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Postoperative delirium

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https://www.readbyqxmd.com/read/27899718/postoperative-delirium-after-liver-transplantation-is-associated-with-increased-length-of-stay-and-lower-survival-in-a-prospective-cohort
#1
Sonja Beckmann, Maria Schubert, Hanna Burkhalter, Philipp Dutkowski, Sabina De Geest
INTRODUCTION: Although postoperative delirium (POD) is a common in-hospital complication associated with negative outcomes, evidence in liver transplantation (LT) is scarce. OBJECTIVE: We examined the incidence and duration of POD, its impact on outcomes and health-care utilization, and described predisposing and precipitating factors favoring POD development. DESIGN: This prospective cohort study included adults undergoing transplantation in a tertiary hospital...
November 28, 2016: Progress in Transplantation
https://www.readbyqxmd.com/read/27893697/morbidity-and-mortality-predictivity-of-nutritional-assessment-tools-in-the-postoperative-care-unit
#2
Şule Özbilgin, Volkan Hanc, Dilek Ömür, Mücahit Özbilgin, Mine Tosun, Serhan Yurtlu, Semih Küçükgüçlü, Atalay Arkan
The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27884743/mortality-and-morbidity-after-spinal-surgery-in-patients-with-parkinson-s-disease-a-retrospective-matched-pair-cohort-study
#3
Takeshi Oichi, Hirotaka Chikuda, Junichi Ohya, Ryo Ohtomo, Kojiro Morita, Hiroki Matsui, Kiyohide Fushimi, Sakae Tanaka, Hideo Yasunaga
BACKGROUND CONTEXT: There is a lack of information about postoperative outcomes and related risk factors associated with spinal surgery in patients with Parkinson's disease (PD). PURPOSE: To investigate the postoperative morbidity and mortality associated with spinal surgery for patients with PD, and the risk factors for poor outcomes. STUDY DESIGN: Retrospective matched-pair cohort study. PATIENT SAMPLE: Data of patients who underwent elective spinal surgery between July 2010 and March 2013 were extracted from the Diagnosis Procedure Combination database, a nationwide inpatient database in Japan...
November 21, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27882039/pediatric-tooth-extractions-under-sedoanalgesia
#4
Ayse Hande Arpaci, Berrin Isik
OBJECTIVE: The present study aims to evaluate intravenous ketamine and inhalation sedation in children, their unwanted side-effects and surgeon satisfaction. METHODS: In this study, data of 922 children aged between 1-18 who underwent tooth extraction under sedoanalgesia in our department between September 2015-January 2016 were gathered and anesthesia approaches, unwanted side effects and surgical satisfaction was investigated. Postoperative recovery emergence agitation or delirium was evaluated with Watcha Behavior Scale (WBS)...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27881118/electrolyte-disorders-and-aging-risk-factors-for-delirium-in-patients-undergoing-orthopedic-surgeries
#5
Li-Hong Wang, Dong-Juan Xu, Xian-Jiao Wei, Hao-Teng Chang, Guo-Hong Xu
BACKGROUND: At present, the exact mechanism of postoperative delirium has not been elucidated. The purpose of this study was to analyze the incidence of delirium in patients undergoing orthopedic surgeries and to explore possible related factors. METHODS: This is a retrospective study. We used 582 patients who had undergone orthopedic surgery between January 2011 and December 2014. The surgeries consisted of 155 cases of internal fixation for intertrochanteric fracture (IFIF), 128 cases of femoral head replacement (FHR), 169 cases of total hip arthroplasty (THA) and 130 cases of total knee arthroplasty (TKA)...
