Delirium after a traumatic brain injury: predictors and symptom patterns

Jutaporn Maneewong,1 Benchalak Maneeton,1 Narong Maneeton,1 Tanat Vaniyapong,2 Patrinee Traisathit,3 Natthanidnan Sricharoen,3 Manit Srisurapanont1 1Department of Psychiatry, 2Department of Surgery, Faculty of Medicine, 3Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Ma...

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Autores principales:	Maneewong J, Maneeton B, Maneeton N, Vaniyapong T, Traisathit P, Sricharoen N, Srisurapanont M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Traumatic brain injury delirium non-cognitive symptoms cognitive symptoms Glasgow Coma Scale score Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/c22dffeff4f44f4282d8be90ce30b530
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spelling	oai:doaj.org-article:c22dffeff4f44f4282d8be90ce30b5302021-12-02T05:42:16ZDelirium after a traumatic brain injury: predictors and symptom patterns1178-2021https://doaj.org/article/c22dffeff4f44f4282d8be90ce30b5302017-02-01T00:00:00Zhttps://www.dovepress.com/delirium-after-a-traumatic-brain-injury-predictors-and-symptom-pattern-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Jutaporn Maneewong,1 Benchalak Maneeton,1 Narong Maneeton,1 Tanat Vaniyapong,2 Patrinee Traisathit,3 Natthanidnan Sricharoen,3 Manit Srisurapanont1 1Department of Psychiatry, 2Department of Surgery, Faculty of Medicine, 3Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand Background: Delirium in traumatic brain injury (TBI) is common, may be predictable, and has a multifaceted symptom complex. This study aimed to examine: 1) the sum score of Glasgow Coma Scale (GCS) and if its component scores could predict delirium in TBI patients, and 2) the prominent symptoms and their courses over the first days after TBI. Methods: TBI patients were recruited from neurosurgical ward inpatients. All participants were hospitalized within 24 hours after their TBI. Apart from the sum score of GCS, which was obtained at the emergency department (ED), the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnostic criteria for delirium were applied daily. The severity of delirium symptoms was assessed daily using the Delirium Rating Scale – Revised-98 (DRS-R-98). Results: The participants were 54 TBI patients with a mean GCS score of 12.7 (standard deviation [SD] =2.9). A total of 25 patients (46.3%) met the diagnosis of delirium and had a mean age of 36.7 years (SD =14.8). Compared with 29 non-delirious patients, 25 delirious patients had a significantly lower mean GCS score (P=0.04), especially a significantly lower verbal component score (P=0.03). Among 18 delirious patients, four symptoms of the DRS-R-98 cognitive domain (orientation, attention, long-term memory, and visuospatial ability) were moderate symptoms (score ≥2) at the first day of admission. After follow-up, three cognitive (orientation, attention, and visuospatial ability) and two noncognitive symptoms (lability of affect and motor agitation) rapidly resolved. Conclusion: Almost half of patients with mild to moderate head injuries may develop delirium in the first 4 days after TBI. Those having a low GCS score, especially the verbal component score, at the ED were likely to have delirium in this period. Most cognitive domains of delirium described in the DRS-R-98 were prominent within the first 4 days of TBI with delirium. Three cognitive and two noncognitive symptoms of delirium decreased significantly. Keywords: Delirium Rating Scale Revised-98, DRS-R-98, brain injuries, traumatic, noncognitive symptoms, cognitive symptoms, Glasgow Coma Scale scoreManeewong JManeeton BManeeton NVaniyapong TTraisathit PSricharoen NSrisurapanont MDove Medical PressarticleTraumatic brain injurydeliriumnon-cognitive symptomscognitive symptomsGlasgow Coma Scale scoreNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 459-465 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Traumatic brain injury delirium non-cognitive symptoms cognitive symptoms Glasgow Coma Scale score Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Traumatic brain injury delirium non-cognitive symptoms cognitive symptoms Glasgow Coma Scale score Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Maneewong J Maneeton B Maneeton N Vaniyapong T Traisathit P Sricharoen N Srisurapanont M Delirium after a traumatic brain injury: predictors and symptom patterns
