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Postoperative delirium

Xin Jiang, Dong Chen, Yahao Lou, Zhongshi Li
BACKGROUND: Postoperative delirium is a common complication following various operative procedures with an incidence rate of 10-77 %. AIM: To analyze various risk factors for postoperative delirium after spine surgery in the middle- and old-aged patients. METHODS: This study retrospectively reviewed 451 patients (226 males and 225 females, an average age of 65.1 ± 18.3 years) who underwent spinal surgery in our hospital between January 2010 and August 2015...
October 20, 2016: Aging Clinical and Experimental Research
Susana Vacas, Vincent Degos, Mervyn Maze
BACKGROUND: Sleep is integral to biologic function, and sleep disruption can result in both physiological and psychologic dysfunction including cognitive decline. Surgery activates the innate immune system, inducing neuroinflammatory changes that interfere with cognition. Because surgical patients with sleep disorders have an increased likelihood of exhibiting postoperative delirium, an acute form of cognitive decline, we investigated the contribution of perioperative sleep fragmentation (SF) to the neuroinflammatory and cognitive responses of surgery...
October 11, 2016: Anesthesia and Analgesia
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)
Hannah A D Keage, Ashleigh Smith, Tobias Loetscher, Peter Psaltis
Older individuals can now undergo invasive cardiovascular procedures without serious concern about mortality, and the numbers and proportions of the over 65s and 85s doing so in Australia has been increasing over the last 20 years. There is overwhelming evidence linking cardiovascular conditions to late-life (65 years and over) cognitive impairment and dementia including Alzheimer's Disease, primarily due to impaired cerebrovascularisation and cascading neuropathological processes. Somewhat paradoxically, these cardiovascular interventions, carried out with the primary aim of revascularisation, are not usually associated with short- or long-term improvements in cognitive function in older adults...
September 23, 2016: Heart, Lung & Circulation
Leslie S P Eide, Anette H Ranhoff, Bengt Fridlund, Rune Haaverstad, Karl Ove Hufthammer, Karel K J Kuiper, Jan Erik Nordrehaug, Tone M Norekvål
OBJECTIVES: To determine whether postoperative delirium predicts first-time readmissions and mortality in octogenarian patients within 180 days after aortic valve therapy with surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI), and to determine the most common diagnoses at readmission. DESIGN: Prospective cohort study of patients undergoing elective SAVR or TAVI. SETTING: Tertiary university hospital that performs all SAVRs and TAVIs in Western Norway...
October 5, 2016: BMJ Open
Rostislav Horacek, Barbora Krnacova, Jan Prasko, Klara Latalova
BACKGROUND: The aim of this study was to examine the impact of somatic illnesses, electrolyte imbalance, red blood cell count, hypotension, and antipsychotic and opioid treatment on the duration of delirium in Central Intensive Care Unit for Surgery. PATIENTS AND METHODS: Patients who were admitted to the Department of Central Intensive Care Unit for Surgery in the University Hospital Olomouc from February 2004 to November 2008 were evaluated using Riker sedation-agitation scale...
2016: Neuropsychiatric Disease and Treatment
Charles H Brown, Andrew LaFlam, Laura Max, Julie Wyrobek, Karin J Neufeld, Khaled M Kebaish, David B Cohen, Jeremy D Walston, Charles W Hogue, Lee H Riley
OBJECTIVES: To characterize the incidence, risk factors, and consequences of delirium in older adults undergoing spine surgery. DESIGN: Prospective observational study. SETTING: Academic medical center. PARTICIPANTS: Individuals aged 70 and older undergoing spine surgery (N = 89). MEASUREMENTS: Postoperative delirium and delirium severity were assessed using validated methods, including the Confusion Assessment Method (CAM), CAM for the Intensive Care Unit, Delirium Rating Scale-Revised-98, and chart review...
October 3, 2016: Journal of the American Geriatrics Society
Matthew Umholtz, John Cilnyk, Christopher K Wang, Jahan Porhomayon, Leili Pourafkari, Nader D Nader
STUDY OBJECTIVE: Recovery from anesthesia may be complicated with development of severe panic symptoms and anxiety. Preexisting anxiety disorder has been reported as a risk factor for development of these symptoms. We aimed to examine the frequency of emergence delirium (EDL) among veterans diagnosed with posttraumatic stress disorders (PTSDs). DESIGN: Retrospective cohort. SETTING: Postoperative recovery area. PATIENTS: Perioperative information of 1763 consecutive patients who underwent a surgical procedure requiring general anesthesia were collected...
November 2016: Journal of Clinical Anesthesia
Neziha Karabulut, Yeşim Yaman Aktaş
PURPOSE: The purpose of the study was to examine nurses' approaches to care of patients with postoperative delirium in the postanesthesia care unit and intensive care unit. DESIGN: A descriptive survey design was used. METHODS: Eighty-seven nurses who have been working at a Training and Research Hospital in Erzurum, east of Turkey, were enrolled in this study between October 1 and November 20, 2012. FINDINGS: 83.9% of the nurses reported that they had given pharmacologic therapy for pain management in delirium patients, 39...
