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    Delirium is associated with increased mortality in the geriatric population
    (Taylor & Francis Ltd, 2018) Tasar, Pinar Tosun; Sahin, Sevnaz; Akcam, Nur Ozge; Dinckal, Cigdem; Ulusoy, Merve Gulsah; Sarikaya, Ozan Fatih; Duman, Soner; Akcicek, Fehmi; Noyan, Aysin
    Objective: The aim of this study was to investigate the prevalence of delirium and its association with mortality rates in elderly inpatients.Methods: The medical records of 1435 patients over 65years old who were treated at a regional university hospital and were referred to the university's Consultation and Liaison Psychiatry Clinic for psychological evaluation were retrospectively analyzed. Patients with and without a diagnosis of delirium were compared. The National Survival Database was used to determine mortality rates.Results: The prevalence of delirium was 25.5%. The delirium group was older (p<.0001) and had a larger proportion of males (p<.0001). Mortality rate was higher in the delirium group at 1, 2, 3, 4, and 5years (p<.0001 for all). Age, gender, lower urinary system diseases, chronic liver disease, solid hematologic malignancy, infections, and Alzheimer's disease emerged as significant parameters associated with mortality. Multivariate analysis of these parameters indicated that comorbid diseases (lower urinary system diseases, chronic liver disease, solid hematologic malignancy, infections, and Alzheimer's disease) are risk factors for mortality independent of demographic data such as age and gender.Conclusions: Independent of all other factors, delirium is associated with higher mortality risk.
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    Evaluation of attempted older adults suicides admitted to a University Hospital Emergency Department: Izmir study
    (Elsevier Science Bv, 2017) Gokcelli, Duygu Keskin; Tasar, Pinar Tosun; Akcam, Nur Ozge; Sahin, Sevnaz; Akarca, Funda Karbek; Aktas, Ekin Ozgur; Duman, Soner; Akcicek, Fehmi; Noyan, Aysin
    Introduction: Advanced age is one of the risk factors for attempting suicide. Suicide attempts are one of the reasons for elderly patients to admit emergency services. The aim of this study was to investigate the relationship between suicidal behavior and sociodemographic factors and concurrent somatic diseases. Methods: The medical records of patients aged 60 years and over who presented to the emergency department of our university hospital for attempted suicide between the dates of January 1, 2007 and December 31, 2015 were screened retrospectively. Individuals recorded as cases of suicide on the forensic case report form were identified, the data recorded at our hospital were obtained, and telephone interviews were conducted to acquire any missing data. Results: A total of 63 patients with a mean age of 65.88 years were included in the study. A large proportion of the suicide attempts occurred in the years 2014 and 2015. Overall, 23.8% of the patients had a previous history of suicide attempt. Overdose was the method in 74.6% of the suicide attempts, and 70.2% were impulsive; 63.5% of the patients had a history of psychiatric disease. The most common psychopathology was major depressive disorder. Conclusion: We found that suicide attempts were more common among older adults with a history of depression, that approximately one in four had previously attempted suicide, and that the majority of individuals attempting suicide chose to use their own medication.
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    Investigation of metabolic disorders in the etiology of delirium in geriatric patients
    (Bayrakol Medical Publisher, 2022) Dinckal, Cigdem; Tasar, Pinar Tosun; Karasahin, Omer; Sahin, Sevnaz; Ulusoy, Merve Gulsah; Akcam, Nur Ozge; Sarikaya, Ozan Fatih
    Aim: The aim of this study was to examine metabolic parameters, which are among the factors that promote delirium, in geriatric patients pre-diagnosed with delirium by the Consultation-Liaison Psychiatry Unit of our medical school. Material and Methods: The diagnosis and treatment records of 1435 patients over 65 years of age were retrospectively screened. For patients diagnosed with delirium, demographic data, mode of presentation, leukocyte count, and levels of hematocrit, sodium, potassium, albumin, C-reactive protein (CRP), urea, creatinine, glucose, vitamin B12, TSH, and T4 were recorded. Results: Of the 1435 patients screened, 1147 patients with available survival and laboratory data were included in the study. Of these, 285 patients were diagnosed with delirium and 861 patients were not. In the delirium group, 63% of the patients had anemia, 33% had leukocytosis, 28% had hyponatremia, 47% had elevated serum creatinine, 90% had elevated CRP, 60% had hypoalbuminemia, and 53% had hyperglycemia. Discussion: Our comparison of patients with and without delirium indicates that metabolic disorders such as hyponatremia, hypopotassemia, hypoalbuminemia, impaired renal function, hyperglycemia, presence of infection, and anemia are contributing factors in delirium. Delirium is a serious and common problem that increases morbidity and mortality in geriatric patients. Identifying metabolic markers of delirium can help diagnose delirium and predict mortality.