Postoperative delirium in patients with history of alcohol abuse

Sousa, Gabriela; Pinho, Carlos; Santos, Alice; Abelha, Fernando

doi:10.1016/j.redare.2017.02.001

Cited by 7 publications

(5 citation statements)

References 30 publications

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“…With the development of the 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 ]. The results of this study prove that alcohol consumption is a risk factor for POD.…”

Section: Discussionmentioning

confidence: 99%

“…With the rapid growth of the Chinese economy, alcohol consumption in China is greatly rising [ 6 ]. According to epidemiological findings, 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 ].…”

Section: Introductionmentioning

confidence: 99%

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

Wu,

Zhang,

Zhou

et al. 2023

BMC Anesthesiol

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Objectives This study aimed to reveal the relationship between alcohol consumption and Postoperative delirium (POD) in the elderly. Methods We selected 252 patients from the Perioperative Neurocognitive Disorder And Biomarker Lifestyle (PNDABLE ) study. Patients in the PNDABLE database have been measured for Alzheimer-related biomarkers in CSF (Aβ40, Aβ42, P-tau, and tau protein). Mini-Mental State Examination (MMSE) was used to assess the 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). Logistic regression analysis was utilized to explore the association of alcohol consumption with POD. Linear regression analysis was used to study the relationship between alcohol consumption and CSF biomarkers. Mediation analyses with 10,000 bootstrapped iterations were used to explore the mediation effects. 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%. Logistic regression showed that alcohol consumption (OR = 1.016, 95%CI 1.009–1.024, P < 0.001) is a risk factor for 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. Mediation analyses showed that alcohol consumption is likely to partially mediate POD through Aβ42 (proportion:14.21%). ROC curve showed that alcohol consumption (AUC = 0.904; P < 0.001) exhibited a relatively better discriminatory ability in POD prediction compared to Aβ42 (AUC = 0.798; P < 0.001). The calibration curve indicated a good nomogram prediction (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: 99%

Section: Introductionmentioning

confidence: 99%

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

Wu,

Zhang,

Zhou

et al. 2023

BMC Anesthesiol

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“…This finding may be related to the more frequent alcohol consumption by men among the elderly Chinese population (Liu et al, 2019). Furthermore, prospective studies on the relationship between alcohol abuse and POD have confirmed that alcohol abuse is an independent risk factor for POD (Sousa et al, 2017). Laboratory tests on POD found that POD patients exhibited an average erythrocyte volume > 95.0 fl, a marker often associated with alcoholism (Findley et al, 2010).…”

Section: Discussionmentioning

confidence: 97%

Incidence of delirium after non-cardiac surgery in the Chinese elderly population: a systematic review and meta-analysis

Gong

Hou

Yang

et al. 2023

Front. Aging Neurosci.

