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Charlson's comorbidity index, risk factor delirium

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https://www.readbyqxmd.com/read/29567515/in-hospital-complication-rate-following-microendoscopic-versus-open-lumbar-laminectomy-a-propensity-score-matched-analysis
#1
Takeshi Oichi, Yasushi Oshima, Hirotaka Chikuda, Junichi Ohya, Hiroki Matsui, Kiyohide Fushimi, Sakae Tanaka, Hideo Yasunaga
BACKGROUND CONTEXT: The incidence of postoperative complications after microendoscopic laminectomy (MEL) has not been compared with that of open laminectomy in a large study, so it is not clear whether MEL is a safer procedure. PURPOSE: To compare postoperative morbidity and mortality following lumbar laminectomy between patients treated with MEL and open laminectomy. STUDY DESIGN: Retrospective cohort study with propensity score-matched analysis...
March 19, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29372598/risk-of-hospitalization-associated-with-anticholinergic-medication-for-patients-with-dementia
#2
Shuichi Watanabe, Takahide Fukatsu, Kosuke Kanemoto
BACKGROUND: With the ageing of the general population, demand has grown for measures to prevent hospitalization for dementia, which can exacerbate problems associated with activities of daily living in elderly individuals. Anticholinergic medication has been shown to cause falls, delirium, and cognitive impairment in aged patients. However, the risk of hospitalization associated with the administration of anticholinergics is unclear. METHODS: We analyzed the records of 61 outpatients (26 men, 35 women; mean age: 78 ± 7 years; mean follow-up period: 420 days) diagnosed with dementia (Alzheimer's disease: n = 45; dementia with Lewy bodies: n = 3; undifferentiated n = 13) and prescribed anti-dementia drugs between May 2013 and December 2014...
January 2018: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://www.readbyqxmd.com/read/29214512/anticholinergic-prescribing-in-medicare-part-d-beneficiaries-residing-in-nursing-homes-results-from-a-retrospective-cross-sectional-analysis-of-medicare-data
#3
Joshua Niznik, Xinhua Zhao, Tao Jiang, Joseph T Hanlon, Sherrie L Aspinall, Joshua Thorpe, Carolyn Thorpe
BACKGROUND: Prescribing of medications with anticholinergic properties in older nursing home residents is relatively common, despite an association with an increased risk for falls, delirium, and other outcomes. Few studies have investigated what factors influence different levels of prescribing of these agents. OBJECTIVES: The primary objective was to identify factors associated with low- and high-level anticholinergic burden in nursing home residents. A secondary objective was to examine in detail the contribution of different medications to low versus high burden to aid in determining which drugs to target in interventions...
December 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29178096/-risk-factors-and-outcomes-of-postoperative-delirium-in-colorectal-cancer-patients-over-60-years
#4
Haitao Zhang, Yuanzhi Tang, Ying Qin
OBJECTIVE: To determine the incidence, risk factors and clinical outcomes of postoperative delirium in colorectal cancer patients over 60 years. METHODS: Consecutive 382 patients older than 60 years undergoing colorectal cancer surgery at Shenzhen Second People's Hospital from June 2013 to June 2016 were recruited prospectively in this study. These patients were evaluated daily after surgery for 7 days by confusion assessment method. Clinical outcomes were compared between patients with and without postoperative delirium, including postoperative complications, length of hospital stay, and mortality within 30 days...
