Relationship between Preoperative Diabetes and Delirium in Patients Undergoing Neurosurgery
-
Amir Behnam Kharazmi
,
Mahmoud Dehghani-Ghorbi
,
Seyed Amir Sheikholeslami
,
Parisa Delkash
,
Soheila Sadeghi
Abstract
Background: One of the surgeries that led to the hospitalization of the patient in the ICU and the creation of postoperative delirium (POD) is neurosurgery. We conducted this study to investigate the relationship between preoperative diabetes and delirium in patients undergoing neurosurgery in the ICU.
Methods: In this study, before performing the surgery, the checklist designed by the researchers was completed by interviewing the patients, and the necessary information was completed through clinical examination, interviewing the patient, and studying the documents in the patient's file. Then, the research tool to identify POD was reviewed and completed on a daily basis from the time the patient entered the ICU until the time the patient was discharged. In order to investigate delirium, the researchers conducted a clinical examination, observed the patient's clinical record, and completed the CAM-ICU-7 questionnaire. After completing the research tools, the data were entered into SPSS software, and their analysis was done using version 16 data analysis.
Results: Results showed, in patients with diabetes, the prevalence of POD in patients with a history of smoking, high creatinine, agitation, and intubation was higher than in other patients (P value < 0.05). Also, the prevalence of POD diabetic patients was 54 (38.57%), which is 38 (54.28%) in diabetic patients and 16 (22.85%) in non-diabetic patients.
Conclusion: Considering that a significant relationship was observed between diabetes and the prevalence of POD, it is important to carry out the necessary prevention in this field.
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[2] Bazgir N, Taghinezhad F, Nourmohammadi H, Azami G, Ahmadi I, Mozafari A. Comparing the COVID-19 mortality rate in cancer patients with and without a history of chemotherapy. Int J Cancer Manag. 2022; 15(10):e128404.
[3] Pakseresht M, Rassouli M, Rejeh N, Rostami S, Barasteh S, Molavynejad S. Explore the bereavement needs of families of children with cancer from the perspective of health caregivers: A qualitative study. Front Psychol. 2021; 12:750838.
[4] Ko JR, Seo DY, Kim TN, Park SH, Kwak H-B, Ko KS, et al. Aerobic exercise training decreases hepatic asprosin in diabetic rats. J Clin Med. 2019; 8(5):666.
[5] Yousefinejad M, Omidi M, Taheri Kalani A. The effect of 8 weeks of aerobic training on serum levels of asprosin and insulin resistance index in diabetic rats. Iranian J Diabetes Lipid Disord. 2024; 24(3):162-9.
[6] Jiang S, Young JL, Wang K, Qian Y, Cai L. Diabetic-induced alterations in hepatic glucose and lipid metabolism: The role of type 1 and type 2 diabetes mellitus. Mol Med Rep. 2020; 22(2):603-11.
[7] Mohamed J, Nafizah AN, Zariyantey A, Budin S. Mechanisms of diabetes-induced liver damage: The role of oxidative stress and inflammation. Sultan Qaboos Univ Med J. 2016; 16(2):e132.
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[9] Karimian M, Gholami A, Farzaei MH, Stefanucci A, Mollica A, Mahmoudi Y, et al. The effect of angipars™ on wound healing in patients with diabetes: A systematic review. J Chem Health Risks. 2020; 10(3):195-202.
[10] Vasigh A, Abdi A, Borji M, Tarjoman A. The prevalence of neuropathy among type 1 diabetic adolescents in Iran: A systematic review and meta-analysis. Int J Adolesc Med Health. 2019; 33(4).
[11] Shahabi N, Hosseini Z, Aghamolaei T, Behzad A, Ghanbarnejad A, Dadipoor S. Determinants of adherence to treatment in type 2 diabetic patients: A directed qualitative content analysis based on Pender’s health promotion model. Qual Health Res. 2024; 34(1-2):114-25.
[12] Skriver LKL, Nielsen MW, Walther S, Nørlev JD, Hangaard S. Factors associated with adherence or nonadherence to insulin therapy among adults with type 2 diabetes mellitus: A scoping review. J Diabetes Complications. 2023; 37:108596.
