Miss Catherine Anderson1, Miss Julie Adsett1, Miss Anita Plaza1
1Royal Brisbane And Women’s Hospital, Herston, Australia
Delirium is a common complication after surgery in hospitalized older adults, however there are limited reports of the incidence, predictive factors and outcomes associated with the development of delirium after burn injury. The aims of this study were to report the incidence and predictive factors for the development of delirium and to describe the associated rehabilitation outcomes in patients following burn surgery.
Methods: A retrospective review was conducted of all patients aged > 14 years, admitted for ≥48 hours and requiring surgical burn management. Delirium was identified by chart documentation. Logistic regression models were used to identify predictive factors for the development of delirium and the association between delirium and rehabilitation outcomes.
Results: 329 participants were included. The overall incidence of delirium was 7% (n=24) and 31% (n=15) of those admitted to the intensive care unit (ICU). Predictive factors for the development of delirium included age > 70 years, mental health history, ICU admission and the presence of sepsis. Delirium was associated with a longer length of stay (p<0.001), decreased adherence with inpatient physiotherapy (OR 2.8, 95%CI 1.1-7.1, p=0.035), decreased functional independence (OR 2.9, 95%CI 1.1-7.4, p=0.029), increased support or transfer to another facility for further rehabilitation (OR 6.1, 95%CI 2.4-15.5, p<0.001) and increased utilization of outpatient physiotherapy services (OR 8.4, 95%CI 2.9-24.2, p<0.001).
Conclusion: Independent predictors of delirium development were advanced age, ICU admission, sepsis and mental health history. Furthermore, delirium was associated with poorer rehabilitation outcomes. Future prospective studies are recommended using a designated delirium-screening tool.
Catherine Anderson is a Physiotherapist at the Royal Brisbane and Women’s Hospital. She is currently undertaking an MD at The University of Queensland and has a strong clinical interest in Burn management and rehabilitation.