description	Jutaporn Maneewong,1 Benchalak Maneeton,1 Narong Maneeton,1 Tanat Vaniyapong,2 Patrinee Traisathit,3 Natthanidnan Sricharoen,3 Manit Srisurapanont1 1Department of Psychiatry, 2Department of Surgery, Faculty of Medicine, 3Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand Background: Delirium in traumatic brain injury (TBI) is common, may be predictable, and has a multifaceted symptom complex. This study aimed to examine: 1) the sum score of Glasgow Coma Scale (GCS) and if its component scores could predict delirium in TBI patients, and 2) the prominent symptoms and their courses over the first days after TBI. Methods: TBI patients were recruited from neurosurgical ward inpatients. All participants were hospitalized within 24 hours after their TBI. Apart from the sum score of GCS, which was obtained at the emergency department (ED), the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnostic criteria for delirium were applied daily. The severity of delirium symptoms was assessed daily using the Delirium Rating Scale – Revised-98 (DRS-R-98). Results: The participants were 54 TBI patients with a mean GCS score of 12.7 (standard deviation [SD] =2.9). A total of 25 patients (46.3%) met the diagnosis of delirium and had a mean age of 36.7 years (SD =14.8). Compared with 29 non-delirious patients, 25 delirious patients had a significantly lower mean GCS score (P=0.04), especially a significantly lower verbal component score (P=0.03). Among 18 delirious patients, four symptoms of the DRS-R-98 cognitive domain (orientation, attention, long-term memory, and visuospatial ability) were moderate symptoms (score ≥2) at the first day of admission. After follow-up, three cognitive (orientation, attention, and visuospatial ability) and two noncognitive symptoms (lability of affect and motor agitation) rapidly resolved. Conclusion: Almost half of patients with mild to moderate head injuries may develop delirium in the first 4 days after TBI. Those having a low GCS score, especially the verbal component score, at the ED were likely to have delirium in this period. Most cognitive domains of delirium described in the DRS-R-98 were prominent within the first 4 days of TBI with delirium. Three cognitive and two noncognitive symptoms of delirium decreased significantly. Keywords: Delirium Rating Scale Revised-98, DRS-R-98, brain injuries, traumatic, noncognitive symptoms, cognitive symptoms, Glasgow Coma Scale score
format	article
author	Maneewong J Maneeton B Maneeton N Vaniyapong T Traisathit P Sricharoen N Srisurapanont M
author_facet	Maneewong J Maneeton B Maneeton N Vaniyapong T Traisathit P Sricharoen N Srisurapanont M
author_sort	Maneewong J
title	Delirium after a traumatic brain injury: predictors and symptom patterns
title_short	Delirium after a traumatic brain injury: predictors and symptom patterns
title_full	Delirium after a traumatic brain injury: predictors and symptom patterns
title_fullStr	Delirium after a traumatic brain injury: predictors and symptom patterns
title_full_unstemmed	Delirium after a traumatic brain injury: predictors and symptom patterns
title_sort	delirium after a traumatic brain injury: predictors and symptom patterns
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/c22dffeff4f44f4282d8be90ce30b530
work_keys_str_mv	AT maneewongj deliriumafteratraumaticbraininjurypredictorsandsymptompatterns AT maneetonb deliriumafteratraumaticbraininjurypredictorsandsymptompatterns AT maneetonn deliriumafteratraumaticbraininjurypredictorsandsymptompatterns AT vaniyapongt deliriumafteratraumaticbraininjurypredictorsandsymptompatterns AT traisathitp deliriumafteratraumaticbraininjurypredictorsandsymptompatterns AT sricharoenn deliriumafteratraumaticbraininjurypredictorsandsymptompatterns AT srisurapanontm deliriumafteratraumaticbraininjurypredictorsandsymptompatterns
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Delirium after a traumatic brain injury: predictors and symptom patterns

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