November 23, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27880971/the-risk-factors-of-postoperative-delirium-after-total-knee-arthroplasty
#6
Lih Wang, Sangyun Seok, Sungsoo Kim, Kyungtaek Kim, Seunghyun Lee, Kyungho Lee
We investigated the results of delirium which developed after total knee arthroplasty (TKA) and the risk factors for delirium in the patients who are older than 65 years. From March 2008 to March 2012, we performed a retrospective study on 296 knees of 265 patients who were treated with TKA. They were divided into two groups: 216 patients without delirium and 49 patients diagnosed with delirium by psychiatry. We analyzed the risk factors into three categories: First, the preoperative factors including gender, age, body mass index (BMI), clinical and functional knee joint score (Knee Society Knee Score and Knee Society Function Score) and the number of underlying diseases and associations with each disease; Second, the operative factors including the anesthesia method, amount of blood loss, operating time, laboratory factors, and transfusion count; Third, the postoperative factors such as start time of walking and duration of hospital stay were analyzed...
November 23, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27874185/translating-delirium-prevention-strategies-for-elderly-adults-with-hip-fracture-into-routine-clinical-care-a-pragmatic-clinical-trial
#7
Susan Freter, Katalin Koller, Michael Dunbar, Chris MacKnight, Kenneth Rockwood
OBJECTIVES: To compare the feasibility (adherence) and effectiveness (prevalence of delirium, length of stay, mortality, discharge site) of delirium-friendly preprinted postoperative orders (PPOs) for individuals with hip fracture, administered by regular orthopedic nurses, with routine postoperative orders. DESIGN: Pragmatic clinical trial to evaluate a quality improvement intervention. SETTING: Tertiary care hospital. PARTICIPANTS: Individuals aged 65 and older admitted for hip fracture repair (N = 283)...
November 22, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27871631/-benefit-of-general-anesthesia-monitored-by-bispectral-index-compared-with-monitoring-guided-only-by-clinical-parameters-systematic-review-and-meta-analysis
#8
Carlos Rogério Degrandi Oliveira, Wanderley Marques Bernardo, Victor Moisés Nunes
BACKGROUND: The bispectral index parameter is used to guide the titration of general anesthesia; however, many studies have shown conflicting results regarding the benefits of bispectral index monitoring. The objective of this systematic review with meta-analysis is to evaluate the clinical impact of monitoring with the bispectral index parameter. METHODS: The search for evidence in scientific information sources was conducted during December 2013 to January 2015, the following primary databases: Medline/PubMed, LILACS, Cochrane, CINAHL, Ovid, SCOPUS and TESES...
November 18, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27871601/effects-of-low-dose-propofol-vs-ketamine-on-emergence-cough-in-children-undergoing-flexible-bronchoscopy-with-sevoflurane-remifentanil-anesthesia-a-randomized-double-blind-placebo-controlled-trial
#9
Tulun Ozturk, Arzu Acıkel, Ozge Yılmaz, Ismet Topçu, Eralp Çevıkkalp, Hasan Yuksel
STUDY OBJECTIVE: To determine the effects of low-dose ketamine and propofol on cough during emergence and the recovery period when administered at emergence in children undergoing fiberoptic bronchoscopy for bronchoalveolar lavage (FOBL) with sevoflurane-remifentanil anesthesia. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Operating room, postoperative recovery area. PATIENTS: Sixty-eight children aged 1 to 8 years old undergoing elective diagnostic FOBL...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27852723/regional-versus-general-anesthesia-for-promoting-independence-after-hip-fracture-regain-protocol-for-a-pragmatic-international-multicentre-trial
#10
Mark D Neuman, Susan S Ellenberg, Frederick E Sieber, Jay S Magaziner, Rui Feng, Jeffrey L Carson
INTRODUCTION: Hip fractures occur 1.6 million times each year worldwide, with substantial associated mortality and losses of independence. At present, anaesthesia care for hip fracture surgery varies widely within and between countries, with general anaesthesia and spinal anaesthesia representing the 2 most common approaches. Limited randomised evidence exists regarding potential short-term or long-term differences in outcomes between patients receiving spinal or general anaesthesia for hip fracture surgery...