[13] Ghanassia E, Villon L, Thuan dit Dieudonné J-Fo, Boegner C, Avignon A, Sultan A. Long-term outcome and disability of diabetic patients hospitalized for diabetic foot ulcers: A 6.5-year follow-up study. Diabetes Care. 2008; 31(7):1288-92.
[14] Abejew AA, Belay AZ, Kerie MW. Diabetic complications among adult diabetic patients of a tertiary hospital in northeast Ethiopia. Adv Public Health. 2015; 2015(1):290920.
[15] Rubin DJ. Hospital readmission of patients with diabetes. Curr Diabetes Rep. 2015; 15:1-9.
[16] Zhao H, Ying H-L, Zhang C, Zhang S. Relative hypoglycemia is associated with delirium in critically ill patients with diabetes: A cohort study. Diabetes Metab Syndr Obes. 2022; 15:3339-46.
[17] Abdollahi R, Moradi Y. Caring limbo for nurses, caring for patients with delirium: A letter to the editor. Tehran Univ Med J. 2024; 81(12):1024-5.
[18] Ladak AN. A nurse-led delirium prevention program for hospitalized older adults: University of California, Los Angeles; 2020.
[19] Golparvaran M, Shariati B, Kamalzadeh L, Rashedi V, Bahadori F, Kamalinajad K, et al. Prevalence of delirium and its related factors in the elderly admitted to selected hospitals in Tehran, Iran. Salmand: Iranian J Ageing. 2023; 17(4):568-79.
[20] Tachibana M, Inada T, Ichida M, Kojima S, Shioya M, Wakayama K, et al. Factors associated with the severity of delirium. Hum Psychopharmacol Clin Exp. 2021; 36(5):e2787.
[21] Lobo-Valbuena B, Gordo F, Abella A, Garcia-Manzanedo S, Garcia-Arias M-M, Torrejón I, et al. Risk factors associated with the development of delirium in general ICU patients: A prospective observational study. PLoS One. 2021; 16(9):e0255522.
[22] Khalighi E, Tarjoman A, Abdi A, Borji M. The prevalence of delirium in patients in Iran: A systematic review and meta-analysis. Future Neurol. 2019; 14(4):FNL34.
[23] Erfani A, Aghamiri SH, Karimi R. Investigating the role of hyper density signal length in the middle cerebral artery on the degree of disability of arterial ischemic stroke patients. Arch Neurosci. 2024; 11(4):e150888.
[24] Komlakh K, Aghamiri SH, Farshadmoghadam H. The role and therapeutic applications of exosomes in multiple sclerosis disease. Clin Exp Pharmacol Physiol. 2022; 49(12):1249-56.
[25] Nagamine T. Correspondence: Association of serum uric acid level with the severity of brain injury and patient's outcome in severe traumatic brain injury. J Clin Diagn Res. 2020; 14(6).
[26] Hatefi M, Azhary S, Naebaghaee H, Mohamadi HR, Jaafarpour M. The effect of fenestration of lamina terminalis on the vasospasm and shunt-dependent hydrocephalus in patients following subarachnoid hemorrhage. J Clin Diagn Res. 2015; 9(7):PC15.
[27] Mohammadi HR, Erfani A, Sadeghi S, Komlakh K, Otaghi M, Vasig A. Investigating factors affecting mortality due to spinal cord trauma in patients admitted to the intensive care unit. Bull Emerg Trauma. 2024; 12(3):136-41.
[28] Mohammadi HR, Asadoola Y, Erfani A, Ghoreishi Amin N, Karimiyarandi H, Sadeghi S, et al. Effectiveness of pulse intravenous infusion of methylprednisolone on pain in patients with lumbar disc herniation: A randomized controlled trial. Anesth Pain Med. 2024; 14(4):e149442.
[29] Khan BA, Perkins AJ, Gao S, Hui SL, Campbell NL, Farber MO, et al. The confusion assessment method for the ICU-7 delirium severity scale: A novel delirium severity instrument for use in the ICU. Crit Care Med. 2017; 45(5):851-7.
[30] Alvarez RV, Palmer C, Czaja AS, Peyton C, Silver G, Traube C, et al. Delirium is a common and early finding in patients in the pediatric cardiac intensive care unit. J Pediatr. 2018; 195:206-12.
