A,C), drugs concerning chronic diseases were prescribed frequently. In conclusion, pharmacist's role is important. Pharmacists are well informed of the drugs causing delirium or drowsiness and it is important to explain about ADRs slowly and easily to the elderly patients that receive drugs causing delirium or drowsiness. And institutional device is needed. For example, when doctors prescribe drugs for the elderly patients, message is needed that supply some informations about drugs causing delirium or drowsiness.
Title: 고관절 골절 수술후 발생한 섬망환자의 치과보철물에 의한 폐렴

We report a case of delayed diagnosed pneumonia due to an aspirated metallic crown, which had been detached from a molar tooth. Dental prosthesis should be checked and a careful review of the chest radiograph is mandatory when an elderly patient with delirium after hip fracture surgery develops pneumonia postoperatively. (J Korean Soc Traumatol 2012;25:97-100)
Title: 간호사의 섬망사정능력

Purpose: The purpose of this study was to identify related factors of perceived delirium assessment ability (PDAA)of clinical nurses. Methods: A descriptive survey design with a convenience sampling was used with 266 nurses who were recruited from P university hospital. Data were analyzed using descriptive statistics, ANOVA, Pearson correlation, and stepwise multiple regression with the SPSS/WIN 18.0 program. Results: Nurses scored low for knowledge of symptoms and management of delirium. Factors related to PDAA were ‘sufficiency in opportunities for education about delirium’ (β=.325, p<.001), ‘experience of caring for patients with delirium’ (β=.228, p<.001),‘duration of work’ (β=.139, p = .004), and ‘level of knowledge on delirium’ (β=.128, p = .021). These variables explained 24.2% of the variance in PDAA. Conclusion: Findings of the study indicate that nurses need up-to-date educational programs that include actual practices of delirium assessment as well as global knowledge of delirium. Because most nursing floors do not have care manuals for patients with delirium, having care manuals and corresponding educations is essential. Further studies including participants from broader geographical areas and methodology to examine the effects of educational program on PDAA are warranted to enhance the generalizability of the findings and examine the effectiveness of the program.
Title: 섬망 치료에 있어서 Quetiapine과 Risperidone의 효과 비교

Objectives：It has been shown that risperidone, an atypical antipsychotics, has effectiveness for treatment of delirium as good as haloperidol and has less side effects than haloperidol. Quetiapine also has less extrapyramidal side effects and has effectiveness for treatment of delirium. The aim of this study was to investigate whether quetiapine is effective for the treatment of delirium compared with risperidone. Methods：All subjects(71 patients) were randomized to receive either risperidone(35 patients) or quetiapine(36 patients) with fixed dose at the first day of treatment. Then, all subjects received either medications with flexible doses according to judgement on clinical status of patients. The effectiveness was evaluated using Clinical Global Impression-Severity(CGI-S), Korean version of Delirium Rating Scale(K-DRS), Korean Mini Mental Status Examination(K-MMSE), and Korean version of Delirium Rating Scale-Revised-98. Results：There was no significant difference between both groups in the baseline K-DRS, K-DRS-R-98, K-MMSE and CGI scores. At the seventh day of the treatment, K-DRS, K-DRS-R-98 and CGI scores were significantly improved from the baseline both in the quetiapine and risperidone treatment group. Conclusion：Quetiapine is effective for treatment of delirium.
Objectives：It has been shown that risperidone, an atypical antipsychotics, has effectiveness for treatment of delirium as good as haloperidol and has less side effects than haloperidol. Quetiapine also has less extrapyramidal side effects and has effectiveness for treatment of delirium. The aim of this study was to investigate whether quetiapine is effective for the treatment of delirium compared with risperidone. Methods：All subjects(71 patients) were randomized to receive either risperidone(35 patients) or quetiapine(36 patients) with fixed dose at the first day of treatment. Then, all subjects received either medications with flexible doses according to judgement on clinical status of patients. The effectiveness was evaluated using Clinical Global Impression-Severity(CGI-S), Korean version of Delirium Rating Scale(K-DRS), Korean Mini Mental Status Examination(K-MMSE), and Korean version of Delirium Rating Scale-Revised-98. Results：There was no significant difference between both groups in the baseline K-DRS, K-DRS-R-98, K-MMSE and CGI scores. At the seventh day of the treatment, K-DRS, K-DRS-R-98 and CGI scores were significantly improved from the baseline both in the quetiapine and risperidone treatment group. Conclusion：Quetiapine is effective for treatment of delirium.
Title: 섬망 치료에 있어 Aripiprazole과 Haloperidol의 효과 및 부작용 비교

