Pharmacologic Risk Factors for Post-Operative Delirium in Total Joint Arthroplasty Patients: A Case–Control Study

Nandi, Sumon; Harvey, William F.; Saillant, Jason; Kazakin, Anatoly; Talmo, Carl T.; Bono, James V.

doi:10.1016/j.arth.2013.06.004

Cited by 40 publications

(37 citation statements)

References 33 publications

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“…While there is no current literature to support this, opioid use postoperatively has been shown to not increase the risk of postoperative delirium by Nandi et al (15). In the same study, they showed that benzodiazepine and isoflurane use perioperatively is an independent risk factor for postoperative delirium (15).…”

Section: Table 2 Diagnostic Criteria For Deliriummentioning

confidence: 75%

Incidence of postoperative delirium in patients undergoing total knee arthroplasty—an Asian perspective

Huang¹,

Razak²,

Yeo³

2017

Ann. Transl. Med.

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Background: Very little is known in the literature with regards to the incidence of postoperative delirium following total knee arthroplasty (TKA) in Asians and the associated surgical factors. We conducted a retrospective study on incidence of postoperative delirium following TKA in Asians. Methods:One thousand sixteen knees of 954 consecutive patients who underwent TKA by the senior author of this study in the year 2006 were included in this review. All written and electronic medical records for patients were screened. Delirium was recorded to be present based on clinical entry onto the patients' inpatient hospital notes and a diagnosis made by psychiatrist based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). All statistical analysis was performed using SPSS v.18.0 (IBM Corp., Armonk, NY, USA). Results:The incidence of postoperative delirium in our patients undergoing TKA was 0.59%. Six patients had a confirmed diagnosis of delirium postoperatively. We noted an association between a higher mean age (P<0.0001), a lower body mass index (P<0.0001), Chinese ethnicity (P=0.002), male gender (P=0.002) and chronic opioid use (P<0.0001) with incidence of post-operative delirium. We also noted a higher proportion of post-operative DVT (P<0.0001) and wound infection (P<0.0001) in the delirium group. Conclusions:The incidence of postoperative delirium in Asians undergoing TKA in our institution is very low at 0.59%. Advanced age, lower body mass index, Chinese ethnicity, male gender and preoperative chronic opioid use may be associated with developing postoperative delirium.

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Section: Table 2 Diagnostic Criteria For Deliriummentioning

confidence: 75%

Incidence of postoperative delirium in patients undergoing total knee arthroplasty—an Asian perspective

Huang¹,

Razak²,

Yeo³

2017

Ann. Transl. Med.

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“…Pharmacologic risk factors including the use of isoflurane and benzodiazepines have been investigated as risk factors for delirium after THA and TKA (Nandi et al, 2014). In the present study, a history of dementia was investigated as a significant risk factor among several comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Jankowski et al (2011) demonstrated that reduced preoperative neurocognitive and functional status could predict the development of delirium after TKA and total hip arthroplasty (THA). Moreover, pharmacologic risk factors such as the use of isoflurane and benzodiazepines were also investigated as risk factors after THA and TKA (Nandi et al, 2014). However, no study has specifically examined the risk factors associated with perioperative comorbidities and clinical laboratory data while focusing on only TKA.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of delirium in patients undergoing total knee arthroplasty

Chung¹,

Lee²,

Park³

et al. 2015

Archives of Gerontology and Geriatrics

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“…23 Except that we did not observe the occurrence of smoking or diabetes mellitus in patients diagnosed with delirium. 2,11,12,[16][17][18][19][20][21][22] To better understand the pattern of incidence of delirium in this population, comparison with data collected from other hospitals, countries and at other times would be essential, given that knee and hip arthroplasties are elective surgeries and may be subject to such variations. However, this is a complex evaluation involving heterogeneous populations and differences in method, health system and other factors that vary from region to region or even between hospitals and specialized centers.…”

Section: Discussionmentioning

confidence: 99%

“…Age, chronic diseases such as HBP, sleep disorders, smoking and medication use were all factors evaluated when cited in the medical records. 2,11,12,[16][17][18][19][20][21][22] The results obtained were tabulated and their descriptive evaluation performed using Microsoft Excel software (Microsoft Corp., USA), and the appropriate comparisons were made.…”

Section: Methodsmentioning

confidence: 99%

Incidence of delirium in postoperative patients treated with total knee and hip arthroplasty

Bosmak

Gibim

Guimarães

et al. 2017

Rev. Assoc. Med. Bras.

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Summary Introduction: Delirium is a common disorder that can potentiate mortality and comorbidity rates of patients hospitalized in intensive care units. Patients undergoing major orthopedic surgeries, such as knee and hip arthroplasty, are particularly vulnerable as they often have multiple risk factors for this disorder. Method: Descriptive study of the incidence of delirium in patients treated with total knee and hip arthroplasty, given the advanced age and comorbidities in this population. We evaluated the medical records of patients who had previously undergone the designated surgeries for identification of postoperative delirium. Results: We observed in this study an incidence of 8.92% of delirium, mostly affecting females with a mean age of 73 years and hypertension. Conclusion: The incidence of delirium in our study is similar to that observed in the general population, according to the literature. We found no correlation with sleep disorders, smoking or diabetes mellitus in this study, even though the importance of these factors for the onset of delirium is well-established in the literature.

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Pharmacologic Risk Factors for Post-Operative Delirium in Total Joint Arthroplasty Patients: A Case–Control Study

Cited by 40 publications

References 33 publications

Incidence of postoperative delirium in patients undergoing total knee arthroplasty—an Asian perspective

Incidence of postoperative delirium in patients undergoing total knee arthroplasty—an Asian perspective

Risk factors of delirium in patients undergoing total knee arthroplasty

Incidence of delirium in postoperative patients treated with total knee and hip arthroplasty

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