[31] Lee H, Oh SY, Yu JH, Kim J, Yoon S, Ryu HG. Risk factors of postoperative delirium in the intensive care unit after liver transplantation. World J Surg. 2018; 42(9):2992-9.
[32] Limpawattana P, Panitchote A, Tangvoraphonkchai K, Suebsoh N, Eamma W, Chanthonglarng B, et al. Delirium in critical care: A study of incidence, prevalence, and associated factors in the tertiary care hospital of older Thai adults. Aging Ment Health. 2016; 20(1):74-80.
[33] Wang J, Ji Y, Wang N, Chen W, Bao Y, Qin Q, et al. Risk factors for the incidence of delirium in cerebrovascular patients in a neurosurgery intensive care unit: A prospective study. J Clin Nurs. 2018; 27(1-2):407-15.
[34] Morshed RA, Young JS, Safaee M, Sankaran S, Berger MS, McDermott MW, et al. Delirium risk factors and associated outcomes in a neurosurgical cohort: A case-control study. World Neurosurg. 2019; 126:e930-e6.
[35] Gao H, Ma H-J, Li Y-J, Yin C, Li Z. Prevalence and risk factors of postoperative delirium after spinal surgery: A meta-analysis. J Orthop Surg Res. 2020; 15(1):138.
[36] van Keulen K, Knol W, Belitser SV, Zaal IJ, van der Linden PD, Heerdink ER, et al. Glucose variability during delirium in diabetic and non-diabetic intensive care unit patients: A prospective cohort study. PLoS One. 2018; 13(11):e0205637.
[37] Shang Z, Jiang Y, Fang P, Zhu W, Guo J, Li L, et al. The association of preoperative diabetes with postoperative delirium in older patients undergoing major orthopedic surgery: A prospective matched cohort study. Anesth Analg. 2024; 138(5):1031-42.
[38] Roozegar MA, Abdi Z, Matin S, Khorshidi A, Azizian M. The effect of 1.2 mg simvastatin mouthwash on the level of interleukin-6 in patients with chronic periodontitis. Indian J Forensic Med Toxicol. 2019;13(3):463-7.
[39] Roozegar MA, Nourmohammadi H, Havasian M, Seidkhani H, Jamdar S. Evaluation of Oral and Dental complications caused by Cyclophosphamide in patients with breast cancer in the Shahid-Mostafa Hospital, Ilam, 2019. Res J Pharm Technol. 2022;15(12):5517-20.
[40] Abdi Z, Roozegar MA, Beigi S, Khorshidi A, Azizian M, Beigi Z. Using simvastatin mouthwash (0.6%, 1.2% and 1.8%) on the improvement of clinical parameters in patients with chronic periodontitis. Res J Pharm Technol. 2020;13(2):862-6.
[2] Bazgir N, Taghinezhad F, Nourmohammadi H, Azami G, Ahmadi I, Mozafari A. Comparing the COVID-19 mortality rate in cancer patients with and without a history of chemotherapy. Int J Cancer Manag. 2022; 15(10):e128404.
[3] Pakseresht M, Rassouli M, Rejeh N, Rostami S, Barasteh S, Molavynejad S. Explore the bereavement needs of families of children with cancer from the perspective of health caregivers: A qualitative study. Front Psychol. 2021; 12:750838.
[4] Ko JR, Seo DY, Kim TN, Park SH, Kwak H-B, Ko KS, et al. Aerobic exercise training decreases hepatic asprosin in diabetic rats. J Clin Med. 2019; 8(5):666.
[5] Yousefinejad M, Omidi M, Taheri Kalani A. The effect of 8 weeks of aerobic training on serum levels of asprosin and insulin resistance index in diabetic rats. Iranian J Diabetes Lipid Disord. 2024; 24(3):162-9.
[6] Jiang S, Young JL, Wang K, Qian Y, Cai L. Diabetic-induced alterations in hepatic glucose and lipid metabolism: The role of type 1 and type 2 diabetes mellitus. Mol Med Rep. 2020; 22(2):603-11.
[7] Mohamed J, Nafizah AN, Zariyantey A, Budin S. Mechanisms of diabetes-induced liver damage: The role of oxidative stress and inflammation. Sultan Qaboos Univ Med J. 2016; 16(2):e132.