Objectives:To compare the efficacy and the safety of aripiprazole and haloperidol in the treatment of patients with delirium. Methods:26 patients with delirium were randomized to receive either aripiprazole or haloperidol and finally 20 patients were analyzed. We collected demographic and clinical data. The Korean Version of Delirium Rating Scale-revised-98 (K-DRS-98) and Korean Version of Drug Induced Extrapyramidal Symptom Scale (DIEPSS-K) were assessed. Blood samples were collected to an- alyze serum sodium ion concentration, plasma cortisol and prolactin level and pulse oximetry was used for measuring oxygen satu- ration. Results:K-DRS-98 severity scores decreased in both groups significantly over the study period, but no statistically significant difference was observed between the two groups. No significant extrapyramidal syndromes were noted in both groups, but the use of haloperidol was associated with increased plasma prolactin level (From 24.0±28.1 ng/mL to 32.0±20.0 ng/mL, p=0.005). Conclusion:Aripiprazole is as effective as haloperidol in the treatment of delirium and aripiprazole may be safer than haloperi- dol in that haloperidol is associated with increased plasma prolactin level.
Objectives:To compare the efficacy and the safety of aripiprazole and haloperidol in the treatment of patients with delirium. Methods:26 patients with delirium were randomized to receive either aripiprazole or haloperidol and finally 20 patients were analyzed. We collected demographic and clinical data. The Korean Version of Delirium Rating Scale-revised-98 (K-DRS-98) and Korean Version of Drug Induced Extrapyramidal Symptom Scale (DIEPSS-K) were assessed. Blood samples were collected to an- alyze serum sodium ion concentration, plasma cortisol and prolactin level and pulse oximetry was used for measuring oxygen satu- ration. Results:K-DRS-98 severity scores decreased in both groups significantly over the study period, but no statistically significant difference was observed between the two groups. No significant extrapyramidal syndromes were noted in both groups, but the use of haloperidol was associated with increased plasma prolactin level (From 24.0±28.1 ng/mL to 32.0±20.0 ng/mL, p=0.005). Conclusion:Aripiprazole is as effective as haloperidol in the treatment of delirium and aripiprazole may be safer than haloperi- dol in that haloperidol is associated with increased plasma prolactin level.
Title: 섬망 환자에서 Amisulpride의 유효성 및 내약성에 관한 예비 연구

Objectives：Delirium is a disorder that needs active treatments since it is associated with poor outcomes such as comorbidity, longer hospital stay, higher mortality rate, higher rates of institutional care and dementia. This study was done to investigate the efficacy and safety of amisulpride, a atypical antipsychotic drug that is in possession of distinguishable pharmacodynamic profile characteristics from other widely used atypical antipsychotic drugs, but it has characteristics that are most similar to haloperidol which was the most commonly used antipsychotic drug treating patients with delirium in a safe manner. Methods：We recruited 19 delirium patients. Korean version of Delirium Rating Scale-Revised-98(K-DRS-R-98) and Korean version of Delirium Rating Scale(K-DRS) had been used to measure severity and improvement of delirium symptoms. Clinical Global Impression Severity Score(CGI-S) had been used to examine general medical conditions in the patients. The assessment on side effects began from day 2 for every visit to patients using Simpson-Angus Scale(SAS), Barnes Akathisia Rating Scale(BARS), Abnormal Involuntary Movement Scale(AIMS). Results：A total of 14 patients completed the study. They were administered with mean amisulpride dose 86.16 (SD=39.01) mg per day. The K-DRS scores were decreased from 21.57±4.72 before the treatment to 7.14±0.84 after the treatment(p＜0.01). The K-DRS-R-98 scores also were significantly decreased from 25.07±6.40 before the treatment to 9.93±1.09 after the treatment(p＜0.01). Among detailed K-DRS-R-98 scale items, the sleep item also showed a significant decrease(p＜0.01). There was no patient who suffered serious side effects. In 35.7% of the patients, the mild rigidity and mild tremor of extrapyramidal symptoms occurred. Conclusion：Amisulpride is expected to be used effectively and safely in treating delirium patients
Title: 폐렴 치료 중 위증(위證)을 동반한 섬망 발생 환자 치험1례

