Perioperative Optimization of Senior Health in Spine Surgery: Impact on Postoperative Delirium

2020 ◽  
Author(s):  
Mark N. Pernik ◽  
Palvasha R. Deme ◽  
Madelina L. Nguyen ◽  
Salah G. Aoun ◽  
Owoicho Adogwa ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Postoperative Delirium ◽  
Senior Health

Incidence and Risk Factors for Postoperative Delirium After Lumbar Spine Surgery

Spine ◽  
2013 ◽  
Vol 38 (20) ◽  
pp. 1790-1796 ◽  
Author(s):  
Steven J. Fineberg ◽  
Sreeharsha V. Nandyala ◽  
Alejandro Marquez-Lara ◽  
Matthew Oglesby ◽  
Alpesh A. Patel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Postoperative Delirium ◽  
Lumbar Spine Surgery

scholarly journals Incidence and Risk Factors of Postoperative Delirium in Cervical Spine Surgery

Spine ◽  
2009 ◽  
Vol 34 (23) ◽  
pp. 2500-2504 ◽  
Author(s):  
Takahiro Ushida ◽  
Takeshi Yokoyama ◽  
Yasuyo Kishida ◽  
Mika Hosokawa ◽  
Shinichirou Taniguchi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Postoperative Delirium ◽  
Cervical Spine Surgery

scholarly journals Retrospective Analysis of Perioperative Variables Associated With Postoperative Delirium and Other Adverse Outcomes in Older Patients After Spine Surgery

2019 ◽  
Vol 31 (4) ◽  
pp. 385-391 ◽  
Author(s):  
Maria J. Susano ◽  
Seth D. Scheetz ◽  
Rachel H. Grasfield ◽  
Dominique Cheung ◽  
Xinling Xu ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Spine Surgery ◽  
Older Patients ◽  
Postoperative Delirium ◽  
Adverse Outcomes

scholarly journals Postoperative Delirium after Spine Surgery: A Single-Center Age-Matched Study

The Nerve ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. 50-56
Author(s):  
Jae Cheol Lee ◽  
Youngoh Bae ◽  
Hyunchul Shin ◽  
Young-Joon Kwon
Keyword(s):  
Spine Surgery ◽  
Postoperative Delirium ◽  
Single Center ◽  
Matched Study

scholarly journals Evaluating Mechanisms of Postoperative Delirium and Cognitive Dysfunction Following Elective Spine Surgery in Elderly Patients (CONFESS): Protocol for a Prospective Observational Trial

10.2196/15488 ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. e15488
Author(s):  
Jonas Müller ◽  
Stephan Nowak ◽  
Antje Vogelgesang ◽  
Bettina von Sarnowski ◽  
Eiko Rathmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Dysfunction ◽  
Spine Surgery ◽  
Postoperative Period ◽  
Postoperative Delirium ◽  
Psychiatric Disease ◽  
Individual Risk ◽  
Care Hospital ◽  
Risk Profiles ◽  
Surgical Strategies

