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 < 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)

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 Preoperative prognostic factors associated with postoperative delirium in older people undergoing surgery: protocol for a systematic review and individual patient data meta-analysis

2020 ◽  
Author(s):  
Tayler A Buchan ◽  
Behnam Sadeghirad ◽  
Nayeli Schmutz ◽  
Nicolai Goettel ◽  
Farid Foroutan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Individual Patient Data ◽  
Elective Surgery ◽  
Meta Analysis ◽  
Patient Data ◽  
Factors Associated ◽  
Increased Risk

Abstract Background: Early identification of patients at risk for postoperative delirium is essential because adequate well-timed interventions could reduce the occurrence of delirium and the related detrimental outcomes.Methods: We will conduct a systematic review and individual patient data (IPD) meta-analysis of prognostic studies evaluating the predictive value of risk factors associated with an increased risk of postoperative delirium in elderly patients undergoing elective surgery. We will identify eligible studies through systematic search of MEDLINE, EMBASE, and CINAHL from their inception to May 2020. Eligible studies will enroll older adults (≥ 50 years) undergoing elective surgery and assess pre-operative prognostic risk factors for delirium and incidence of delirium measured by a trained individual using a validated delirium assessment tool. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible studies. We will contact chief investigators of eligible studies requesting to share the IPD to a secured repository. We will use one-stage approach for IPD meta-analysis and will assess certainty of evidence using the GRADE approach.Discussion: Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent postoperative delirium in elderly patients.

scholarly journals New risk factors of postoperative complications in elective gastrointestinal surgery of elderly patients: a prospective cohort study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kei Yokozuka ◽  
Koichi Tomita ◽  
Masashi Nakagawa ◽  
Itsuki Koganezawa ◽  
Shigeto Ochiai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Skeletal Muscle ◽  
Cohort Study ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Gastrointestinal Surgery ◽  
Male Sex ◽  
Grade Iii

Abstract Background Gastrointestinal surgery in elderly individuals presents unexpected postoperative complications. However, predicting postoperative complications in elderly patients undergoing gastrointestinal surgeries is challenging because of the lack of a reliable preoperative evaluation system. We aimed to prospectively evaluate three new preoperative assessment methods to predict the postoperative complications in elderly patients undergoing elective gastrointestinal surgery. Moreover, we aimed to identify new risk factors of postoperative complications in this patient group. Methods This prospective cohort study enrolled 189 patients (age ≥ 65 years) who underwent elective gastrointestinal surgery at Tokyo Medical University Hachioji Medical Center between April 2017 and March 2019. Assessments performed preoperatively included the biological impedance analysis for evaluating the skeletal muscle mass, the SF-8 questionnaire for evaluating the subjective health-related quality of life, and the blood pressure/pulse wave test for assessing arteriosclerosis. The risk factors for Clavien–Dindo Grade ≥ III postoperative complications were assessed using these new evaluation methods. Results Clavien–Dindo Grade ≥ III postoperative complications were observed in 28 patients (14.8%). Univariate and multivariate analyses identified male sex, low skeletal muscle mass, and cardio-ankle vascular index ≥ 10 (arteriosclerosis) as significant independent risk factors of developing Grade ≥ III complications. Conclusions Male sex, low skeletal muscle mass, and arteriosclerosis were significant risk factors of postoperative complications in elderly patients undergoing elective gastrointestinal surgery. The obtained knowledge could be useful in identifying high-risk patients who require careful perioperative management.

scholarly journals Risk factors for postoperative delirium after elective major abdominal surgery in elderly patients: A cohort study

2019 ◽  
Vol 71 ◽  
pp. 29-35 ◽  
Author(s):  
T.L. Janssen ◽  
E.W. Steyerberg ◽  
M.C. Faes ◽  
J.H. Wijsman ◽  
P.D. Gobardhan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Abdominal Surgery ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Major Abdominal Surgery ◽  
Surgery In Elderly

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

scholarly journals Preoperative prognostic factors associated with postoperative delirium in older people undergoing surgery: protocol for a systematic review and individual patient data meta-analysis

2020 ◽  
Author(s):  
Tayler A Buchan ◽  
Behnam Sadeghirad ◽  
Nayeli Schmutz ◽  
Nicolai Goettel ◽  
Farid Foroutan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Individual Patient Data ◽  
Elective Surgery ◽  
Meta Analysis ◽  
Patient Data ◽  
Factors Associated ◽  
Increased Risk

Abstract Background: Early identification of patients at risk for postoperative delirium is essential because adequate well-timed interventions could reduce the occurrence of delirium and the related detrimental outcomes.Methods: We will conduct a systematic review and individual patient data (IPD) meta-analysis of prognostic studies evaluating the predictive value of risk factors associated with an increased risk of postoperative delirium in elderly patients undergoing elective surgery. We will identify eligible studies through systematic search of MEDLINE, EMBASE, and CINAHL from their inception to May 2020. Eligible studies will enroll older adults (³ 50 years) undergoing elective surgery and assess pre-operative prognostic risk factors for delirium and incidence of delirium measured by a trained individual using a validated delirium assessment tool. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible studies. We will contact chief investigators of eligible studies requesting to share the IPD to a secured repository. We will use one-stage approach for IPD meta-analysis and will assess certainty of evidence using the GRADE approach.Discussion: Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent postoperative delirium in elderly patients. Systematic review registration: CRD42020171366

Risk factors and adverse clinical outcomes of postoperative delirium in Thai elderly patients: A prospective cohort study

2020 ◽  
Author(s):  
Tanyong Pipanmekaporn ◽  
Yodying Punjasawadwong ◽  
Nahathai Wongpakaran ◽  
Tinakon Wongpakaran ◽  
Kittinan Suwannachai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Elderly Patients ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Postoperative Delirium

scholarly journals Preoperative prognostic factors associated with postoperative delirium in older people undergoing surgery: protocol for a systematic review and individual patient data meta-analysis

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Tayler A. Buchan ◽  
Behnam Sadeghirad ◽  
Nayeli Schmutz ◽  
Nicolai Goettel ◽  
Farid Foroutan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Individual Patient Data ◽  
Elective Surgery ◽  
Meta Analysis ◽  
Patient Data ◽  
Factors Associated ◽  
Increased Risk

Abstract Background Early identification of patients at risk for postoperative delirium is essential because adequate well-timed interventions could reduce the occurrence of delirium and the related detrimental outcomes. Methods We will conduct a systematic review and individual patient data (IPD) meta-analysis of prognostic studies evaluating the predictive value of risk factors associated with an increased risk of postoperative delirium in elderly patients undergoing elective surgery. We will identify eligible studies through systematic search of MEDLINE, EMBASE, and CINAHL from their inception to May 2020. Eligible studies will enroll older adults (≥ 50 years) undergoing elective surgery and assess pre-operative prognostic risk factors for delirium and incidence of delirium measured by a trained individual using a validated delirium assessment tool. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible studies. We will contact chief investigators of eligible studies requesting to share the IPD to a secured repository. We will use one-stage approach for IPD meta-analysis and will assess certainty of evidence using the GRADE approach. Discussion Since we are using existing anonymized data, ethical approval is not required for this study. Our results can be used to guide clinical decisions about the most efficient way to prevent postoperative delirium in elderly patients. Systematic review registration CRD42020171366.

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