Postoperative delirium in patients with history of alcohol abuse

Sousa, Gabriela; Mendonça, J.; Norton, Maria C.; Pinho, Carlos; Santos, Alice; Abelha, F.

doi:10.1097/00003643-201406001-00051

Cited by 4 publications

(6 citation statements)

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“…With the development of economy, alcohol as a globally popular beverage was consumed more often, which makes the relationship between alcohol consumption and cognitive impairment more pronounced. 6,7 Results of this study prove that alcohol consumption is a risk factor for POD. Alcohol consumption also has been shown to be associated with cognitive decline in previous studies.…”

Section: Discussionmentioning

confidence: 54%

“…(4) history of severe mental or neurological disorders, such as Alzheimer's disease, Parkinson's syndrome, cerebrovascular accidents and cerebrovascular disease (5) preoperative Mini-Mental State Examination scale (MMSE) ≤ 23 points (6) drug abuse or psychotropic substance abuse, long-term use of steroids and hormonal drugs, (7) family history of genetic disorders (e.g., early-onset familial AD, hereditary ataxia, hereditary spastic paraplegia, etc. ).…”

Section: Participantsmentioning

confidence: 99%

“…6 According to epidemiological ndings, alcohol consumption may increase the risk of cognitive impairment in the elderly. 7 Studies have also shown that alcohol consumption is considered to be an independent risk factor for cognitive impairment. 8 Because POD is often accompanied by cognitive impairment, 4 thus, a possible correlation between alcohol consumption and POD can be inferred.…”

Section: Introductionmentioning

confidence: 99%

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Alcohol consumption may be associated with postoperative delirium in the elderly: the PNDABLE study

Zhang

Zeng

et al. 2023

Preprint

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Objectives: The aim of this study was to reveal the relationship between alcohol consumption and Postoperative delirium (POD) in the elderly. Methods: A total of 284 patients were enrolled in this study (mean age was 69.38 (65-90) years and 7.1% were female). Those who had measurements of CSF Aβ40, Aβ42，P-tau, and tau protein and drinking characteristics were included from the Perioperative Neurocognitive Disorder And Biomarker Lifestyle (PNDABLE ) study. Mini-Mental State Examination (MMSE) was used to assess preoperative mental status of patients. POD was diagnosed using the Confusion Assessment Method (CAM) and assessed for severity using the Memorial Delirium Assessment Scale (MDAS). The two independent samples t-test was used for comparison between the two groups. Logistic regression analysis was utilized to explore the association of alcohol consumption with POD. What’s more, We also performed sensitivity analysis by adding corrected confounders and the results were almost unchanged. Linear regression analysis was used to study the relationship between alcohol consumption and CSF biomarkers. Mediation analyses with 10000 bootstrapped iterations were used to explore the mediation effects. A two-factor ANOVA was used to explore the impact of gender and alcohol consumption on CSF biomarkers. Finally, we constructed the receiver operating characteristic (ROC) curve and the nomogram model to evaluate the efficacy of alcohol consumption and CSF biomarkers in predicting POD. Result: The incidence of POD was 17.5% (44/252). Logistic regression showed that alcohol consumption (OR = 1.016, 95%CI 1.009-1.024, P < 0.001) is a risk factor for POD. In particular, alcohol consumption >24 g (heavy) is more likely to cause POD. What’s more, Aβ42 is a protective factor for POD (OR = 0.993, 95%CI 0.989-0.997, P < 0.05) and P-Tau was a risk factor for POD (OR = 1.093, 95%CI 1.022-1.168, P < 0.05). Linear regression analysis revealed that alcohol consumption was negatively associated with CSF Aβ42 (β = -0.638, P < 0.001) in POD patients. The two independent samples t-test showed that the non-postoperative delirium (NPOD) group had higher Aβ42 levels than the POD group; the POD group had more alcohol consumption than the NPOD group (P < 0.001). Mediation analyses show that alcohol consumption is likely to mediate POD through Aβ42 (proportion:14.21%) partially. ROC curve showed that alcohol consumption (AUC=0.904; P<0.001) exhibited a relative better discriminatory ability in POD prediction compared to Aβ42 (AUC=0.798; P<0.001). The calibration curve indicated good prediction of the nomogram(P=0.797). Conclusion: Alcohol consumption is a risk factor for POD (particularly for those with >24 g a day on average) in the elderly, and contributes to POD through the mediation of Aβ42.

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Section: Discussionmentioning

confidence: 54%

Section: Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Alcohol consumption may be associated with postoperative delirium in the elderly: the PNDABLE study

Zhang

Zeng

et al. 2023

Preprint

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“…En la referida encuesta EDADES del año 2017 (Delegación del Gobierno para el Plan Nacional sobre Drogas, 2017), con el test AUDIT el 5,1% de los españoles de 15 a 64 años se clasificaban dentro del grupo de consumo de riesgo de alcohol (7,6% de hombres y 2,6% de mujeres), cifras muy inferiores a la nuestras. Otra investigaciones llevadas a cabo en Portugal sobre pacientes sometidos a cirugía (Sousa, Pinho, Santos y Abelha, 2017), en Francia sobre personas que acudían a urgencias hospitalarias (Richoux et al, 2011) o en Brasil sobre trabajadores del transporte público (Cunha, Giatti y Assunção, 2016), también encontraron una prevalencia menor que la nuestra, usando el cuestionario CAGE con 2 respuestas afirmativas como punto de corte.…”

Section: Discussionunclassified

Detección de trastornos por uso de alcohol mediante la aplicación del cuestionario CAGE camuflado en tres grupos poblacionales

et al. 2020

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“…100 Additionally, recognizing patients at risk for withdrawal from either drug or alcohol use is crucial to preventing complications from substance withdrawal. 101 Once hospitalized, ensuring urinary catheters are promptly removed, avoiding the use of restraints, avoiding overuse of analgesics, limiting unnecessary room changes, providing frequent reorientation, and encouraging a normal sleep/wake cycle scan also help prevent postoperative delirium. 102,103 Management of delirium focuses on identifying reversible causes and emphasizing reorientation in a stable environment with consistency of staff and location.…”

Section: Management Of Patients With Post-operative Deliriummentioning

confidence: 99%