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Article

Delirium Risk Score in Elderly Patients with Cervical Spinal Cord Injury and/or Cervical Fracture

by
Koji Tamai
1,*,
Hidetomi Terai
1,
Hiroaki Nakamura
1,
Noriaki Yokogawa
2,
Takeshi Sasagawa
2,3,
Hiroaki Nakashima
4,
Naoki Segi
4,
Sadayuki Ito
4,
Toru Funayama
5,
Fumihiko Eto
6,
Akihiro Yamaji
7,
Kota Watanabe
8,
Junichi Yamane
8,
Kazuki Takeda
8,9,
Takeo Furuya
10,
Atsushi Yunde
10,
Hideaki Nakajima
11,
Tomohiro Yamada
12,13,
Tomohiko Hasegawa
12,
Yoshinori Terashima
14,15,
Ryosuke Hirota
14,
Hidenori Suzuki
16,
Yasuaki Imajo
16,
Shota Ikegami
17,
Masashi Uehara
17,
Hitoshi Tonomura
18,
Munehiro Sakata
18,19,
Ko Hashimoto
20,
Yoshito Onoda
20,
Kenichi Kawaguchi
21,
Yohei Haruta
21,
Nobuyuki Suzuki
22,
Kenji Kato
22,
Hiroshi Uei
23,24,
Hirokatsu Sawada
24,
Kazuo Nakanishi
25,
Kosuke Misaki
25,
Akiyoshi Kuroda
26,
Gen Inoue
26,
Kenichiro Kakutani
27,
Yuji Kakiuchi
27,
Katsuhito Kiyasu
28,
Hiroyuki Tominaga
29,
Hiroto Tokumoto
29,
Yoichi Iizuka
30,
Eiji Takasawa
30,
Koji Akeda
31,
Norihiko Takegami
31,
Haruki Funao
32,33,34,
Yasushi Oshima
35,
Takashi Kaito
36,
Daisuke Sakai
37,
Toshitaka Yoshii
38,
Tetsuro Ohba
39,
Bungo Otsuki
40,
Shoji Seki
41,
Masashi Miyazaki
42,
Masayuki Ishihara
43,
Seiji Okada
36,
Shiro Imagama
4 and
Satoshi Kato
2add Show full author list remove Hide full author list
1
Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka-City, Osaka 545-8585, Japan
2
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
3
Department of Orthopedics Surgery, Toyama Prefectural Central Hospital, 2-2-78 Nishinagae, Toyama, Toyama 930-8550, Japan
4
Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
5
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
6
Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
7
Department of Orthopaedic Surgery, Ibaraki Seinan Medical Center Hospital, 2190, Sakaimachi, Sashima, Ibaraki 306-0433, Japan
8
Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
9
Department of Orthopaedic Surgery, Japanese Red Cross Shizuoka Hospital, 8-2 Otemachi, Aoi-ku, Shizuoka 420-0853, Japan
10
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8670, Japan
11
Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences University of Fukui, 23-3 Matsuoka Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
12
Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu City, Shizuoka 431-3192, Japan
13
Department of Orthopaedic Surgery, Nagoya Kyoritsu Hospital, 1-172 Hokke, Nakagawa-ku, Nagoya-shi, Aichi 454-0933, Japan
14
Department of Orthopaedic Surgery, Sapporo Medical University, South 1-West 16-291, Chuo-ku, Sapporo 060-8543, Japan
15
Department of Orthopaedic Surgery, Matsuda Orthopedic Memorial Hospital, North 18-East 4-1 Kita-ku, Sapporo 001-0018, Japan
16
Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube City, Yamaguchi 755-8505, Japan
17
Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
18
Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
19
Department of Orthopaedics, Saiseikai Shiga Hospital, 2-4-1 Ohashi Ritto, Shiga 520-3046, Japan
20
Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
21
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan
22
Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
23
Department of Orthopaedic Surgery, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8393, Japan
24
Department of Orthopaedic Surgery, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo 173-8610, Japan
25
Department of Orthopedics, Traumatology and Spine Surgery, Kawasaki Medical School, 577, Matsushima, Kurashiki, Okayama 701-0192, Japan
26
Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1, Kitazato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan
27
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
28
Department of Orthopaedic Surgery, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku 783-8505, Japan
29
Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
30
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan
31
Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie 514-8507, Japan
32
Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 852 Hatakeda, Narita, Chiba 286-0124, Japan
33
Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba 286-0124, Japan
34
Department of Orthopaedic Surgery and Spine and Spinal Cord Center, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan
35
Department of Orthopaedic Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
36
Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
37
Department of Orthopedics Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
38
Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-Ku, Tokyo 113-8519, Japan
39
Department of Orthopaedic Surgery, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan
40
Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Kyoto 606-8507, Japan
41
Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0194, Japan
42
Department of Orthopaedic Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita 879-5593, Japan
43
Department of Orthopaedic Surgery, Kansai Medical University Hospital, 2-3-1 Shinmachi, Hirakata, Osaka 573-1191, Japan
 