[8] Parsayyrad A, Khorshidi D, Kiani F. The effect of high-intensity interval training on hepatic TCF7L2 expression and glycemic control in type 2 diabetes rats. Iranian J Diabetes Lipid Disord. 2024; 24(3):170-8.
[9] Karimian M, Gholami A, Farzaei MH, Stefanucci A, Mollica A, Mahmoudi Y, et al. The effect of angipars™ on wound healing in patients with diabetes: A systematic review. J Chem Health Risks. 2020; 10(3):195-202.
[10] Vasigh A, Abdi A, Borji M, Tarjoman A. The prevalence of neuropathy among type 1 diabetic adolescents in Iran: A systematic review and meta-analysis. Int J Adolesc Med Health. 2019; 33(4).
[11] Shahabi N, Hosseini Z, Aghamolaei T, Behzad A, Ghanbarnejad A, Dadipoor S. Determinants of adherence to treatment in type 2 diabetic patients: A directed qualitative content analysis based on Pender’s health promotion model. Qual Health Res. 2024; 34(1-2):114-25.
[12] Skriver LKL, Nielsen MW, Walther S, Nørlev JD, Hangaard S. Factors associated with adherence or nonadherence to insulin therapy among adults with type 2 diabetes mellitus: A scoping review. J Diabetes Complications. 2023; 37:108596.
[13] Ghanassia E, Villon L, Thuan dit Dieudonné J-Fo, Boegner C, Avignon A, Sultan A. Long-term outcome and disability of diabetic patients hospitalized for diabetic foot ulcers: A 6.5-year follow-up study. Diabetes Care. 2008; 31(7):1288-92.
[14] Abejew AA, Belay AZ, Kerie MW. Diabetic complications among adult diabetic patients of a tertiary hospital in northeast Ethiopia. Adv Public Health. 2015; 2015(1):290920.
[15] Rubin DJ. Hospital readmission of patients with diabetes. Curr Diabetes Rep. 2015; 15:1-9.
[16] Zhao H, Ying H-L, Zhang C, Zhang S. Relative hypoglycemia is associated with delirium in critically ill patients with diabetes: A cohort study. Diabetes Metab Syndr Obes. 2022; 15:3339-46.
[17] Abdollahi R, Moradi Y. Caring limbo for nurses, caring for patients with delirium: A letter to the editor. Tehran Univ Med J. 2024; 81(12):1024-5.
[18] Ladak AN. A nurse-led delirium prevention program for hospitalized older adults: University of California, Los Angeles; 2020.
[19] Golparvaran M, Shariati B, Kamalzadeh L, Rashedi V, Bahadori F, Kamalinajad K, et al. Prevalence of delirium and its related factors in the elderly admitted to selected hospitals in Tehran, Iran. Salmand: Iranian J Ageing. 2023; 17(4):568-79.
[20] Tachibana M, Inada T, Ichida M, Kojima S, Shioya M, Wakayama K, et al. Factors associated with the severity of delirium. Hum Psychopharmacol Clin Exp. 2021; 36(5):e2787.
[21] Lobo-Valbuena B, Gordo F, Abella A, Garcia-Manzanedo S, Garcia-Arias M-M, Torrejón I, et al. Risk factors associated with the development of delirium in general ICU patients: A prospective observational study. PLoS One. 2021; 16(9):e0255522.
[22] Khalighi E, Tarjoman A, Abdi A, Borji M. The prevalence of delirium in patients in Iran: A systematic review and meta-analysis. Future Neurol. 2019; 14(4):FNL34.
[23] Erfani A, Aghamiri SH, Karimi R. Investigating the role of hyper density signal length in the middle cerebral artery on the degree of disability of arterial ischemic stroke patients. Arch Neurosci. 2024; 11(4):e150888.
[24] Komlakh K, Aghamiri SH, Farshadmoghadam H. The role and therapeutic applications of exosomes in multiple sclerosis disease. Clin Exp Pharmacol Physiol. 2022; 49(12):1249-56.
[25] Nagamine T. Correspondence: Association of serum uric acid level with the severity of brain injury and patient's outcome in severe traumatic brain injury. J Clin Diagn Res. 2020; 14(6).
[26] Hatefi M, Azhary S, Naebaghaee H, Mohamadi HR, Jaafarpour M. The effect of fenestration of lamina terminalis on the vasospasm and shunt-dependent hydrocephalus in patients following subarachnoid hemorrhage. J Clin Diagn Res. 2015; 9(7):PC15.
