Effect of hypertension and medication use regularity on postoperative delirium after maxillofacial tumors radical surgery

Kong, Sijia; Wang, Jing; Xu, Hanlin; Wang, Kaiqiang

doi:10.18632/oncotarget.28048

Cited by 7 publications

(10 citation statements)

References 27 publications

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“…Reasons for exclusion were no diagnosis by physician or research personnel (428 studies), no characterization of predisposing or precipitating factors (338 studies), retrospective study design (86 studies), not diagnosed by reference standard (108 studies), no multivariable model (43 studies), delirium assessment not conducted in person (25 studies), not cohort or case-control design (20 studies), sample included less than 50 patients (12 studies), abstract only (18 studies), cohort previously reported (3 studies), and pediatric population (1 studies). Ultimately, 315 studies…”

Section: Resultsmentioning

confidence: 99%

“…Studies were conducted in 40 different countries, with the plurality in the United States (86 studies [27.3%]), followed by China (48 studies [15.2%]) and the Netherlands (24 studies [7.6%]). Most studies were prospective cohort studies (296 studies…”

Section: Resultsmentioning

confidence: 99%

“…Delirium was measured by research personnel in 171 studies (54.3%), a combination of research personnel and physicians in 5 studies (1.6%), and a physician in 139 studies …”

Section: Resultsmentioning

confidence: 99%

“…The most frequently used assessment tool was the CAM, which was used in 174 studies (55.2%). Delirium was assessed daily or more frequently in 222 studies…”

Section: Resultsmentioning

confidence: 99%

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Predisposing and Precipitating Factors Associated With Delirium

et al. 2023

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ImportanceDespite discrete etiologies leading to delirium, it is treated as a common end point in hospital and in clinical trials, and delirium research may be hampered by the attempt to treat all instances of delirium similarly, leaving delirium management as an unmet need. An individualized approach based on unique patterns of delirium pathophysiology, as reflected in predisposing factors and precipitants, may be necessary, but there exists no accepted method of grouping delirium into distinct etiologic subgroups.ObjectiveTo conduct a systematic review to identify potential predisposing and precipitating factors associated with delirium in adult patients agnostic to setting.Evidence ReviewA literature search was performed of PubMed, Embase, Web of Science, and PsycINFO from database inception to December 2021 using search Medical Subject Headings (MeSH) terms consciousness disorders, confusion, causality, and disease susceptibility, with constraints of cohort or case-control studies. Two reviewers selected studies that met the following criteria for inclusion: published in English, prospective cohort or case-control study, at least 50 participants, delirium assessment in person by a physician or trained research personnel using a reference standard, and results including a multivariable model to identify independent factors associated with delirium.FindingsA total of 315 studies were included with a mean (SD) Newcastle-Ottawa Scale score of 8.3 (0.8) out of 9. Across 101 144 patients (50 006 [50.0%] male and 49 766 [49.1%] female patients) represented (24 015 with delirium), studies reported 33 predisposing and 112 precipitating factors associated with delirium. There was a diversity of factors associated with delirium, with substantial physiological heterogeneity.Conclusions and RelevanceIn this systematic review, a comprehensive list of potential predisposing and precipitating factors associated with delirium was found across all clinical settings. These findings may be used to inform more precise study of delirium’s heterogeneous pathophysiology and treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Delirium was measured by research personnel in 171 studies (54.3%), a combination of research personnel and physicians in 5 studies (1.6%), and a physician in 139 studies …”

Section: Resultsmentioning

confidence: 99%

“…The most frequently used assessment tool was the CAM, which was used in 174 studies (55.2%). Delirium was assessed daily or more frequently in 222 studies…”

Section: Resultsmentioning

confidence: 99%

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Predisposing and Precipitating Factors Associated With Delirium

et al. 2023

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“…[ 21 ] In addition, hypotension over time is also a significant risk factor for POD epidural anesthesia and can lower blood pressure leading to cerebral hypoperfusion and POD. [ 22 23 ]…”

Section: Discussionmentioning

confidence: 99%

Identification of factors contributing to the development of postoperative delirium in geriatric patients with hip fractures- A prospective study