November 15, 2016: BMJ Open
https://www.readbyqxmd.com/read/27849706/26-intraoperative-oxidative-stress-and-postoperative-delirium
#11
Marcos Lopez, Frederic Billings
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849158/neurological-injury-in-intermediate-risk-transcatheter-aortic-valve-implantation
#12
Jonathon P Fanning, Allan J Wesley, Darren L Walters, Eamonn M Eeles, Adrian G Barnett, David G Platts, Andrew J Clarke, Andrew A Wong, Wendy E Strugnell, Cliona O'Sullivan, Oystein Tronstad, John F Fraser
BACKGROUND: The application of transcatheter aortic valve implantation (TAVI) to intermediate-risk patients is a controversial issue. Of concern, neurological injury in this group remains poorly defined. Among high-risk and inoperable patients, subclinical injury is reported on average in 75% undergoing the procedure. Although this attendant risk may be acceptable in higher-risk patients, it may not be so in those of lower risk. METHODS AND RESULTS: Forty patients undergoing TAVI with the Edwards SAPIEN-XT(™) prosthesis were prospectively studied...
November 15, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27847677/the-use-of-moca-and-other-cognitive-tests-in-evaluation-of-cognitive-impairment-in-elderly-patients-undergoing-arthroplasty
#13
Jukka Puustinen, Liisa Luostarinen, Markku Luostarinen, Veijo Pulliainen, Heini Huhtala, Marjo Soini, Jaana Suhonen
OBJECTIVE: To examine the prevalence and effect of cognitive impairment on treatment outcomes in elderly patients undergoing arthroplasty and to describe the feasibility of cognitive tests. MATERIALS AND METHODS: The participants were 52 patients with a mean age of 78 years 11 months (SD: 3.3), waiting for primary arthroplasty. We translated Montreal Cognitive Assessment (MoCA) into Finnish and compared it with Mini-Mental State Examination (MMSE), Mini-Cog, and clock-drawing tests prior to and 3 months after the surgery...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/27846169/decreased-incidence-of-postoperative-delirium-in-robot-assisted-thoracoscopic-esophagectomy-compared-with-open-transthoracic-esophagectomy
#14
Dae Myoung Jeong, Jie Ae Kim, Hyun Joo Ahn, Mikyung Yang, Burn Young Heo, Soo Hee Lee
BACKGROUND: Postoperative delirium (POD) is one of messy complications related with increased mortality and hospital costs. Patients undergoing esophagectomy are more in danger of delirium than other kinds of surgeries. We investigated the impact of robot-assisted thoracoscopic esophagectomy on the incidence of POD compared with open transthoracic esophagectomy. MATERIALS AND METHODS: A retrospective review was completed for the patients who underwent esophagectomy from December 2, 2012 and April 15, 2015 (n=529)...
November 14, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27830713/efficacy-and-acceptability-of-different-auxiliary-drugs-in-pediatric-sevoflurane-anesthesia-a-network-meta-analysis-of-mixed-treatment-comparisons
#15
Wuchao Wang, Panchuan Huang, Weiwei Gao, Fangli Cao, Mingling Yi, Liyong Chen, Xiaoli Guo
Emergence agitation preventive medicine should be combined with pediatric anesthesia because of the high frequency of emergence agitation. However, it is challenging to determine the most appropriate medication that can be introduced into pediatric anesthesia for the sake of emergence agitation prevention. We reviewed and retrieved the data from PubMed and Embase. Various medications were assessed based on several endpoints including Emergence agitation outcomes (EA), postoperative nausea and vomiting (PONV), the number of patients who required analgesic (RA), pediatric anesthesia emergence delirium (PAED), the extubation time, the emergency time and the duration of post-anesthesia care unit (PACU) stay...
November 10, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27830365/haloperidol-prophylaxis-for-preventing-aggravation-of-postoperative-delirium-in-elderly-patients-a-randomized-open-label-prospective-trial
#16
Shinji Fukata, Yasuji Kawabata, Ken Fujishiro, Yuichi Kitagawa, Kojiro Kuroiwa, Hirotoshi Akiyama, Marie Takemura, Masahiko Ando, Hideyuki Hattori
PURPOSES: The aim of this study was to evaluate the safety and efficacy of the early administration haloperidol in preventing the aggravation of postoperative delirium in elderly patients. METHODS: A total of 201 patients (age ≥75 years) who underwent elective surgery were enrolled. The patients were divided into two groups: the intervention group (n = 101) received prophylactic haloperidol (5 mg); the control group (n = 100) did not. Haloperidol was administered daily during postoperative days 0-5 to the patients who presented with NEECHAM scores of 20-24 when measured at 18:00...
