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post operative delirium

Tomas L Griebling
No abstract text is available yet for this article.
May 2017: Journal of Urology
Yi-Qing Zou, Xiao-Bao Li, Zhi-Xing Yang, Jing-Min Zhou, Yi-Nan Wu, Zhi-Hu Zhao, Xiang-Zhu Liu, Chang-Li Hu
BACKGROUND: Conflict findings of the impact of inhalational anesthetics on postoperative cognitive function are reported. No systematic review has been performed to solve the problem. The aim of the study was to assess the effect of different inhalational anesthetics on postoperative cognitive function in a network meta-analysis. METHODS: We will search MEDLINE, EMBASE, the Central Register of Controlled Trials in the Cochrane library, and CINAHL for randomized controlled trials or cohort studies assessing the short-term or long-term cognitive function of elderly patients (over 60 years) receiving major surgeries and inhalational anesthetics (desflurane, isoflurane, sevoflurane, halothane, and nitrous oxide) during surgery...
January 2018: Medicine (Baltimore)
Drayton A Hammond, Laura Baumgartner, Craig Cooper, Elisabeth Donahey, Serena A Harris, Jessica M Mercer, Mandy Morris, Mona K Patel, Angela M Plewa-Rusiecki, Alia A Poore, Ryan Szaniawski, Deanna Horner
PURPOSE: To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2017. The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 32 journals monthly for impactful articles and reviewed 115 during 2017. Two meta-analyses and eight original research trials were reviewed here from those included in the monthly CCPLU. Meta-analyses on early, goal-directed therapy for septic shock and statin therapy for acute respiratory distress syndrome were summarized...
February 26, 2018: Journal of Critical Care
Silvio Simeone, Gianluca Pucciarelli, Marco Perrone, Teresa Rea, Gianpaolo Gargiulo, Assunta Guillari, Gaetano Castellano, Luigi Di Tommaso, Massimo Niola, Gabriele Iannelli
AIMS AND OBJECTIVES: To observe the clinical and structural factors that can be associated with the post-operative onset of delirium in patients who have undergone heart surgery. BACKGROUND: Several risk factors could contribute to the development of delirium, such as the use of some sedative drugs and a patient's history with certain types of acute chronic disease. However, in the literature, there is little knowledge about the association between delirium in patients who have undergone cardio-surgical intervention and their clinical and environmental predictors...
March 1, 2018: Journal of Clinical Nursing
Holger Eggebrecht, Kurt Bestehorn, Tienush Rassaf, Maike Bestehorn, Thomas Voigtländer, Eckhard Fleck, Volker Schächinger, Axel Schmermund, Rajendra H Mehta
AIMS: Randomised trials comparing transcatheter aortic valve replacement (TAVR) with surgical aortic valve replacement (SAVR) have included mainly elderly patients >80 years. The authors investigated comparative in-hospital outcomes of younger patients <75 years undergoing transfemoral (TF) TAVR or isolated SAVR. METHODS AND RESULTS: A total of 6,972 patients aged 65-74 years undergoing TF-TAVR or SAVR between 2013 and 2014 were identified from the observational German Quality Assurance Registry on Aortic Valve Replacement (AQUA), which comprises all TAVR and SAVR procedures performed in Germany...
February 27, 2018: EuroIntervention
Brian J Anderson, Christopher F Chesley, Miranda Theodore, Colin Christie, Ryan Tino, Alex Wysoczanski, Kristy Ramphal, Michelle Oyster, Laurel Kalman, Mary K Porteous, Christian A Bermudez, Edward Cantu, Dennis L Kolson, Jason D Christie, Joshua M Diamond
BACKGROUND: Delirium significantly affects post-operative outcomes, but the incidence, risk factors, and long-term impact of delirium in lung transplant recipients have not been well studied. METHODS: We analyzed 155 lung transplant recipients enrolled in the Lung Transplant Outcomes Group (LTOG) cohort at a single center. We determined delirium incidence by structured chart review, identified risk factors for delirium, determined whether plasma concentrations of 2 cerebral injury markers (neuron-specific enolase [NSE] and glial fibrillary acidic protein [GFAP]) were associated with delirium, and determined the association of post-operative delirium with 1-year survival...
