Postoperative Adverse Outcomes in Surgical Patients with Dementia: A Retrospective Cohort Study

Hu, Chaur‐Jong; Liao, Chien-Chang; Chang, Chia‐Yi; Wu, Chih‐Hsiung; Chen, Ta-Liang

doi:10.1007/s00268-012-1609-x

Cited by 91 publications

(108 citation statements)

References 41 publications

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“…These results are consistent with those previously reported in other types of surgery [9]. Because of the limitations in the available data, we were not able to analyze the cause of the higher risk of complications in patients with dementia.…”

Section: Discussionsupporting

confidence: 93%

“…In addition, postoperative complications were associated with all types of hip fracture surgery. The higher risk of postoperative complications associated with preoperative dementia has been reported for several types of surgery [9]; however, to the best of our knowledge, the present study is the largest retrospective study to show the relationship between preoperative dementia and postoperative complications after hip fracture surgery in elderly patients.…”

Section: Discussionmentioning

confidence: 61%

See 1 more Smart Citation

Association between dementia and postoperative complications after hip fracture surgery in the elderly: analysis of 87,654 patients using a national administrative database

Tsuda

Yasunaga

Horiguchi

et al. 2015

Arch Orthop Trauma Surg

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 61%

Association between dementia and postoperative complications after hip fracture surgery in the elderly: analysis of 87,654 patients using a national administrative database

Tsuda

Yasunaga

Horiguchi

et al. 2015

Arch Orthop Trauma Surg

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“…It is possible that social isolation and communication difficulties could contribute to adverse events in patients with schizophrenia. Contrary to the study conducted by Hu et al [20], our study showed no increased risk for adverse events in demented patients, perhaps related to the use of different statistical approaches. Hu et al [20] conducted a retrospective case-control study, in which patients with dementia, known to have a higher comorbidity burden, were compared with sex-and age-matched nondemented control subjects [20].…”

Section: Discussioncontrasting

confidence: 55%

Do Psychiatric Comorbidities Influence Inpatient Death, Adverse Events, and Discharge After Lower Extremity Fractures?

Menendez

Neuhaus

Bot

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Psychiatric comorbidity is known to contribute to illness (the state of feeling unwell/unable to rely on one's body) and increased use of healthcare resources, but the effect on inpatient outcomes in fracture care is relatively unexplored. Questions/purposes Our primary null hypothesis is that a concomitant diagnosis of depression, anxiety, dementia, or schizophrenia is not associated with (1) discharge to another care facility rather than home after lower extremity fractures. Secondary study questions address the associations between psychiatric comorbidity and (2) longer inpatient stay and inpatient (3) adverse events; (4) blood transfusion; and (5) mortality after lower extremity fractures. Methods Using the National Hospital Discharge Survey database, we analyzed a total estimated number of 10,669,449 patients with lower limb fractures from 1990 to 2007. Sixty-four percent were women, and the mean ± SD age was 67 ± 22 years. The prevalence in the study population was 3.2% for depression, 1.6% for anxiety, 0.6% for schizophrenia, and 2.9% for dementia. Results A discharge diagnosis of psychiatric comorbidity was associated with a lower rate of discharge to home after accounting for an association with greater medical comorbidity (schizophrenia: odds ratio [OR], 5.6, 95% confidence interval [CI], 5.5-5.8; dementia: OR, 1.3, 95% CI, 1.2-1.3; depression: OR, 1.2, 95% CI, 1.2-1.3; anxiety: OR, 1.04, 95% CI, 1.02-1.06). Hospital stay was longer for patients with schizophrenia and dementia but shorter in patients with depression or anxiety compared with patients without any mental disorders. Schizophrenia was associated with more in-hospital adverse events and depression and anxiety with fewer events. A diagnosis of depression was associated with blood transfusion. Psychiatric comorbidity was not associated with a higher risk of in-hospital death.

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“…It has also been suggested that the diagnosis and treatment of pneumonia may be delayed in patients whose ability to communicate is impaired, especially in the early stages when patients may be afebrile [30]. A bidirectional relationship between cognitive function and pneumonia has recently been demonstrated, whereby declines in cognitive status increased patients' risk of the development of pneumonia and the rate of cognitive decline accelerated following an episode of pneumonia [43].…”

Section: Discussionmentioning

confidence: 99%

“…The risk of developing pneumonia was significantly elevated in patients with dementia admitted for medical and surgical reasons - by 37% and 66%, respectively [29]. In a large sample restricted to surgical admissions, the presence of dementia was associated with a significant increase in the development of a number of post-operative complications, including pneumonia (OR = 2.44, 95% CI 2.31-2.58) [30]. In addition to a greater frequency of hospitalizations related to dementia, the age- and sex-adjusted odds of in-hospital mortality from all causes have been reported to be 1.77 [31] and 2.1 [5] times higher for patients with dementia.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis Examining Pneumonia-Associated Mortality in Dementia

Foley

Affoo

Martin³

2014

Dement Geriatr Cogn Disord

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Background: Although it is generally accepted that deaths associated with pneumonia are more common in patients with dementia, no comprehensive reviews on the subject have previously been published. Summary: Relevant studies were identified through a literature search of the PubMed, EMBASE, Scopus, and ISI Web of Science databases for publications up to August 2013. Studies were included if (1) a group of adult subjects with dementia and a (comparison) group composed of subjects without dementia were included, (2) the cause(s) of death was/were reported, and (3) pneumonia was identified as one of the possible causes of death. The occurrence of death due to pneumonia associated with dementia was expressed as an odds ratio (OR) with 95% confidence interval (CI). Thirteen studies were included. The odds of death resulting from pneumonia were significantly increased for persons with any form of dementia compared with those without dementia (OR = 2.22, 95% CI 1.44-3.42, p < 0.001). In a subgroup analysis, using the results from 8 studies that restricted inclusion to persons with Alzheimer's disease, the odds of death resulting from pneumonia were also significantly higher (OR = 1.70, 95% CI 1.12-2.58, p = 0.013). Key Messages: The odds of pneumonia-associated mortality were increased more than 2-fold for patients with dementia. © 2014 S. Karger AG, Basel

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Postoperative Adverse Outcomes in Surgical Patients with Dementia: A Retrospective Cohort Study

Cited by 91 publications

References 41 publications

Association between dementia and postoperative complications after hip fracture surgery in the elderly: analysis of 87,654 patients using a national administrative database

Association between dementia and postoperative complications after hip fracture surgery in the elderly: analysis of 87,654 patients using a national administrative database

Do Psychiatric Comorbidities Influence Inpatient Death, Adverse Events, and Discharge After Lower Extremity Fractures?

A Systematic Review and Meta-Analysis Examining Pneumonia-Associated Mortality in Dementia

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