November 9, 2016: Surgery Today
https://www.readbyqxmd.com/read/27822212/systemic-hmgb1-neutralization-prevents-postoperative-neurocognitive-dysfunction-in-aged-rats
#17
Niccolò Terrando, Ting Yang, Xueqin Wang, Jiakai Fang, Mengya Cao, Ulf Andersson, Harris Helena Erlandsson, Wen Ouyang, Jianbin Tong
Postoperative neurocognitive disorders are common complications in elderly patients following surgery or critical illness. High mobility group box 1 protein (HMGB1) is rapidly released after tissue trauma and critically involved in response to sterile injury. Herein, we assessed the role of HMGB1 after liver surgery in aged rats and explored the therapeutic potential of a neutralizing anti-HMGB1 monoclonal antibody in a clinically relevant model of postoperative neurocognitive disorders. Nineteen to twenty-two months Sprague-Dawley rats were randomly assigned as: (1) control with saline; (2) surgery, a partial hepatolobectomy under sevoflurane anesthesia and analgesia, + immunoglobulin G as control antibody; (3) surgery + anti-HMGB1...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27822051/production-of-inflammatory-cytokines-cortisol-and-a%C3%AE-1-40-in-elderly-oral-cancer-patients-with-postoperative-delirium
#18
Lulu Sun, Peiyu Jia, Junfeng Zhang, Xin Zhang, Yiwei Zhang, Hong Jiang, Wei Jiang, Yong Guo
AIM: Pathophysiological disorders after surgery might be related to postoperative delirium (POD). This study was designed to elucidate the pathogenesis of POD in elderly oral cancer patients by determining the perioperative kinetics of inflammatory cytokines, cortisol, and amyloid β1-40 (Aβ1-40). METHODS: A total of 257 elderly oral cancer patients who underwent tumor resection surgery were selected. Venous blood was collected prior to surgery (T0), at the end of surgery (T1), and at 12 hours after surgery (T2)...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27821819/-effect-of-ultra-fast-track-extubation-in-cardiovascular-surgery
#19
Toshiro Kobayashi, Hiroshi Kurazumi, Hidenori Gohra, Seiichi Shibasaki, Yuko Kudo, Naoko Yamauchi, Takashi Tamura, Michio Shigedomi
Fast-track surgery has been widely implemented and allows such immediate extubation as in the operating room(OR). We retrospectively investigated the effect of routine ultra-fast-track(UFT) surgery extubating in the OR in patients undergoing cardiovascular operations. Among 333 consecutive patients, 224 (67.3%)were extubated in the OR. Five patients were re-intubated, but none were because of heart or respiratory failure. Independent predictors for failure of OR extubation were preoperative renal failure, pre-existent cerebrovascular disease, emergency surgery, and prolonged operation and/or cardiopulmonary bypass times...
November 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27809817/a-personality-trait-contributes-to-the-occurrence-of-postoperative-delirium-a-prospective-study
#20
Jung Eun Shin, Sunghyon Kyeong, Jong-Seok Lee, Jin Young Park, Woo Suk Lee, Jae-Jin Kim, Kyu Hyun Yang
BACKGROUND: Although various physical risk factors for delirium have been identified, the effect of psychological aspects is currently unknown. This study aimed to examine psychological risk factors for postoperative delirium and to identify hidden subgroups of delirium in clinical and psychological feature space. METHODS: Among 200 patients with hip fracture, 78 elderly patients were prospectively evaluated for clinical and psychological assessments before surgery...
November 3, 2016: BMC Psychiatry
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