Objective : Postoperative delirium (POD) is characterized by an acute change in cognitive function and can result in longer hospital stays, higher morbidity rates, and more frequent discharges to long-term care facilities. In this study, we investigated the incidence and risk factors of POD in 224 patients older than 70 years of age, who had undergone a neurosurgical operation in the last two years. Methods : Data related to preoperative factors (male gender, >70 years, previous dementia or delirium, alcohol abuse, serum levels of sodium, potassium and glucose, and co-morbidities), perioperative factors (type of surgery and anesthesia, and duration of surgery) and postoperative data (length of stay in recovery room, severity of pain and use of opioid analgesics) were retrospectively collected and statistically analyzed. Results : POD appeared in 48 patients (21.4%) by postoperative day 3. When we excluded 26 patients with previous dementia or delirium, 17 spontaneously recovered by postoperative day 14, while 5 patients recovered by postoperative 2 months with medication, among 22 patients with newly developed POD. The univariate risk factors for POD included previously dementic or delirious patients, abnormal preoperative serum glucose level, pre-existent diabetes, the use of local anesthesia for the operation, longer operation time (>3.2 hr) or recovery room stay (>90 min), and severe pain (VAS>6.8) requiring opioid treatment (p<0.05). Backward regression analysis revealed that previously dementic patients with diabetes, the operation being performed under local anesthesia, and severe postoperative pain treated with opioids were independent risk factors for POD. Conclusion : Our study shows that control of blood glucose levels and management of pain during local anesthesia and in the immediate postoperative period can reduce unexpected POD and help preventing unexpected medicolegal problems and economic burdens.
Three species of marine algae, two browns and one red were newly reported from the eastern and the southern coast of Korea including Cheju Island. Their vegetative and reproductive structures were described. Colpomenia phaeodactyla Wynne et J.N. Norris (Scytosiphonaceae, Phaeophyceae) commonly occurred in middle to lower intertidal zone of southern coast. Plants consisted of clusters of elongated and hollow sacs arising from an adherent colpomenioid base. Plurilocular sporangia were multiseriate, forming dense, extensive sori over the erect sacs. Cutleria adspersa (Mertens ex Roth) De Notaris (Cutleriaceae, Phaeophyceae) was collected from subtidal region of Cheju Island. It was characterized by broadly fan-shaped habits with golden brown colour and hair-fringed margins, attached by rhizoids along undersurface. Halarachnion latissimum Okamura (Furcellariaceae, Rhodophyceae) was found adrift from several areas of southern coast. Plants were brownish red, filmy and delicate, membranaceous roundish fronds. Cystocarps were globular and formed under the cortical layer. Tetrasporangia were oblong and zonately divided.
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