Venkatakrishnaiah

Anandkumar

Wooly

et al. 2022

J Family Med Prim Care

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Introduction: Geriatric hip fractures are a major cause of concern globally and often a frequent reason for morbidity and mortality. Postoperative delirium (POD) is a frequent but often under-diagnosed complication, especially after a major hip surgery. Some of the factors that have been associated with POD are diabetes, high American Society of Anesthesiologists (ASA) grading, electrolyte imbalance, and blood pressure fluctuations. Malnutrition as a risk factor is only recently being recognized. Although there are many possible risk factors reported, they are quite conflicting and not very clear. Therefore, we have attempted to conduct this study to identify the potential risk factors for the development of POD in patients with hip fractures. Materials and Methods: A prospective observational study was performed on 110 geriatric hip fracture patients admitted to tertiary health care in South India. Data regarding preoperative blood investigations, ASA grading, hypertension and diabetes status, MNA (mini nutritional assessments) status, serum albumin, and serum electrolytes values were recorded. The Confusion Assessment Method tool (CAM) was used to diagnose delirium in the postoperative period. Statistical analysis was done for various factors influencing the occurrence of POD. Results: Among the total of 110 cases of geriatric hip fractures patients, 44.5% of the patients developed postoperative delirium. Advancing age, hypoalbuminemia, malnourishment, and uncontrolled diabetes played an important role to the development of post operative delirium in patients with hip fractures. Conclusion: Advancing age, hypoalbuminemia, malnourishment, and uncontrolled diabetes are strong predictors for the development of postoperative delirium in geriatric hip fracture patients. Since age is a non-modifiable risk factor, interventional strategies aimed at correcting modifiable risk factors like nutrition, serum albumin levels, and diabetes control play an important part in preventing delirium in the postoperative period in elderly hip fracture patients. MeSH terms: Hip Fractures, Postoperative Complication, Delirium, Nutrition Assessment, Serum Albumin

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Daytime dysfunction may be associated with postoperative delirium in patients undergoing total hip/knee replacement: The PNDABLE study

Lin,

Pan,

et al. 2023

Brain and Behavior

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PurposePostoperative delirium (POD) is a usual complication after total hip/knee replacement, which may be affected by sleep characteristics. However, up to now, preoperative sleep characteristics have not been evaluated as risk factors of POD. The relationship between self‐reported sleep characteristics and POD in patients has been investigated in this study.Patients and MethodsWe recruited 495 cognitively intact individuals in the final analysis from the Perioperative Neurocognitive Disorder and Biomarker Lifestyle study. Sleep characteristics were tested by the Pittsburgh Sleep Quality Index (PSQI). Mini‐mental state examination was applied to assess preoperative mental status of patients. Postoperatively, we used confusion assessment method and memorial delirium assessment scale to evaluate the incidence of POD and POD severity, respectively. The cerebrospinal fluid (CSF) levels of T‐tau, P‐tau, Aβ40, and Aβ42 were detected by enzyme‐linked immune‐sorbent assay before the operation. Logistic regression, multiple linear regression, and mediation effects were performed to analyze the relationship between self‐reported sleep characteristics and POD.ResultsPOD was detected in 11.31% (56/495) of the patients, with logistic regression analysis showing that daytime dysfunction, P‐tau, and T‐tau were risk factors of POD, and Aβ42 was a protective factor of POD. Multiple linear regression analysis confirmed that daytime dysfunction was positively correlated with P‐tau in patients with POD. Meanwhile, compared to the patients with no postoperative delirium, the CSF levels of P‐ and T‐tau were higher in patients with POD. Furthermore, mediation analysis showed that it was probable that daytime dysfunction mediated POD through P‐tau (proportion: 12.90%) partially.ConclusionDaytime dysfunction is a risk factor of POD preoperatively. To sum up, CSF P‐tau protein might partially mediate the influence of daytime dysfunction on POD.Clinical trial registrationThis study was registered at Chinese Clinical Trial Registry (ChiCTR2000033439).

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Effect of hypertension and medication use regularity on postoperative delirium after maxillofacial tumors radical surgery

Cited by 7 publications

References 27 publications

Predisposing and Precipitating Factors Associated With Delirium

Predisposing and Precipitating Factors Associated With Delirium

Identification of factors contributing to the development of postoperative delirium in geriatric patients with hip fractures- A prospective study

Daytime dysfunction may be associated with postoperative delirium in patients undergoing total hip/knee replacement: The PNDABLE study

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