Agnes Erzse, Nicola Christofides, Nicholas Stacey, Kelsey Lebard, Louise Foley, Karen Hofman
Availability and advertising of sugar sweetened beverages in South African public primary schools following a voluntary pledge by a major beverage company: a mixed methods study
Global health action
prior studies reported incidence hypoactive hyperactive subtypes postoperative delirium consider cognitive symptoms delirium highlighted dsm5 criteria delirium study aims address gap literature classifying cases delirium according constellation cognitive motoric symptoms delirium using statistical technique called latent class analysis lca data five independent study cohorts n 1968 patients underwent elective spine kneehip elective gastrointestinal thoracic procedures 2001 2017 assessments delirium symptoms conducted using long form confusion assessment method cam pre postsurgery latent class analyses cam data first 2 days surgery conducted determine subtypes delirium based patterns cognitive motoric symptoms delirium also determined perioperative patient characteristics associated latent class delirium assessed whether length delirium patterns delirium symptoms identified latent class analysis latent class model postoperative day 1 revealed three distinct patterns delirium symptoms one pattern symptoms denoted hyperalert class included patients whose predominant symptoms hyperalert overly sensitive environmental stimuli low level motor activity another pattern symptoms denoted hypoalert class included patients whose predominant symptom hypoalert lethargic drowsy third pattern symptoms denoted cognitive changes class included patients experienced new onset disorganized thinking memory impairment disorientation among 352 patients met cam criteria delirium postoperative day 1 34 symptoms fit within hyperalert latent class 39 symptoms fit within hypoalert latent class 27 symptoms fit within cognitive changes latent class similar findings found latent class analysis applied met cam criteria delirium postoperative day 2 multinomial regression analyses revealed asa class surgery type preoperative cognitive status measured telephone interview cognitive status tics scores associated class membership length delirium differed latent classes cognitive changes latent class longer duration compared two classes older elective surgery patients acute events illnesses diagnosis dementia prior surgery displayed varying symptoms delirium surgery compared prior studies described hypoactive hyperactive subtypes delirium identified novel subtype delirium reflects cognitive symptoms delirium three subtypes delirium reveal distinct patterns delirium symptoms provide insight varying risks care needs patients delirium indicating necessity future research reducing risk cognitive symptoms delirium