November 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29164173/factors-related-to-the-severity-of-delirium-in-the-elderly-patients-with-infection
#5
R A Tuty Kuswardhani, Yosef Samon Sugi
Objective: Delirium is a common neuropsychiatric syndrome in the elderly characterized by concurrent impairments in cognition and behavior. Infection is one of the most important risk factors for delirium. The objective of this study is to elaborate the factors related to the severity of delirium in the elderly patients with infection. Method: An observational study on the relationship of several clinical parameters and the severity of delirium in elderly patients (more than 60 years) with infection was conducted at Geriatric Inpatient Ward, Sanglah Hospital...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28822348/risk-factors-for-potential-drug-drug-interactions-in-intensive-care-unit-patients
#6
Slobodan M Janković, Ana V Pejčić, Miloš N Milosavljević, Valentina D Opančina, Nikola V Pešić, Tamara T Nedeljković, Goran M Babić
PURPOSE: To determine risk factors for each severity-based category of potential drug-drug interactions (DDIs) encountered at intensive care unit (ICU) patients. METHODS: This was a retrospective cohort analysis of patients treated at the ICU of the Clinical Center Kragujevac, a public tertiary care hospital in Kragujevac, Serbia. Three interaction checkers were used to reveal drug-drug interactions: Medscape, Epocrates and Micromedex. RESULTS: The study included 201 patients, 66...
February 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/28655417/-functional-impairment-associated-with-cognitive-impairment-in-hospitalised-elderly
#7
José Mauricio Ocampo-Chaparro, José Ignacio Mosquera-Jiménez, Annabelle S Davis, Carlos A Reyes-Ortiz
INTRODUCTION: The aim of this study was to analyse the effect of cognitive impairment on functional decline in hospitalised patients aged ≥60 years. METHODS: Measurements at admission included demographic data, Charlson's comorbidity index, and cognitive impairment (according to education level). Data were also collected on hospital length of stay, depression, and delirium developed during hospitalisation. The outcome, Barthel Index (BI), was measured at admission, discharge, and 1-month post-discharge...
January 2018: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28421731/intraoperative-dexmedetomidine-sedation-reduces-the-postoperative-agitated-behavior-in-elderly-patients-undergoing-orthopedic-surgery-compared-to-the-propofol-sedation
#8
Hyun-Jung Shin, Bon-Wook Koo, Seung-Uk Bang, Jin-Hee Kim, Jung-Won Hwang, Sang-Hwan DO, Hyo-Seok Na
BACKGROUND: Postoperative agitation or confusion is one of the symptoms of hyperactive delirium in elderly patients. We retrospectively evaluated the incidence of postoperative abnormal psychomotor behavior in elderly surgical patients according to the use of different intraoperative sedative agents: dexmedetomidine vs. propofol. METHODS: The medical records of 855 elderly patients, who underwent orthopedic surgery with regional anesthesia between July 2012 and September 2015, were divided into two groups, the dexmedetomidine group (N...
October 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28329149/prediction-of-long-term-cognitive-decline-following-postoperative-delirium-in-older-adults
#9
Elizabeth E Devore, Tamara G Fong, Edward R Marcantonio, Eva M Schmitt, Thomas G Travison, Richard N Jones, Sharon K Inouye
Background: Increasing evidence suggests that postoperative delirium may result in long-term cognitive decline among older adults. Risk factors for such cognitive decline are unknown. Methods: We studied 126 older participants without delirium or dementia upon entering the Successful AGing After Elective Surgery (SAGES) study, who developed postoperative delirium and completed repeated cognitive assessments (up to 36 months of follow-up). Pre-surgical factors were assessed preoperatively and divided into nine groupings of related factors ("domains")...
November 9, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28291765/cervical-spine-surgery-complications-and-risks-in-the-elderly
#10
Kris Radcliff, Kevin L Ong, Scott Lovald, Edmund Lau, Mark Kurd
STUDY DESIGN: Cervical decompression (CD) and cervical fusion (CF) patients in 5% Medicare Part B claims data. OBJECTIVE: Evaluate the complication rate and associated risk factors after cervical spine surgery using a national sample of elderly patients. SUMMARY OF BACKGROUND DATA: The number of cervical spine procedures in the United States has risen along with associated hospital costs. Postoperative complications lead to longer hospitalizations and greater costs...