Background Elderly people are at particular high risk for postoperative delirium (POD) following spine surgery, which is associated with longer hospital stays, higher costs, risk for delayed complications, long-term care dependency, and cognitive dysfunction (POCD). It is insufficiently understood which mechanisms and risk factors contribute to the development of POD and POCD following these major but plannable surgeries. Objective This study aims to identify modifiable risk factors in spine surgery. A better understanding thereof would help adapt medical management and surgical strategies to individual risk profiles. Methods This is a single-center observational study jointly conducted by the departments of neurosurgery, neurology, and anesthesiology at a tertiary care hospital in Germany. All patients aged 60 years and older presenting to the neurosurgery outpatient clinic or ward for elective spine surgery are screened for eligibility. Exclusion criteria include presence of neurodegenerative or history of psychiatric disease and medication with significant central nervous system activity (eg, antidepressants, antipsychotics, sedatives). Surgical and anesthetic procedures including duration of surgery as primary end point of this study are thoroughly documented. All patients are furthermore evaluated for their preoperative cognitive abilities by a number of tests, including the Consortium to Establish a Registry for Alzheimer's Disease Plus test battery. Physical, mental, and social health and well-being are assessed using the Patient-Reported Outcome Measurement Information System Profile 29 and Hospital Anxiety and Depression Scale. Patients additionally receive preoperative cerebrovascular ultrasound and structural and functional brain imaging. The immediate postoperative period includes screening for POD using the Nursing Delirium Screening Scale and validation through Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, criteria. We furthermore investigate markers of (neuro)inflammation (eg, interleukins, C-reactive protein, tumor necrosis factor alpha). Preoperative examinations are repeated 3 months postoperatively to investigate the presence of POCD and its mechanisms. Statistical analyses will compare delirious and nondelirious patients for predictors of immediate (POD) and delayed (POCD) cognitive dysfunction. Results This is the first study to prospectively evaluate risk factors for POD and POCD in spine surgery. Recruitment is ongoing, and data collection is estimated to be finished with the inclusion of 200 patients by mid-2020. Conclusions The identification of mechanisms, possibly common, underlying POD and POCD would be a major step toward defining effective interventional strategies early in or even before the postoperative period, including the adaptation of surgical strategies to individual risk profiles. Trial Registration ClinicalTrials.gov NCT03486288; https://clinicaltrials.gov/ct2/show/NCT03486288

Depression Independently Predicts Postoperative Delirium in Spine Deformity Patients Undergoing Elective Spine Surgery

2017 ◽  
Vol 17 (10) ◽  
pp. S179
Author(s):  
Aladine A. Elsamadicy ◽  
Owoicho Adogwa ◽  
Emily C. Lydon ◽  
Amanda Sergesketter ◽  
Syed I. Khalid ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Postoperative Delirium ◽  
Spine Deformity

scholarly journals Efficacy of Intervention for Prevention of Postoperative Delirium after Spine Surgery

2020 ◽  
Author(s):  
Fumihiro Arizumi ◽  
Keishi Maruo ◽  
Kazuki Kusuyama ◽  
Kazuya Kishima ◽  
Toshiya Tachibana
Keyword(s):  
Spine Surgery ◽  
Postoperative Delirium

scholarly journals Comparison of postoperative delirium in patients anesthetized with isoflurane versus desflurane during spinal surgery: A prospective randomized controlled trial

2019 ◽  
Vol 10 ◽  
pp. 226
Author(s):  
Steve Joys ◽  
Tanvir Samra ◽  
Vishal Kumar ◽  
Manju Mohanty ◽  
Harsimrat B. S. Sodhi ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Postoperative Delirium ◽  
Controlled Trial ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Double Blind ◽  
Anesthetic Agents ◽  
Number Of Patients ◽  
Severity Scores

Background: Following spine surgery, different types of inhalational anesthetic agents can result in postoperative delirium (POD) that can increase perioperative/postoperative morbidity. Here, we compared the incidence of POD in adults undergoing spine surgery anesthetized with isoflurane versus desflurane. Methods: A prospective randomized double-blind clinical trial for patients undergoing spinal surgery was performed in 60 adults (aged 18–65 years); they were randomized to receive isoflurane or desflurane. On postoperative days 1 and 3, the diagnosis and severity of POD utilized 3D-Confusion Assessment Method (CAM) and CAM-severity delirium severity scores to assess patients’ status. Multiple other variables which may have influenced the frequency/severity of POD were also studied. Results: For the two groups, the incidence of POD utilizing isoflurane and desflurane was similar on postoperative days 1 (10% vs. 13.3%, P > 0.05) and 3 (6.6% vs. 0%, P > 0.05). The severity scores of POD for both anesthetic agents were also similar on postoperative days 1 (1.5 vs. 1) and 3 (0.5 vs. 0.5). In addition, there was no significant association of POD with other perioperative factors. Conclusion: A significant number of patients undergoing spine surgery experience POD. However, the incidence and severity of POD remained similar when utilizing either isoflurane or desflurane.

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