scholarly journals Risk factors for postoperative delirium in elderly patients after spinal fusion surgery

2020 ◽  
Vol 15 (3) ◽  
pp. 275-282
Author(s):  
Sijin Choi ◽  
Inyoung Jung ◽  
Byunghoon Yoo ◽  
Sangseok Lee ◽  
Mun Cheol Kim
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Cognitive Dysfunction ◽  
Emergency Surgery ◽  
Spinal Surgery ◽  
Postoperative Delirium ◽  
Spinal Fusion Surgery ◽  
Diagnostic And Statistical Manual ◽  
Relevant Risk Factor ◽  
Anesthesia Time

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.

scholarly journals Emergency surgery and male gender are risk factors of postoperative delirium after general or gastrointestinal surgery in elderly patients: A multicenter cohort study

2020 ◽  
Author(s):  
Kazuyoshi Yamamoto ◽  
Noriko Shimakawa ◽  
Takao Mizumoto ◽  
Kazuhisa Shiroyama ◽  
Tsutomu Shichino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Elderly Patients ◽  
Emergency Surgery ◽  
Postoperative Delirium ◽  
Elective Surgery ◽  
Gastrointestinal Surgery ◽  
Male Gender ◽  
Hospital Organization ◽  
Multicenter Cohort Study

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 &lt; 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 &lt; 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)

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 ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Emergency Surgery ◽  
Postoperative Delirium

Incidence and risk factors of acute postoperative delirium in elderly patients after elective and emergency surgery

2011 ◽  
Vol 28 ◽  
pp. 224
Author(s):  
V. Gherghina ◽  
G. Nicolae ◽  
A. Balcan ◽  
I. Cindea ◽  
D. Costea ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Emergency Surgery ◽  
Postoperative Delirium

scholarly journals Assessment of risk factors for postoperative cognitive dysfunction after coronary artery bypass surgery: a single-center retrospective cohort study

2021 ◽  
Vol 41 (2) ◽  
Author(s):  
Yongtao Sun ◽  
Hai Feng ◽  
Ting Zou ◽  
Ming Hou ◽  
Yanwu Jin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Coronary Artery Bypass ◽  
Cognitive Dysfunction ◽  
Carotid Artery Stenosis ◽  
Artery Bypass ◽  
Postoperative Cognitive Dysfunction ◽  
Aortic Plaque ◽  
Anesthesia Time

Abstract Aim: To find out risk factors for postoperative cognitive dysfunction (POCD) after coronary artery bypass grafting (CABG), and to provide basis for clinical prevention of POCD. A total of 88 patients who underwent CABG were surveyed with Telephone Questionnaire (TICS-M) for their cognitive impairment after 3, 7, 21, 90, 180 days post-surgery. The occurrence of POCD was diagnosed by Neuropsychological Battery which included Vocabular Learning Test (VLT), Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT) and Symbol Digit Modalities Test (SDMT). The preoperative, intraoperative and postoperative risk factors were assessed by the χ2 or t test. Multivariate analysis was used to study the correlation between the risk factors and the occurrence of POCD. Age, aortic plaque, carotid artery stenosis, cerebrovascular disease, anesthesia time, the rate of decline in intraoperative hemoglobin concentration (ΔHb) and systemic inflammatory response syndrome (SIRS) score on postoperative day 2 had statistically significant (P&lt;0.05) influence on the occurrence of POCD. Aortic plaque, carotid artery stenosis, anesthesia time and SIRS score (odds ratio (OR) value &gt; 1, P&lt;0.05) are the risk factors for POCD. The incidence of day-21 and -180 POCD was approximately 26.1 and 22.7%, respectively.

scholarly journals Postoperative Delirium after elective and emergency surgery: analysis and checking of risk factors. A study protocol

BMC Surgery ◽  
2005 ◽  
Vol 5 (1) ◽  
Author(s):  
Vanni Agnoletti ◽  
Luca Ansaloni ◽  
Fausto Catena ◽  
Rabbih Chattat ◽  
Angelo De Cataldis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Study Protocol ◽  
Emergency Surgery ◽  
Postoperative Delirium

scholarly journals Incidence and risk factors of postoperative delirium in the elderly patients with hip fracture

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Chen-guang Wang ◽  
Ya-fei Qin ◽  
Xin Wan ◽  
Li-cheng Song ◽  
Zhi-jun Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
The Elderly

scholarly journals Incidence & Risk Factors of Postoperative Delirium After Spinal Surgery in Older Patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Taewook Kang ◽  
Si Young Park ◽  
Jin Hyeok Lee ◽  
Soon Hyuck Lee ◽  
Jong Hoon Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Surgery ◽  
Older Patients ◽  
Postoperative Delirium ◽  
Incidence Risk

scholarly journals Systematic review and meta-analysis of risk factor for postoperative delirium following spinal surgery

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Hao Jie Zhang ◽  
Xue Hai Ma ◽  
Jin Biao Ye ◽  
Cong Zhi Liu ◽  
Zhi Yang Zhou
Keyword(s):  
Risk Factors ◽  
Spinal Surgery ◽  
Postoperative Delirium ◽  
Meta Analysis ◽  
Operating Time ◽  
Economic Costs ◽  
Total Blood ◽  
Low Sodium ◽  
Low Potassium ◽  
History Of

Abstract Background Postoperative delirium is a common psychiatric disorder among patients who undergo spinal surgery. The purpose of current meta-analysis was to assess the potential risk factors related to delirium in spinal surgery. Methods We searched the following databases: PubMed, EMBASE, the Cochrane Library, and Web of Science, from inception to July 2020. Two reviewers independently assessed the quality of the included studies using the previously described Newcastle-Ottawa Scale (NOS). We included spinal surgery patients who suffered with delirium or not. Stata 12.0 was used for meta-analysis. Results Thirteen trial studies that met our inclusion criteria were incorporated into the meta-analysis. Postoperative delirium was associated with an increase of the duration of hospital stay (P = 0.044) and increased perioperative readmission rate (P = 0.013) and economic costs (P = 0.002). This meta-analysis demonstrates that there were twenty-two risk factors: general characteristic: old age, female patients, history of surgery, diabetes mellitus, hypertension; preoperative data: low hematocrit, low hemoglobin, low albumin, low sodium, depression; operative data: operating time, total blood loss; postoperative data: low sodium, low hemoglobin, low hematocrit, low albumin, fever, low potassium, blood sugar, and visual analog scale (VAS). Conclusions Delirium not only prolongs the length of hospital stay, but also increases readmission rate and the economic costs. Several risk factors including old age, female patients, history of surgery, diabetes mellitus, low hematocrit, low hemoglobin, low albumin, low sodium, depression; operative data: operating time, total blood loss, low sodium, low hemoglobin, low hematocrit, low albumin, fever, low potassium, blood sugar, and VAS were significant predictors for postoperative delirium after spinal surgery.

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