March 15, 2017: Spine
https://www.readbyqxmd.com/read/28260868/the-diagnosis-of-delirium-in-an-acute-care-hospital-in-moscow-what-does-the-pandora-s-box-contain
#11
Olga N Tkacheva, Nadezda K Runikhina, Arkadiy L Vertkin, Irina V Voronina, Natalia V Sharashkina, Elen A Mkhitaryan, Valentina S Ostapenko, Elena A Prokhorovich, Tamar Freud, Yan Press
BACKGROUND: Delirium, a common problem among hospitalized elderly patients, is not usually diagnosed by doctors for various reasons. The primary aim of this study was to evaluate the effect of a short training course on the identification of delirium and the diagnostic rate of delirium among hospitalized patients aged ≥65 years. The secondary aim was to identify the risk factors for delirium. METHODS: A prospective study was conducted in an acute-care hospital in Moscow, Russia...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27984252/perioperative-complications-of-spinal-metastases-surgery
#12
Panya Luksanapruksa, Jacob M Buchowski, Lukas P Zebala, Christopher K Kepler, Weerasak Singhatanadgige, David B Bumpass
The incidence of symptomatic spinal metastasis has increased due to treatment improvements and longer patient survival. More patients with spinal tumors are choosing operative treatment with an associated increased rate of perioperative complications. Operative metastatic disease treatment complication rates have also increased with overall rates ranging from 5.3% to 76.20%. The common surgical-related complications are iatrogenic dural injury and wound complications. The most common postoperative medical complications are delirium, pneumonia, and deep vein thrombosis...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27650453/a-simple-tool-to-predict-development-of-delirium-after-elective-surgery
#13
Andy Dworkin, David S H Lee, Amber R An, Sarah J Goodlin
OBJECTIVES: To identify a quick clinical tool to assess the risk of delirium after elective surgery. DESIGN: Prospective observational study. SETTING: Preoperative assessment clinic at the Veterans Affairs Portland Health Care System. PARTICIPANTS: Community-living veterans aged 65 and older scheduled for elective surgery requiring general or major anesthesia. MEASUREMENTS: Confusion Assessment Method (CAM) or Family Confusion Assessment Method (FAM-CAM)...
November 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27463247/postoperative-delirium-in-patients-after-pancreaticoduodenectomy
#14
Yasuhiro Ito, Yuta Abe, Kan Handa, Shintaro Shibutani, Tomohisa Egawa, Atsushi Nagashima, Minoru Kitago, Osamu Itano, Yuko Kitagawa
BACKGROUND/AIMS: Postoperative delirium (POD) is one of the most common complications after various types of surgery. The aim of this study was to investigate the incidence and risk factors for delirium after pancreaticoduodenectomy (PD). METHODS: This was a retrospective study of 146 consecutive patients who underwent PD between April 2007 and June 2015 at Saiseikai Yokohamashi Tobu Hospital. RESULTS: Twenty-nine patients (19.9%) were diagnosed with delirium...
2017: Digestive Surgery
https://www.readbyqxmd.com/read/27105460/medical-complications-after-adult-spinal-deformity-surgery-incidence-risk-factors-and-clinical-impact
#15
Alex Soroceanu, Douglas C Burton, Jonathan Haim Oren, Justin S Smith, Richard Hostin, Christopher I Shaffrey, Behrooz A Akbarnia, Christopher P Ames, Thomas J Errico, Shay Bess, Munish C Gupta, Vedat Deviren, Frank J Schwab, Virginie Lafage
STUDY DESIGN: Retrospective review of a prospective multicenter database evaluating surgical adult spinal deformity (ASD) patients. OBJECTIVE: This study aims to identify risk factors for medical complications in ASD patients undergoing surgery. SUMMARY OF BACKGROUND DATA: ASD surgery is known for its high complication rate. This study examines baseline patient characteristics for predictors of medical complications in surgical ASD patients...