February 2, 2018: Journal of Heart and Lung Transplantation
Leopold Eberhart, Götz Geldner, Susanne Huljic, Kerstin Marggraf, Thomas Keller, Tilo Koch, Peter Kranke
OBJECTIVE: To compare the effectiveness of 20:1 cafedrine/theodrenaline approved for use in Germany to ephedrine in the restoration of arterial blood pressure and on postoperative outcomes in patients with intraoperative arterial hypotension of any origin under standard clinical practice conditions. METHODS AND RESULTS: 'HYPOTENS' is a national, multicenter, prospective, open-label, two-armed, non-interventional study. Effectiveness and post-operative outcome following cafedrine/theodrenaline or ephedrine therapy will be evaluated in two cohorts of hypotensive patients...
February 7, 2018: Current Medical Research and Opinion
E Levinoff, A Try, J Chabot, L Lee, D Zukor, O Beauchet
BACKGROUND: Hip fractures precipitate several acute adverse outcomes in elderly people, thus leading to chronic adverse outcomes. OBJECTIVES: The objective of our study was to examine the clinical characteristics associated with incident delirium in community dwelling elderly individuals who have a hip fracture. DESIGN: Retrospective observational cohort study. SETTING: Data was collected from an academic tertiary hospital affiliated with McGill University...
2018: Journal of Frailty & Aging
Aladine A Elsamadicy, Owoicho Adogwa, Michael Ongele, Amanda R Sergesketter, Aaron Tarnasky, David E T Lubkin, Nicolas Drysdale, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
BACKGROUND: Measures of healthcare utilization such as length of hospital stay (LOS) are used as proxies for quality of care after spine surgery. Accordingly, hospitals and health systems are investing considerable resources into the pre-operative identification of patients at risk for prolonged LOS. This study aims to investigate the impact of preoperative hemoglobin on outcomes and LOS after spinal fusion. METHODS: The medical records of 204 elderly (≥60 years) male patients undergoing elective spinal fusion (≥3 levels) at a major academic institution from 2005 to 2015 were reviewed...
January 17, 2018: World Neurosurgery
Eduardo Tobar, Mario A Abedrapo, Jaime A Godoy, Jose L Llanos, Mauricio J Díaz, Rodrigo Azolas, Gunther R Bocic, Jaime A Escobar, Rodrigo A Cornejo, Carlos M Romero
BACKGROUND: Post-operative delirium is a serious complication in patients undergoing major abdominal surgery. It remains unclear whether peri-operative hemodynamic and perfusion variables affect the risk for postoperative delirium. The objective of this pilot study was to evaluate the association between perfusion and hemodynamics peri-operative with the appearance of post-operative delirium. METHODS: Prospective cohort study of adults 60 years or older undergoing elective open colon surgery...
December 26, 2017: Revista Brasileira de Anestesiologia
Sirimas Potharajaroen, Sookjaroen Tangwongchai, Thavatchai Tayjasanant, Thammasak Thawitsri, George Anderson, Michael Maes
This study examined the effects of bright light therapy (BLT) on the incidence of delirium in post-operative patients admitted to a surgical intensive care unit (SICU) and delineates risk and protective factors. We included 62 patients in a single-blind, randomized controlled study. The intervention group was treated with care as usual plus BLT for three consecutive days. Delirium was diagnosed by DSM-5 criteria with the Confusion Assessment Method-Intensive Care Unit (CAM-ICU). Risk factors for delirium were measured, including the APACHE II score, Insomnia Severity Index (ISI), as well as hematocrit and bicarbonate levels...
March 2018: Psychiatry Research
Heng Fan, Yu Zhao, Min Sun, Ji-Hui Ye, Guo-Dong Chen, Jian-Hua Zhu
Background: Using dexmedetomidine (Dex) as a sedative agent may benefit the clinical outcomes of post-surgery patients. We reviewed randomized controlled trials (RCTs) to assess whether use of a Dex could improve the outcomes in post-surgery critically ill adults. Methods: We searched Medline, Embase, PubMed, and the Cochrane databases for RCTs comparing Dex with propofol or a placebo in post-operative patients, all included RCTs should be published in English before Jul 2016...
December 2017: Iranian Journal of Public Health
Simon P Hammond, Jane L Cross, Lee Shepstone, Tamara Backhouse, Catherine Henderson, Fiona Poland, Erika Sims, Alasdair MacLullich, Bridget Penhale, Robert Howard, Nigel Lambert, Anna Varley, Toby O Smith, Opinder Sahota, Simon Donell, Martyn Patel, Clive Ballard, John Young, Martin Knapp, Stephen Jackson, Justin Waring, Nick Leavey, Gregory Howard, Chris Fox
BACKGROUND: Health and social care provision for an ageing population is a global priority. Provision for those with dementia and hip fracture has specific and growing importance. Older people who break their hip are recognised as exceptionally vulnerable to experiencing confusion (including but not exclusively, dementia and/or delirium and/or cognitive impairment(s)) before, during or after acute admissions. Older people experiencing hip fracture and confusion risk serious complications, linked to delayed recovery and higher mortality post-operatively...
