ABSTRACT
Background: Delirium is a complex, reversible neuropsychiatric disorder that frequently occurs in the geriatric age group in acute care settings with multifactorial etiology and numerous knowledge gaps in the pathogenesis. Objective: This study aimed to establish an association between leptin levels and delirium in patients aged 60 years and above admitted under the geriatric medicine department of a tertiary care hospital. Materials and Methods: A prospective observational study was conducted in consecutively admitted patients to the geriatric ward. Patients were assessed for delirium within 24 h of admission and daily thereafter until they were discharged from the hospital or died using the Confusion Assessment Method (CAM) or CAM?intensive care unit with subsequent division into delirium and nondelirium groups. Serum leptin levels were measured using enzyme?linked immunosorbent assay. Results: Two hundred patients were recruited in the study. The mean age of participants was found to be 73.1 ± 8.8 years. Prevalence rates of delirium at the time of admission and incidence rates during hospital stay were found to be 20% and 5%, respectively. The occurrence of delirium was also found to be significantly associated with mortality (32.5% vs. 8.7%, P = 0.001). Serum leptin levels were found to be significantly lower in patients with delirium (2.58 ± 1.01 ng/mL vs. 10.72 ± 1.46 ng/mL, P = 0.03). Multivariable regression analysis revealed delirium to significantly correlate positively with age (Odds Ratio [OR]: 1.63 (1.07–2.47), P = 0.021) and negatively with leptin levels (OR: 0.94 (0.90–0.99), P = 0.018). Conclusion: Delirium is a frequently occurring condition in hospitalized older adults with high mortality rates. Leptin might serve as a potential predictor of delirium owing to its probable role in the pathophysiological processes of delirium.
ABSTRACT
Background:Cancellation of any scheduled surgery is a significant drain on health resources and potentially stressful for patients. It is frequent in menstruating women who are scheduled to undergo open heart surgery (OHS), based on the widespread belief that it increases surgical and menstrual blood loss. Aims: The aim of this study was to evaluate blood loss in women undergoing OHS during menstruation. Settings and Design: A prospective,matched case?control study which included sixty women of reproductive age group undergoing OHS. Patients and Methods: The surgical blood loss was compared between women who weremenstruating (group?M;n = 25) and their matched controls, i.e., women who were not menstruating (group?NM; n = 25) at the time of OHS. Of the women in group M, the menstrual blood loss during preoperative (subgroup?P) and perioperative period (subgroup?PO) was compared to determine the effect of OHS onmenstrual blood loss. Results: The surgical blood loss was comparable among women in both groups irrespective of ongoing menstruation (gr?M = 245.6 ± 120.1 ml vs gr?NM = 243.6 ± 129.9 ml, P value = 0.83). The menstrual blood loss was comparable between preoperative and perioperative period in terms of total menstrual blood loss (gr?P = 36.8 ± 4.8 ml vs gr?PO = 37.7 ± 5.0 ml, P value = 0.08) and duration of menstruation (gr?P = 4.2 ± 0.6 days vs gr?PO = 4.4 ± 0.6 days, P value = 0.10). Conclusion: Neither the surgical blood loss nor the menstrual blood loss is increased in women undergoing OHS during menstruation.