November 15, 2016: Spine
https://www.readbyqxmd.com/read/26955385/the-influence-of-patient-characteristics-on-anticholinergic-events-in-older-people
#16
Mohammed Saji Salahudeen, Prasad S Nishtala, Stephen B Duffull
AIMS: To examine patient characteristics that predict adverse anticholinergic-type events in older people. METHODS: This retrospective population-level study included 2,248 hospitalised patients. Individual data on medicines that are commonly associated with anticholinergic events (delirium, constipation and urinary retention) were identified. Patient characteristics examined were medicines with anticholinergic effects (ACh burden), age, sex, non-anticholinergic medicines (non-ACM), Charlson comorbidity index scores and ethnicity...
September 2015: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/26412147/short-form-mini-nutritional-assessment-as-a-useful-method-of-predicting-the-development-of-postoperative-delirium-in-elderly-patients-undergoing-orthopedic-surgery
#17
Che-Sheng Chu, Chih-Kuang Liang, Ming-Yueh Chou, Yu-Te Lin, Chien-Jen Hsu, Po-Han Chou, Chin-Liang Chu
OBJECTIVE: Postoperative delirium (POD) is a major cause for concern among elderly patients undergoing surgery, often resulting in poor outcome. It is therefore important to predict and prevent POD. The aim of this study was to evaluate the Mini Nutritional Assessment Short-Form (MNA-SF) as a predictor of POD after orthopedic surgery. METHODS: Elderly patients undergoing orthopedic surgery between April 2011 and March 2013 were included in the study (n=544; mean age, 74...
January 2016: General Hospital Psychiatry
https://www.readbyqxmd.com/read/26044170/delirium-among-elderly-patients-admitted-to-a-post-acute-care-facility-and-3-months-outcome
#18
Doris Ka Ying Miu, Ching Wai Chan, Ching Kok
AIM: To investigate the prevalence and risk factors of delirium in an extended care unit, the persistence of delirium and 3-month outcome. METHOD: Patients aged >65 years were recruited. Basic demographic data, medical comorbidity using the Charlson Comorbidity Index, pre-existing cognitive impairment using the informant questionnaire on cognitive decline in the elderly, place of residence and physical function as measured by the modified Barthel Index were recorded...
May 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/25920706/delirium-and-other-clinical-factors-with-clostridium-difficile-infection-that-predict-mortality-in-hospitalized-patients
#19
Laurie R Archbald-Pannone, Timothy L McMurry, Richard L Guerrant, Cirle A Warren
BACKGROUND: Clostridium difficile infection (CDI) severity has increased, especially among hospitalized older adults. We evaluated clinical factors to predict mortality after CDI. METHODS: We collected data from inpatients diagnosed with CDI at a U.S. academic medical center (HSR-IRB#13630). We evaluated age, Charlson comorbidity index (CCI), whether patients were admitted from a long-term care facility, whether patients were in an intensive care unit (ICU) at the time of diagnosis, white blood cell count (WBC), blood urea nitrogen (BUN), low body mass index, and delirium as possible predictors...
July 1, 2015: American Journal of Infection Control
https://www.readbyqxmd.com/read/25641773/impact-of-an-inpatient-geriatric-consultative-service-on-outcomes-for-cognitively-impaired-patients
#20
Arif Nazir, Babar Khan, Steven Counsell, Macey Henderson, Sujuan Gao, Malaz Boustani
BACKGROUND: Impact of geriatric consultative services (GCS) on hospital readmission and mortality outcomes for cognitively impaired (CI) patients is not known. OBJECTIVE: Evaluate impact of GCS on hospital readmission and mortality among CI inpatients. DESIGN: Secondary data analysis of a prospective trial of a computerized decision support system between July 1, 2006 and May 30, 2008. SETTING: Study conducted at Eskenazi hospital, Indianapolis, Indiana, a 340-bed, public hospital with over 2300 yearly admissions of patients ages 65 years or older...
May 2015: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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