December 4, 2017: Trials
Yi-Hwa Choi, Dae-Hwan Kim, Tae-Young Kim, Tae-Wan Lim, Seok-Woo Kim, Je-Hyun Yoo
Purpose: Postoperative delirium is a risk factor for worse outcome after hip fracture surgery in elderly patients. Postoperative delirium is associated with anesthesia, postoperative pain, and patient factors. We investigated the incidence, predictors, and prognostic implications of post-operative delirium after hemiarthroplasty (HA) in elderly patients with femoral neck fracture. Patients and methods: A total of 356 consecutive patients aged >70 years who underwent HA for femoral neck fracture were enrolled...
2017: Clinical Interventions in Aging
Owoicho Adogwa, Aladine A Elsamadicy, Amanda Sergesketter, Deborah Oyeyemi, Diego Galan, Victoria D Vuong, Syed Khalid, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
OBJECTIVE: To determine whether preoperative chronic kidney disease (CKD) is associated with inferior perioperative outcomes in patients undergoing lumbar arthrodesis. METHODS: Medical records of 293 adult (≥18 years old) patients with spine deformity undergoing elective lumbar spine decompression and fusion at a major academic institution from 2006 to 2015 were reviewed. We identified 18 (6.1%) patients with a clinical diagnosis of CKD (CKD group, n = 18; no-CKD group, n = 275)...
February 2018: World Neurosurgery
Owoicho Adogwa, Aladine A Elsamadicy, Emily Lydon, Victoria D Vuong, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
BACKGROUND: Pre-existing cognitive impairment (CI) is emerging as a predictor of poor post-operative outcomes in elderly patients. Little is known about impaired preoperative cognition and outcomes after elective spine surgery in this patient population. The purpose of this study was to assess the prevalence of neuro CI in elderly patients undergoing deformity surgery and its impact on postoperative outcomes. METHODS: Elderly subjects undergoing elective spinal surgery for correction of adult degenerative scoliosis were enrolled in this study...
September 2017: Journal of Spine Surgery (Hong Kong)
Eliza E Moskowitz, Douglas M Overbey, Teresa S Jones, Edward L Jones, Todd R Arcomano, John T Moore, Thomas N Robinson
No abstract text is available yet for this article.
October 5, 2017: American Journal of Surgery
Claudia C Vasilian, Simona C Tamasan, Diana Lungeanu, Dan V Poenaru
BACKGROUND: Currently applied cognitive tests for assessing the risk of post-operative delirium require time and specialised medical staff, in addition to the patients' mental strain. We investigated the four-point scoring Clock-Drawing Test (CDT-4) as a preoperative independent predictor for post-operative delirium. METHODS: A total of 100 consecutive patients aged over 65 years admitted for accidental hip fracture were assessed for delirium using the Confusion Assessment Method Scale...
October 13, 2017: World Journal of Surgery
Marco Cascella, Maria R Muzio, Sabrina Bimonte, Arturo Cuomo, Jan G Jakobsson
Postoperative delirium, the onset of confusion/delirium during the early postoperative phase, is the most common post-operative complication in older adults and represents a medical emergency that requires immediate assessment and treatment. On the other hand, the term postoperative cognitive decline or dysfunction refers to a wide spectrum of clinical conditions featuring a decline in a variety of neuropsychological domains including memory, executive functioning, and speed of processing emerging week to months after anesthesia and surgery...
October 4, 2017: Minerva Anestesiologica
Christina Florou, Dimitrios Theofilopoulos, Styliani Tziaferi, Maria Chania
Hippocrates a Greek physician commonly known as the Father of Medicine was the first to describe delirium, 'phrenitis', differencing it from other disorders such as melancholia and mania. Since then, it still remains a clinical problem which is not yet resolved.Postoperative delirium is a common medical problem that occurs preferentially in surgical patients aged 65 years and older. It is a true medical emergency that requires immediate professional attention and treatment. Faced by health professionals and especially nurses it is often undetected, misdiagnosed, and under-treated as a complication by them during clinical care...
2017: Advances in Experimental Medicine and Biology
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