October 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Fernanda Herrera da Costa, Paulo Adilson Herrera, Cecília Luiz Pereira-Stabile, Glaykon Alex Vitti Stabile
Delirium is an organic mental syndrome with acute onset characterized by diffuse brain dysfunction and neural activity disorganization. It is usually related to cognition and perception changes, decreased level of consciousness, and disorganization of thoughts that are unrelated to previous dementia. Occurrence is more frequent in patients with previous degenerative disease and elderly patients, especially those older than 85 years. Although the pathophysiology is not totally known, studies have shown that, among the main factors that lead to delirium, the drugs used for general anesthesia induction are the most relevant (hypnotics, anticholinergic drugs, and H2 receptor blockers), especially those used in long surgical procedures...
August 27, 2016: Journal of Oral and Maxillofacial Surgery
Ane-Victoria Idland, Torgeir Bruun Wyller, Randi Støen, Lars Magne Eri, Frede Frihagen, Johan Ræder, Farrukh Abbas Chaudhry, Oskar Hansson, Henrik Zetterberg, Kaj Blennow, Nenad Bogdanovic, Anne Brækhus, Leiv Otto Watne
BACKGROUND: The clinical relevance of brain β-amyloidosis in older adults without dementia is not established. As delirium and dementia are strongly related, studies on patients with delirium may give pathophysiological clues. OBJECTIVE: To determine whether the Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers amyloid-β 1-42 (Aβ42), total tau (T-tau), and phosphorylated tau (P-tau) are associated with delirium in hip fracture patients with and without dementia...
September 20, 2016: Journal of Alzheimer's Disease: JAD
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)...
September 21, 2016: Journal of the American Geriatrics Society
G Sousa, C Pinho, A Santos, F J Abelha
INTRODUCTION: Postoperative delirium (POD) is an acute confusional state characterized by changes in consciousness and cognition, which may be fluctuating, developing in a small period of time. The aim of this study was to evaluate the relationship between alcohol abuse and the development of POD. METHODS: We prospectively evaluated consecutively all postoperative patients admitted in the Post-anesthesia Care Unit over a 1-month period for delirium, using the Portuguese versions of the the Nursing Delirium Screening Scale...
September 15, 2016: Revista Española de Anestesiología y Reanimación
Jean Gabriel Charchaflieh
No abstract text is available yet for this article.
October 2016: Critical Care Medicine
J W Raats, S L Steunenberg, D C de Lange, L van der Laan
BACKGROUND: Postoperative delirium is a common and serious adverse event in the elderly patient and is associated with significant morbidity and mortality. It is of great importance to identify patients at risk for delirium, in order to focus preventive strategies. The aim of this article is to systematically review current available literature on pre-operative risk factors for delirium after vascular surgery. METHODS: A systematic literature search was conducted using PubMed and EMBASE, using the MeSH terms and key words "delirium", "surgery" and "risk factor"...
September 6, 2016: International Journal of Surgery
Judith H Tomlinson, Judith S L Partridge
Postoperative delirium is a common complication in the older surgical population, occurring in 10-50 % of cases. It is thought to be more common if an individual is identified as frail. Postoperative delirium is associated with poor outcome including higher mortality rates, prolonged length of hospital stay, increased care needs on discharge and longer term post-traumatic stress disorder. Guidelines from the American Geriatric Society and the National Institute for Health and Care Excellence highlight the importance of risk assessment at the time of the preoperative visit...
2016: Perioperative Medicine
Erica J Stein, David B Glick
PURPOSE OF REVIEW: Initial studies suggested that the use of processed electroencephalogram technology could significantly decrease the incidence of unintended intraoperative awareness events during general anesthesia. Subsequent work has cast doubts on these findings. This review will examine the current state of awareness monitoring. RECENT FINDINGS: Recently published randomized controlled trials examining the use of the bispectral index during general anesthesia have not been able to show superiority over other forms of monitoring depth of anesthesia, such as end-tidal anesthetic-agent concentration...
August 31, 2016: Current Opinion in Anaesthesiology
Li-Kai Wang, Kuo-Mao Lan, Yao-Tsung Lin, Jen-Yin Chen
No abstract text is available yet for this article.
2016: Neuropsychiatric Disease and Treatment
M Franck, K Nerlich, B Neuner, P Schlattmann, W R Brockhaus, C D Spies, F M Radtke
BACKGROUND: Post-operative delirium and post-operative cognitive dysfunction (POCD) are both common but it has not been clarified how closely they are associated. We aimed to assess the possible relationship in a secondary analysis of data from the 'Surgery Depth of anaesthesia and Cognitive outcome'- study. METHODS: We included patients aged ≥ 60 years undergoing non-cardiac surgery planned for longer than 60 min. Delirium was assessed according to the Diagnostic and Statistical Manual of Mental Disorders IV criteria in the post-anaesthesia care unit (PACU) as well as within the first week after surgery...
November 2016: Acta Anaesthesiologica Scandinavica
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