The incidence of postoperative delirium in elderly patients after urologic surgery.

BACKGROUND: Postoperative delirium (POD) is a frequent postoperative disorder to the sick and elderly, and always has been associated with extended of day stay in hospital, and certainly more cost for the hospital as well. Additionally, delirium is associated with increased postoperative complications, longer length of stay, longer intensive care unit stay (ICU), and much higher rates of discharge to a nursing home. As a result, delirium adds significant cost to hospitalization and subsequent medical care. The delirium causes an increased mortality and an increasing of mental status deterioration characterized by reduction of environmental recognition as well as the disorder of alertness. The purposes of this study are: a) the effectiveness of routine screening of postoperative Delirium in the elderly using Confusion Assessment Method (CAM)). In those cases psychiatrists are not necessary; b) understanding of risk factors and strategies for prevention and treatment; c) understanding of the impact of this psychotic disorders in postoperative morbidity and mortality; d) recognition of the economic impact of these disorders in the health service; e) describing of the etiology and incidence of Delirium post-operative. MATERIAL AND METHODS: In this study are included 640 patients aged over 65 years who underwent an operation at the urologic clinic. This study is prospective and casual. Are excluded from the study all patients with psychological problems in admission and that were treated for these pathologies before admission in Urology Clinic. RESULTS: Are evaluated all the data taken from patients and from their examinations as: age, use of medications, symptoms and problems, biochemical and clinical balance, hemodynamic examination, and preoperative, intra operative and postoperative evaluations. Is observed that post operative Delirium occurred at 166 patients from 640 in total on the average of 26% of patients. Incidence was increased with increasing of age from 19% to 31%. CONCLUSION: Postoperative Delirium occurs as a result of the combination of several factors, not just those related to internal physiological age, but combining of these factors with the diseases which carries this age, with medications used for this age, with surgical stress, with biochemical imbalances, hemodynamic problems, and electrolytic disorders as well.

Road accidents in Prishtina in the period 2005-2008.

The results of the research conducted in the Emergency Center during the period 2005 - 2008 are showing an enormous increase in the number of road traffic accidents. In this increase, except reasons mentioned above and among others, the following factors have contributed: enormous increase of number of persons equipped with driving license (5,6), driving speeds above permitted norms are considered a primary cause of road traffic accidents. An important factor that has influenced the cause of accidents was the consumption of alcohol before or during driving the vehicle, non-wearing of seat belts and protective helmets. The worldwide data show that the role of the safety belts enables a reduction of health consequences (1-3). We don't have any precise data from the Kosovo police service in regard to the existing correlation between wearing the safety belt and the degree of damage to the injured, as these data are not taken by the traffic police when an accident happens. The negligence of pedestrians continues to remain a matter of concern and the pedestrians are considered as a vulnerable group (7.8).