Delirium is an acute syndrome of disorientaion caused by dysfunction of brain and has many various symptoms. The characteristic symptoms of delirium are conscious disturbance with disorientation, dysarthria and emotional disturbance. We experienced 84-year-old man who had Wi syndrome(위證) as well as delirium during the treatment of pneumonia, and whose condition was improved through Oriental medical treatment. The patient was diagnosed as Yangmyeong Disease(陽明病) that was caused by heat in the stomach and stool in the colon, and was treated with Daeseungki-tang (Dachengqi-tang, 大承氣湯). We were able to improve the delirium caused by high fever infection through Oriental medical treatment.
Title: 섬망 심각도와 관련된 위험 요인

ObjectivesZZThe purpose of this study was to investigate the relationship between the sum of the risk factors for delirium and the severity of delirium and to identify those risk factors which increase the severity of delirium. MethodsZZThe participants were 151 patients who were consulted with a consultation-liaison psychiatrist and diagnosed using DSM-IV criteria as suffering from delirium. Sociodemographic and clinical characteristics were obtained through structured interviews and medical chart reviews. The severity of delirium symptoms was measured by the Korean version of the Delirium Rating Scale-Revised 98 (K-DRS-R98). Patients were divided into two groups : a ‘mild delirium group (MDG)’, whose total scores on the K-DRS-R98 were below 16, and a ‘severe delirium group (SDG)’ with the scores above 16. ResultsZZThere was a positive correlation between the sum of known risk factors for delirium and total scores on the K-DRS-R98 (p=0.009). The SDG showed a significantly higher incidence of abnormal potassium levels, abnormal sodium levels, old age, and polypharmacy than the MDG (p=0.010, p=0.046, p=0.042, and p=0.033 respectively). In a logistic regression model, old age, abnormal sodium and potassium levels, and polypharmacy were found to predict increased severity of the delirium (p=0.001, p=0.007, p=0.019, and p=0.005 respectively). ConclusionZZThe present findings suggested that there are certain factors which not only affect the occurrence of delirium, but also severity of delirium symptoms.
ObjectivesZZThe purpose of this study was to investigate the relationship between the sum of the risk factors for delirium and the severity of delirium and to identify those risk factors which increase the severity of delirium. MethodsZZThe participants were 151 patients who were consulted with a consultation-liaison psychiatrist and diagnosed using DSM-IV criteria as suffering from delirium. Sociodemographic and clinical characteristics were obtained through structured interviews and medical chart reviews. The severity of delirium symptoms was measured by the Korean version of the Delirium Rating Scale-Revised 98 (K-DRS-R98). Patients were divided into two groups : a ‘mild delirium group (MDG)’, whose total scores on the K-DRS-R98 were below 16, and a ‘severe delirium group (SDG)’ with the scores above 16. ResultsZZThere was a positive correlation between the sum of known risk factors for delirium and total scores on the K-DRS-R98 (p=0.009). The SDG showed a significantly higher incidence of abnormal potassium levels, abnormal sodium levels, old age, and polypharmacy than the MDG (p=0.010, p=0.046, p=0.042, and p=0.033 respectively). In a logistic regression model, old age, abnormal sodium and potassium levels, and polypharmacy were found to predict increased severity of the delirium (p=0.001, p=0.007, p=0.019, and p=0.005 respectively). ConclusionZZThe present findings suggested that there are certain factors which not only affect the occurrence of delirium, but also severity of delirium symptoms.
Title: 다음증, 약물 남용, 섬망 등을 보이며 불안을 동반한 39세 남자 환자

ObjectivesZZThe first objective of this study was to examine the extent to which the results of the visual interpretation of brain single photon emission computed tomography (SPECT) images correspond with those of SPM analysis in patients with traumatic brain injury (TBI). The second objective was to explore the possibility of the clinical application of SPM analysis for finding the brain lesions related to the neuropsychiatric symptoms, of which the patients complained. MethodsZZSPECT images from 10 TBI patients (all male, mean age: 46.8±12.32) and 10 age- and sex-matched control subjects were interpreted by an experienced radiologist. Their SPECT images were also analyzed by SPM2 software for comparing the individual images with the controls. ResultsZZThe results of visual interpretation of SPECT images generally corresponded with those of SPM analysis in five of the 10 TBI cases. In the remaining cases, brain lesions not identified from visual interpretation were found through SPM analysis. The location of these lesions included the anterior cingulate gyrus, caudate nucleus, thalamus, and subcallosal gyrus. SPM analysis also made it easy to find brain hypoperfusion areas associated with the TBI patients’ neuropsychiatric symptoms. ConclusionZZThis study suggested possible clinical applications of SPM analysis of SPECT data from patients with TBI. Its advantages and limitations were discussed.