[27] Mohammadi HR, Erfani A, Sadeghi S, Komlakh K, Otaghi M, Vasig A. Investigating factors affecting mortality due to spinal cord trauma in patients admitted to the intensive care unit. Bull Emerg Trauma. 2024; 12(3):136-41.
[28] Mohammadi HR, Asadoola Y, Erfani A, Ghoreishi Amin N, Karimiyarandi H, Sadeghi S, et al. Effectiveness of pulse intravenous infusion of methylprednisolone on pain in patients with lumbar disc herniation: A randomized controlled trial. Anesth Pain Med. 2024; 14(4):e149442.
[29] Khan BA, Perkins AJ, Gao S, Hui SL, Campbell NL, Farber MO, et al. The confusion assessment method for the ICU-7 delirium severity scale: A novel delirium severity instrument for use in the ICU. Crit Care Med. 2017; 45(5):851-7.
[30] Alvarez RV, Palmer C, Czaja AS, Peyton C, Silver G, Traube C, et al. Delirium is a common and early finding in patients in the pediatric cardiac intensive care unit. J Pediatr. 2018; 195:206-12.
[31] Lee H, Oh SY, Yu JH, Kim J, Yoon S, Ryu HG. Risk factors of postoperative delirium in the intensive care unit after liver transplantation. World J Surg. 2018; 42(9):2992-9.
[32] Limpawattana P, Panitchote A, Tangvoraphonkchai K, Suebsoh N, Eamma W, Chanthonglarng B, et al. Delirium in critical care: A study of incidence, prevalence, and associated factors in the tertiary care hospital of older Thai adults. Aging Ment Health. 2016; 20(1):74-80.
[33] Wang J, Ji Y, Wang N, Chen W, Bao Y, Qin Q, et al. Risk factors for the incidence of delirium in cerebrovascular patients in a neurosurgery intensive care unit: A prospective study. J Clin Nurs. 2018; 27(1-2):407-15.
[34] Morshed RA, Young JS, Safaee M, Sankaran S, Berger MS, McDermott MW, et al. Delirium risk factors and associated outcomes in a neurosurgical cohort: A case-control study. World Neurosurg. 2019; 126:e930-e6.
[35] Gao H, Ma H-J, Li Y-J, Yin C, Li Z. Prevalence and risk factors of postoperative delirium after spinal surgery: A meta-analysis. J Orthop Surg Res. 2020; 15(1):138.
[36] van Keulen K, Knol W, Belitser SV, Zaal IJ, van der Linden PD, Heerdink ER, et al. Glucose variability during delirium in diabetic and non-diabetic intensive care unit patients: A prospective cohort study. PLoS One. 2018; 13(11):e0205637.
[37] Shang Z, Jiang Y, Fang P, Zhu W, Guo J, Li L, et al. The association of preoperative diabetes with postoperative delirium in older patients undergoing major orthopedic surgery: A prospective matched cohort study. Anesth Analg. 2024; 138(5):1031-42.
[38] Roozegar MA, Abdi Z, Matin S, Khorshidi A, Azizian M. The effect of 1.2 mg simvastatin mouthwash on the level of interleukin-6 in patients with chronic periodontitis. Indian J Forensic Med Toxicol. 2019;13(3):463-7.
[39] Roozegar MA, Nourmohammadi H, Havasian M, Seidkhani H, Jamdar S. Evaluation of Oral and Dental complications caused by Cyclophosphamide in patients with breast cancer in the Shahid-Mostafa Hospital, Ilam, 2019. Res J Pharm Technol. 2022;15(12):5517-20.
[40] Abdi Z, Roozegar MA, Beigi S, Khorshidi A, Azizian M, Beigi Z. Using simvastatin mouthwash (0.6%, 1.2% and 1.8%) on the improvement of clinical parameters in patients with chronic periodontitis. Res J Pharm Technol. 2020;13(2):862-6.
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How to Cite
1.
Kharazmi AB, Dehghani-Ghorbi M, Sheikholeslami SA, Delkash P, Sadeghi S. Relationship between Preoperative Diabetes and Delirium in Patients Undergoing Neurosurgery. Arch Anesth & Crit Care. 2025;.