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BackgroundPOD places a heavy burden on the healthcare system as the number of elderly people undergoing surgery is increasing annually because of the aging population. As a large country with a severely aging population, China's elderly population has reached 267 million. There has been no summary analysis of the pooled incidence of POD in the elderly Chinese population.MethodsSystematic search databases included PubMed, Web of Science, EMBASE, Cochrane Library Databases, China Knowledge Resource Integrated Database (CNKI), Chinese Biomedical Database (CBM), WanFang Database, and Chinese Science and Technology Periodicals (VIP). The retrieval time ranged from the database's establishment to February 8, 2023. The pooled incidence of delirium after non-cardiac surgery was calculated using a random effects model. Meta-regression, subgroup, and sensitivity analyses were used to explore the source of heterogeneity.ResultsA total of 52 studies met the inclusion criteria, involving 18,410 participants. The pooled incidence of delirium after non-cardiac surgery in the elderly Chinese population was 18.6% (95% CI: 16.4–20.8%). The meta-regression results revealed anesthesia method and year of publication as a source of heterogeneity. In the subgroup analysis, the gender subgroup revealed a POD incidence of 19.6% (95% CI: 16.9–22.3%) in males and 18.3% (95% CI: 15.7–20.9%) in females. The year of publication subgroup analysis revealed a POD incidence of 20.3% (95% CI: 17.4–23.3%) after 2018 and 14.6 (95% CI: 11.6–17.6%) in 2018 and before. In the subgroup of surgical types, the incidence of hip fracture surgery POD was 20.7% (95% CI: 17.6–24.3%), the incidence of non-cardiac surgery POD was 18.4% (95% CI: 11.8–25.1%), the incidence of orthopedic surgery POD was 16.6% (95% CI: 11.8–21.5%), the incidence of abdominal neoplasms surgery POD was 14.3% (95% CI: 7.6–21.1%); the incidence of abdominal surgery POD was 13.9% (95% CI: 6.4–21.4%). The anesthesia methods subgroup revealed a POD incidence of 21.5% (95% CI: 17.9–25.1%) for general anesthesia, 15.0% (95% CI: 10.6–19.3%) for intraspinal anesthesia, and 8.3% (95% CI: 10.6–19.3%) for regional anesthesia. The measurement tool subgroup revealed a POD incidence of 19.3% (95% CI: 16.7–21.9%) with CAM and 16.8% (95% CI: 12.6–21.0%) with DSM. The sample size subgroup revealed a POD incidence of 19.4% (95% CI: 16.8–22.1%) for patients ≤ 500 and 15.3% (95% CI: 11.0–19.7%) for patients > 500. The sensitivity analysis suggested that the pooled incidence of postoperative delirium in this study was stable.ConclusionOur systematic review of the incidence of delirium after non-cardiac surgery in elderly Chinese patients revealed a high incidence of postoperative delirium. Except for cardiac surgery, the incidence of postoperative delirium was higher for hip fracture surgery than for other types of surgery. However, this finding must be further explored in future large-sample studies.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: PROSPERO CRD42023397883.

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“…Alcohol drinking can induce headache and sleep disorders and cause activation of the autonomic nervous system and changes in cognitive condition. These symptoms can be aggravated by fatigue, malnutrition, physical diseases and depression, leading to delirium (Sousa et al, 2017). Although no significant correlation was found between alcohol drinking and postoperative delirium in this study, further studies to identify relevant factors are needed.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for postoperative delirium in patients with colorectal cancer

Kim

박희옥

Kim

2021

Journal of Clinical Nursing

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Aim:The purpose of this study was to identify the incidence of postoperative delirium in PCC (patients with colorectal cancer) and the related factors of postoperative delirium by analysing the differences in the general, disease-related and operation-related characteristics.Background: Previous studies had some limitations in generalising the risk factors for postoperative delirium in PCC due to the lack of relevant factors, such as disease-and operation-related characteristics. There is a need to investigate the factors of postoperative delirium by including cancer and surgical characteristics. Design:The current study is a cross-sectional study to investigate the correlated factors of postoperative delirium in PCC. Methods: A total of 196 patients who underwent colorectal cancer surgery at the Keimyung University Dongsan Hospital in Korea participated in the study. Data collection was performed from 15 August 2018 to 10 July 2019. Patients' general,disease-related and operation-related characteristics were collected from questionnaires and electronic medical records. Data analysis was performed using descriptive statistics, t test, Chi-square test and logistic regression using SPSS/WIN 22.0. The STROBE checklist has been used to report this study. Results:The results of this study showed that 26 (13.2%) PCC exhibited postoperative delirium and the risk factors for postoperative delirium were physical activity (OR = 2.94, p = .001), infection (OR = 2.17, p = .001) and nutritional status (OR = 1.10, p = .028). Conclusion:To reduce and prevent the occurrence of postoperative delirium in PCC, encouraging participation in physical activity before and after surgery are required, and regular monitoring of the infection symptoms and nutritional status.Relevance to clinical practice: Based on the results of this study, postoperative delirium in PCC could be decreased by encouraging physical activity immediately following operation, monitoring the signs and symptoms of infection using diverse objective laboratory findings and maintaining the nutritional status within the normal range.

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Postoperative delirium in patients with history of alcohol abuse

Cited by 7 publications

References 30 publications

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

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

Incidence of delirium after non-cardiac surgery in the Chinese elderly population: a systematic review and meta-analysis

Risk factors for postoperative delirium in patients with colorectal cancer

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