Risk factors and incidence of postoperative delirium in elderly patients after elective and emergency surgery

2010 ◽  
Vol 97 (2) ◽  
pp. 273-280 ◽  
Author(s):  
L. Ansaloni ◽  
F. Catena ◽  
R. Chattat ◽  
D. Fortuna ◽  
C. Franceschi ◽  
...  
Author(s):  
Kazuyoshi Yamamoto ◽  
Noriko Shimakawa ◽  
Takao Mizumoto ◽  
Kazuhisa Shiroyama ◽  
Tsutomu Shichino ◽  
...  

Objective: The aim of this study was to investigate the incidence and risk factors of postoperative delirium (PD) in elderly patients after general or gastrointestinal surgery. Summary of Background Data: Societies worldwide are rapidly aging and the number of surgeries in elderly patients has been increasing. PD, which adversely influences postoperative course, has thus become more common. Methods: The Surgery and Anesthesia Network Group of the National Hospital Organization in Japan conducted this retrospective cohort study of patients aged over 70 years who underwent general or gastrointestinal surgery. Results: A total of 219 patients from 9 participating institutes underwent surgery between July 2013 and August 2014. We excluded 2 patients who died within 2 weeks after surgery. Of the remaining 217 cases, 31 (14.3%) developed PD. These patients were older (80 vs. 76 years, P = 0.013), more likely to be male (74.2 vs. 54.8%, P = 0.039), and had higher American Society of Anesthesia Physical Status scores than those without PD. Emergency surgery was more common than elective surgery in the PD group (41.9 vs. 10.2%, P < 0.0001). Multivariate analysis showed that male gender (odds ratio, 3.31; 95% confidence interval, 1.32-9.39; P = 0.0098) and emergency surgery (7.47; 2.79-20.83; P < 0.0001) were independent risk factors of PD. Conclusions: The incidence of PD was high in male patients and those undergoing emergency surgery. Effective interventions in these groups will be necessary to improve treatment outcomes in elderly patients. (UMIN R000022185)


2020 ◽  
Vol 15 (3) ◽  
pp. 275-282
Author(s):  
Sijin Choi ◽  
Inyoung Jung ◽  
Byunghoon Yoo ◽  
Sangseok Lee ◽  
Mun Cheol Kim

Background: Postoperative delirium (POD) has an incidence rate of 9% to 41%. It is directly linked to decreasing cognitive function, increasing length of hospitalization and cost, as well as other complications and mortality. We aimed to assess the risk factors for POD among elderly patients by analyzing data from those who underwent spinal surgery.Methods: This study included 446 patients aged 65 years or older who underwent spinal surgery at our institution between March 2013 and May 2018. Data were collected retrospectively from the patients’ electronic medical records, and logistic regression was used to identify the risk factors associated with POD. The diagnosis of POD was based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and was made through consultation with a psychiatrist during postoperative hospitalization and before discharge.Results: Seventy-eight (78/446, 17.4%) patients were diagnosed with POD. The most relevant risk factor for POD was preoperative cognitive dysfunction (odds ratio [OR], 4.37; 95% confidence interval [CI], 1.60 to 11.93; P = 0.004), followed by emergency surgery (OR, 2.70; 95% CI, 1.27 to 5.74; P = 0.01), age (OR, 1.19; 95% CI, 1.13 to 1.26; P < 0.001), and anesthesia time (OR, 1.01; 95% CI 1.00 to 1.01; P = 0.002).Conclusions: Preoperative cognitive dysfunction, emergency surgery, age, and anesthesia time were factors that affected POD occurrence after spinal surgery. Patients with such associated factors may be at a higher risk for POD when undergoing spinal surgery, and hence, careful management may be necessary for these patients.


2011 ◽  
Vol 28 ◽  
pp. 224
Author(s):  
V. Gherghina ◽  
G. Nicolae ◽  
A. Balcan ◽  
I. Cindea ◽  
D. Costea ◽  
...  

BMC Surgery ◽  
2005 ◽  
Vol 5 (1) ◽  
Author(s):  
Vanni Agnoletti ◽  
Luca Ansaloni ◽  
Fausto Catena ◽  
Rabbih Chattat ◽  
Angelo De Cataldis ◽  
...  

Author(s):  
Chen-guang Wang ◽  
Ya-fei Qin ◽  
Xin Wan ◽  
Li-cheng Song ◽  
Zhi-jun Li ◽  
...  

2008 ◽  
Vol 21 (3) ◽  
pp. 189 ◽  
Author(s):  
Ki-Hwan Kim ◽  
Duk-Hwan Kho ◽  
Ju-Yong Shin ◽  
Jin-Yong Choi ◽  
Eung-Sik Kim ◽  
...  

2018 ◽  
Vol 37 ◽  
pp. S311-S312
Author(s):  
R. Tanaka ◽  
S.-W. Lee ◽  
M. Kawai ◽  
K. Tashiro ◽  
Y. Imai ◽  
...  

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