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A personality trait contributes to the occurrence of postoperative delirium: a prospective study

 Jung Eun Shin  ;  Sunghyon Kyeong  ;  Jong-Seok Lee  ;  Jin Young Park  ;  Woo Suk Lee  ;  Jae-Jin Kim  ;  Kyu Hyun Yang 
 BMC PSYCHIATRY, Vol.16(1) : 371, 2016 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Anesthesia/adverse effects ; Anesthesia/methods ; Anesthesia/psychology* ; Anxiety Disorders/psychology* ; Delirium/psychology* ; Female ; Hip Fractures/psychology ; Hip Fractures/surgery ; Humans ; Male ; Neuropsychological Tests ; Neuroticism ; Personality* ; Postoperative Complications/psychology* ; Prospective Studies ; Risk Factors
Delirium ; Logistic regression ; Personality ; Risk factor ; Topological data analysis
BACKGROUND: Although various physical risk factors for delirium have been identified, the effect of psychological aspects is currently unknown. This study aimed to examine psychological risk factors for postoperative delirium and to identify hidden subgroups of delirium in clinical and psychological feature space. METHODS: Among 200 patients with hip fracture, 78 elderly patients were prospectively evaluated for clinical and psychological assessments before surgery. As delirium was assessed from the next day to the 7th day after surgery, postoperative delirium was found in 40 patients, but not in 38 patients. Univariate and multivariate logistic regression analyses were used to explore risk factors for postoperative delirium. Phenotypic subgroups of delirium were assessed using Topological Data Analysis, in which the significant risk factors were used for evaluating filter and distance metrics. RESULTS: Mini-Mental State Examination, neuroticism, conscientiousness, and regional anesthesia were identified as a predictive risk factor for postoperative delirium. The filter metric showed significant negative correlations with nutrition-related factors such as total protein and albumin. When filter metric and Euclidean distances were entered, delirious patients were bifurcated as a function of personality traits and anesthesia method in the patient-patient network. CONCLUSIONS: A personality trait of neuroticism and conscientiousness may predispose elderly patients to postoperative delirium and this influence may be amplified by regional anesthesia. This study verifies the contribution of psychological risk factors to delirium and provides new insight for complex etiologies of delirium by mapping various clinical variables in the topological space.
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1. College of Medicine (의과대학) > BioMedical Science Institute (의생명과학부) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kyeong, Sung Hyon(경성현)
Kim, Jae Jin(김재진) ORCID logo https://orcid.org/0000-0002-1395-4562
Park, Jin Young(박진영) ORCID logo https://orcid.org/0000-0002-5351-9549
Yang, Kyu Hyun(양규현) ORCID logo https://orcid.org/0000-0001-7183-588X
Lee, Woo Suk(이우석) ORCID logo https://orcid.org/0000-0002-0798-1660
Lee, Jong Seok(이종석) ORCID logo https://orcid.org/0000-0002-7945-2530
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