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*
Author to whom correspondence should be addressed.
J. Clin. Med. 2023, 12(6), 2387; https://doi.org/10.3390/jcm12062387
Submission received: 13 January 2023 / Revised: 4 March 2023 / Accepted: 15 March 2023 / Published: 20 March 2023
(This article belongs to the Section Orthopedics)
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Abstract

The number of elderly patients with cervical trauma is increasing. Such patients are considered to be at high risk for delirium, which is an acute neuropsychological disorder that reduces the patient’s capacity to interact with their environment due to impairments in cognition. This study aimed to establish a risk score that predicts delirium in elderly patients with cervical SCI and/or cervical fracture regardless of treatment type. This retrospective cohort study included 1512 patients aged ≥65 years with cervical SCI and/or cervical fracture. The risk factors for delirium according to treatment type (surgical or conservative) were calculated using multivariate logistic regression. A delirium risk score was established as the simple arithmetic sum of points assigned to variables that were significant in the multivariate analyses. Based on the statistical results, the delirium risk score was defined using six factors: old age (≥80 years), hypoalbuminemia, cervical fracture, major organ injury, dependence on pre-injury mobility, and comorbid diabetes. The score’s area under the curve for the prediction of delirium was 0.66 (p < 0.001). Although the current scoring system must be validated with an independent dataset, the system remains beneficial because it can be used after screening examinations upon hospitalization and before deciding the treatment strategy.
Keywords: delirium; elderly; cervical fracture; cervical spinal cord injury; prediction delirium; elderly; cervical fracture; cervical spinal cord injury; prediction

Share and Cite

MDPI and ACS Style

Tamai, K.; Terai, H.; Nakamura, H.; Yokogawa, N.; Sasagawa, T.; Nakashima, H.; Segi, N.; Ito, S.; Funayama, T.; Eto, F.; et al. Delirium Risk Score in Elderly Patients with Cervical Spinal Cord Injury and/or Cervical Fracture. J. Clin. Med. 2023, 12, 2387. https://doi.org/10.3390/jcm12062387

AMA Style

Tamai K, Terai H, Nakamura H, Yokogawa N, Sasagawa T, Nakashima H, Segi N, Ito S, Funayama T, Eto F, et al. Delirium Risk Score in Elderly Patients with Cervical Spinal Cord Injury and/or Cervical Fracture. Journal of Clinical Medicine. 2023; 12(6):2387. https://doi.org/10.3390/jcm12062387

Chicago/Turabian Style

Tamai, Koji, Hidetomi Terai, Hiroaki Nakamura, Noriaki Yokogawa, Takeshi Sasagawa, Hiroaki Nakashima, Naoki Segi, Sadayuki Ito, Toru Funayama, Fumihiko Eto, and et al. 2023. "Delirium Risk Score in Elderly Patients with Cervical Spinal Cord Injury and/or Cervical Fracture" Journal of Clinical Medicine 12, no. 6: 2387. https://doi.org/10.3390/jcm12062387

APA Style

Tamai, K., Terai, H., Nakamura, H., Yokogawa, N., Sasagawa, T., Nakashima, H., Segi, N., Ito, S., Funayama, T., Eto, F., Yamaji, A., Watanabe, K., Yamane, J., Takeda, K., Furuya, T., Yunde, A., Nakajima, H., Yamada, T., Hasegawa, T., ... Kato, S. (2023). Delirium Risk Score in Elderly Patients with Cervical Spinal Cord Injury and/or Cervical Fracture. Journal of Clinical Medicine, 12(6), 2387. https://doi.org/10.3390/jcm12062387

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