A clinical risk analysis of early post-operative delirium after laparoscopic colorectal cancer surgery in elderly patients: a retrospective study

Hiraki, Masatsugu; Tanaka, Toshiya; Ishii, Hironobu; Sadashima, Eiji; Miura, Daisuke; Sunami, Takashi; Hanafusa, Kiyoji; Sato, Hirofumi; Kono, Kenji

doi:10.1007/s00384-021-03919-5

Cited by 5 publications

(4 citation statements)

References 25 publications

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“…So anticholinergic drugs were replaced by other cardiovascular active drugs such as isoprotereno in our study when the heart rate fell. Masatsugu Hiraki has found that maximum intraoperative temperature ≥ 37 • C is an independent risk factor of early postoperative delirium after laparoscopic colorectal surgery in elderly patients (Hiraki et al, 2021). So we strictly controlled and monitored the patients' temperature at 36.3-36.9 • C. Next, we analyzed the difference in gut microbiota between the POD groups and non-POD groups.…”

Section: Discussionmentioning

confidence: 99%

Post-Operative Neuropsychiatric Disorder

2024

Frontiers Research Topics

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Frontiers is more than just an open access publisher of scholarly articles: it is a pioneering approach to the world of academia, radically improving the way scholarly research is managed. The grand vision of Frontiers is a world where all people have an equal opportunity to seek, share and generate knowledge. Frontiers provides immediate and permanent online open access to all its publications, but this alone is not enough to realize our grand goals. Frontiers journal seriesThe Frontiers journal series is a multi-tier and interdisciplinary set of openaccess, online journals, promising a paradigm shift from the current review, selection and dissemination processes in academic publishing. All Frontiers journals are driven by researchers for researchers; therefore, they constitute a service to the scholarly community. At the same time, the Frontiers journal series operates on a revolutionary invention, the tiered publishing system, initially addressing specific communities of scholars, and gradually climbing up to broader public understanding, thus serving the interests of the lay society, too. Dedication to qualityEach Frontiers article is a landmark of the highest quality, thanks to genuinely collaborative interactions between authors and review editors, who include some of the world's best academicians. Research must be certified by peers before entering a stream of knowledge that may eventually reach the public -and shape society; therefore, Frontiers only applies the most rigorous and unbiased reviews. Frontiers revolutionizes research publishing by freely delivering the most outstanding research, evaluated with no bias from both the academic and social point of view. By applying the most advanced information technologies, Frontiers is catapulting scholarly publishing into a new generation. What are Frontiers Research Topics?Frontiers Research Topics are very popular trademarks of the Frontiers journals series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area.

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Section: Discussionmentioning

confidence: 99%

Post-Operative Neuropsychiatric Disorder

2024

Frontiers Research Topics

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“…Long-term susceptibility to delirium should be regarded as an integral aspect of the overall cerebrovascular disease burden 39,40 . Several studies have indicated that cognitive dysfunction and reduced functional capacity are associated with a heightened risk of POD [41][42][43] .…”

Section: Discussionmentioning

confidence: 99%

Development of an individualized model for predicting postoperative delirium in elderly patients with hepatocellular carcinoma

Yan,

Lin,

Zheng

et al. 2024

Sci Rep

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Postoperative delirium (POD) is a common complication in older patients with hepatocellular carcinoma (HCC) that adversely impacts clinical outcomes. We aimed to evaluate the risk factors for POD and to construct a predictive nomogram. Data for a total of 1481 older patients (training set: n=1109; validation set: n=372) who received liver resection for HCC were retrospectively retrieved from two prospective databases. The receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis (DCA) were used to evaluate the performance. The rate of POD was 13.3% (148/1109) in the training set and 16.4% (61/372) in the validation set. Multivariate analysis of the training set revealed that factors including age, history of cerebrovascular disease, American Society of Anesthesiologists (ASA) classification, albumin level, and surgical approach had significant effects on POD. The area under the ROC curves (AUC) for the nomogram, incorporating the aforementioned predictors, was 0.798 (95% CI 0.752–0.843) and 0.808 (95% CI 0.754–0.861) for the training and validation sets, respectively. The calibration curves of both sets showed a degree of agreement between the nomogram and the actual probability. DCA demonstrated that the newly established nomogram was highly effective for clinical decision-making. We developed and validated a nomogram with high sensitivity to assist clinicians in estimating the individual risk of POD in older patients with HCC.

