Cognitive and brain reserve and the risk of postoperative delirium in older patients: analysis of data from a prospective observational study

Abstract Background: Postoperative delirium (POD) among older patients is a common, serious disease and is associated with a high incidence of negative outcomes. For early detection of POD and subsyndromal delirium (SSD), this study was conducted to identify risk factors of POD and SSD in older patients who were scheduled for surgery in a surgical ward.Methods: This was a prospective observational study. Study participants were older than 65 years, underwent urology surgery, and were hospitalized in the surgical ward between April and September 2019. Both POD and SSD were assessed by using the Confusion Assessment Method (CAM) on the preoperative day, the day of surgery, and postoperative days 1–3 by the surgical ward nurses. SSD was defined as the presence of one or more CAM criteria and the absence of a diagnosis of delirium based on the CAM algorithm. Personal characteristics, clinical data, cognitive function, physical functions, laboratory test results, medication use, type of surgery and anesthesia, and use of physical restraint were collected from medical records. Logistic regression analyses were conducted to identify the risk factors for POD and SSD.Results: A total of 101 participants (mean age 74.9 years) were enrolled; 19 (18.8%) developed POD and SSD. The use of bed sensors (odds ratio 10.2, p=.001) were identified as risk factors for POD and SSD.Conclusions: Our study shows that the use of bed sensors might be related to the development of POD and SSD among older patients in surgical wards.

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Risk factors for postoperative delirium and subsyndromal delirium in older surgical patients in the general ward: a prospective observational study

10.21203/rs.3.rs-44194/v1 ◽

2020 ◽

Author(s):

Maya Kanno ◽

Mana Doi ◽

Kazumi Kubota ◽

Yuka Kanoya

Keyword(s):

Risk Factors ◽

Observational Study ◽

Odds Ratio ◽

Older Patients ◽

Postoperative Delirium ◽

Prospective Observational Study ◽

General Ward ◽

Subsyndromal Delirium ◽

Laboratory Test Results ◽

General Wards

Abstract Background Postoperative delirium (POD) among older patients is a common, serious disease and is associated with a high incidence of negative outcomes. For early detection of POD and subsyndromal delirium (SSD), this study was conducted to identify risk factors of POD and SSD in older patients in a general ward who were scheduled for surgery. Methods This was a prospective observational study. Study participants were older than 65 years, underwent urology surgery, and were hospitalized in the general ward between April and September 2019. Both POD and SSD were assessed by using the Confusion Assessment Method on the preoperative day, the day of surgery, and postoperative days 1–3. Personal characteristics, clinical data, cognitive function, physical functions, laboratory test results, medication use, type of surgery and anesthesia, and use of restraints were collected from medical records. Univariate and multivariate analyses were conducted to identify the risk factors for POD and SSD. Results A total of 101 participants (mean age 74.9 years) were enrolled; 19 (18.8%) developed POD and SSD. The use of bed sensors (odds ratio 10.2, p = .001) and preoperative level of C-reactive protein (CRP; odds ratio 1.5, p = .054) were identified as risk factors for POD and SSD. Conclusions POD and SSD among older patients in general wards were related to bed sensor use and the preoperative CRP level. Therefore, this study suggests that in order prevent POD and SSD for older patients in general wards, it is necessary to avoid bed sensor use as restraints and to assess the preoperative CRP level.

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Risk factors for postoperative delirium and subsyndromal delirium in older patients in the surgical ward: A prospective observational study

PLoS ONE ◽

10.1371/journal.pone.0255607 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0255607

Author(s):

Maya Kanno ◽

Mana Doi ◽

Kazumi Kubota ◽

Yuka Kanoya

Keyword(s):

Risk Factors ◽

Observational Study ◽

Older Patients ◽

Postoperative Delirium ◽

Prospective Observational Study ◽

Physical Restraint ◽

Assessment Method ◽

Subsyndromal Delirium ◽

Laboratory Test Results ◽

Surgical Ward

Postoperative delirium (POD) and subsyndromal delirium (SSD) among older patients is a common, serious condition associated with a high incidence of negative outcomes. However, there are few accurate methods for the early detection of POD and SSD in surgical wards. This study aimed to identify risk factors of POD and SSD in older patients who were scheduled for surgery in a surgical ward. This was a prospective observational study. Study participants were older than 65 years, underwent urology surgery, and were hospitalized in the surgical ward between April and September 2019. Delirium symptoms were assessed using the Confusion Assessment Method (CAM) on the preoperative day, the day of surgery, and postoperative days 1–3 by the surgical ward nurses. SSD was defined as the presence of one or more CAM criteria and the absence of a diagnosis of delirium based on the CAM algorithm. Personal characteristics, clinical data, cognitive function, physical functions, laboratory test results, medication use, type of surgery and anesthesia, and use of physical restraint and bed sensor were collected from medical records. Multiple logistic regression analyses were conducted to identify the risk factors for both POD and SSD. A total of 101 participants (mean age 74.9 years) were enrolled; 19 (18.8%) developed POD (n = 4) and SSD (n = 15). The use of bed sensors (odds ratio 10.2, p = .001) was identified as a risk factor for both POD and SSD. Our findings suggest that the use of bed sensors might be related to the development of both POD and SSD among older patients in surgical wards.

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