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KMID : 0607520040120010015
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Korean Journal of Psychosomatic Medicine
2004 Volume.12 No. 1 p.15 ~ p.22
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Delirium after Head Trauma at Psychiatric Consultation
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Kim Hyun-Chul
Lee Sang-Chul
Kim Do-Hoon
Lee Sang-Kyu
Hong Seung-Gwan
Son Bong-Ki
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Abstract
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Objectives: Delirium after head trauma results in various cognitive and behavioral dysfunction. This study aimed at developing and validating a predicitive model for clinical improvement after delirium based on precipitating factors during hospitalization
Method: Data were collected on 45 patients who developed delirium after head trauma using 5 year retrospective design, based on reviews of medical charts including psychiatric consultation reports. The differences of the group who sustained residual symptoms of delirium(The RS group) and the group of full recovery(The FR group) at 4 week follow-up visits were compared by motoric type of delirium, socio-demographic variables, neuroimaging variables and clinical variables of interest.
Result:There was significant difference in reason for initial consultation between two groups, in terms of hyperactivity(p<.01). The presence of compensation claim, subcortical gray matter lesion was significantly associated with the RS group(p<.05). Total length of intensive care unit(ICU) admission and of hospital stay were significantly longer in RS group than FR group(p<.01).
Conclusion: This study shows that hyperactivity on initial consultation, compensation claims, specific brain lesion were altogether significant factors in explaining prolonged duration of delirium after head trauma. A simple predictive model based on the presence of precipitating factors might be used to identify delirious patients at high risk for prolonged cognitive dysfunction. Early psychiatric intervention would be required for evaluating efficacious management and shortening admission period.
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KEYWORD
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Psychiatric consultation, Head trauma, Delirium, Initial reason for consultation, Hyperactivity, Length of hospital stay
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