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“…So anticholinergic drugs were replaced by other cardiovascular active drugs such as isoprotereno in our study when the heart rate fell. Masatsugu Hiraki has found that maximum intraoperative temperature ≥ 37°C is an independent risk factor of early postoperative delirium after laparoscopic colorectal surgery in elderly patients ( Hiraki et al, 2021 ). So we strictly controlled and monitored the patients’ temperature at 36.3–36.9°C.…”

Section: Discussionmentioning

confidence: 99%

Mechanical Bowel Preparation Is a Risk Factor for Postoperative Delirium as It Alters the Gut Microbiota Composition: A Prospective Randomized Single-Center Study

Yang

Tong

Qian

et al. 2022

Front. Aging Neurosci.

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Background and ObjectivePostoperative delirium (POD) is a frequent complication in patients undergoing gastrectomy. Increasing evidence suggests that abnormal gut microbiota composition may contribute to its morbidity. However, it is unclear whether mechanical bowel preparation would cause postoperative delirium by altering the gut microbiota of patients. This study aimed to investigate the association between mechanical bowel preparation and postoperative delirium in patients undergoing gastrectomy.MethodsA prospective randomized single-center study was performed. A total of 81 patients with gastric cancer were enrolled and randomly assigned to two groups: preparation group and non-preparation group according to whether the patient received MBP before surgery. To diagnose postoperative delirium, we used the 3-Min Diagnostic Interview for Confusion Assessment Method-defined delirium for five successive days after surgery. 16s rRNA gene sequencing was used to investigate changes in the intestinal bacteria. The linear discriminant analysis and effect size (LefSe) analysis were also used to identify the different taxa of fecal microbiota between the postoperative delirium and non-postoperative delirium groups.ResultsWe found that there was a significant difference in β-diversity of the gut microbiota between the preparation group and non-preparation group (P = 0.048). Furthermore, patients in the preparation group had a much higher rate of postoperative delirium (13/40, 32.5%) compared with that in non-preparation groups (4/41, 9.8%). Multivariate regression analysis adjusted by other risk factors indicated that mechanical bowel preparation was associated with the occurrence of delirium (odds ratio = 4.792; 95% confidence interval: 1.274–18.028; P = 0.020). When comparing the gut microbiota of patients with and without POD, Bacteroides and Veillonella (genus), which were higher in the preparation group, were also higher in delirium patients (P < 0.05). Genus Olsenella was both relatively higher in the non-preparation group and non-POD group (P < 0.05).ConclusionMechanical bowel preparation not only altered the gut microbiota composition of patients with gastric cancer but also increased the incidence of postoperative delirium. Among all the gut microbiota altered by mechanical bowel preparation, Bacteroides and Veillonella genus might be a risk factor of POD. Genus Olsenella might be a beneficial bacteria to reduce the incidence of POD.

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A clinical risk analysis of early post-operative delirium after laparoscopic colorectal cancer surgery in elderly patients: a retrospective study

Cited by 5 publications

References 25 publications

Post-Operative Neuropsychiatric Disorder

Post-Operative Neuropsychiatric Disorder

Development of an individualized model for predicting postoperative delirium in elderly patients with hepatocellular carcinoma

Mechanical Bowel Preparation Is a Risk Factor for Postoperative Delirium as It Alters the Gut Microbiota Composition: A Prospective Randomized Single-Center Study

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