Risk factors for postoperative delirium in elderly patients undergoing gastroenterological surgery: A single‐center retrospective study

Abstract

AimTo investigate the risk factors for postoperative delirium among elderly patients undergoing elective surgery for gastroenterological cancer.MethodsFrom May 2020 to March 2022, patients ≥75 years old with gastroenterological cancer who underwent radical surgery were enrolled. The geriatric assessment, including evaluations of frailty, physical function, nutrition status, and cognitive function, was conducted preoperatively. The confusion assessment method was used to diagnose postoperative delirium. A multivariate logistic regression analysis was used to determine risk factors for postoperative delirium.ResultsA total of 158 patients were eligible for inclusion in this study. Of these 53 patients (34%) developed postoperative delirium. In the univariate analysis, the age, regular use of sleeping drugs and benzodiazepine, Charlson Comorbidity Index score, performance status, Fried's frailty score, Vulnerable Elders Survey‐13 score, grip weakness, Short Physical Performance Battery (SPPB) score, Mini Nutritional Assessment Short‐Form score, and Mini‐Mental State Examination score were statistically associated with the incidence of postoperative delirium. In the multivariate analysis, a SPPB score ≤9, Mini Nutritional Assessment score ≤11, a Mini‐Mental State Examination score ≤24, and regular use of benzodiazepine were found to be independent preoperative risk factors for postoperative delirium.ConclusionCertain findings during the preoperative geriatric assessment, especially low SPPB, Mini Nutritional Assessment Short‐Form and Mini‐Mental State Examination scores, and regular use of benzodiazepine were risk factors for postoperative delirium in elderly patients undergoing gastroenterological surgery.

Predictive value of the Naples prognostic score on postoperative delirium in the elderly with gastrointestinal tumors: a retrospective cohort study

“…Fortunately, POD could be prevented, and exploring potential risk factors for delirium and early intervention were the first step in treating POD [ 23 ]. Over the past few years, several studies had examined various independent risk factors associated with POD in patients underwent gastrointestinal tumor surgery [ 21 , 24 ]. Notably, our current study investigated the predictive power of preoperative NPS for POD in patients underwent gastrointestinal tumor surgery.…”

Preoperative cognitive function as a risk factor of postoperative delirium in cancer surgeries: A systematic review and meta‐analysis

“…A total of 48 articles were included in this study (Table 1), of which 39 (81.25%) studies were cohort, [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][39][40][41][42][45][46][47][49][50][51]54,57,[59][60][61][62][63][64][65][66][67][68] and 8 (16.6%) were randomized clinical 38,43,44,48,52,53,55,58 trials (one article excluded in the late stage as it was retracted in the publisher journal).…”

“…Figure 1 depicts the flow of retrieving the articles. Twenty-three studies included samples comprised of patient with gastrointestinal (GI) cancers, 22,24,26,[28][29][30][31][32][33]35,36,39,40,42,49,50,53,55,57,58,60,65,67 seven with urological cancers, 25,27,[45][46][47]62,68 nine on various cancers, 34,38,43,48,51,52,56,59,64 three with head and neck cancers, 21,23,41 and one with gynecological, lung, oral, and brain (tumor) cancers, respectively. Of the 48 studies, 39 [21][22][23][24][25][26][27]…”

“…Of the 48 studies, 39 [21][22][23][24][25][26][27][28][29][30][31][32][33]35,36,[38][39][40]42,43,[48][49][50][51][52][53][54][55][56][57][58][59][60][61]63,[65][66][67][68] used MMSE to assess cognitive function, six 34,[44][45][46][47]64 used Mini-cog, one 37 used Montreal Cognitive Assessment (MoCA), one 62 used Hierarchic Dementia Scale-Revised (HDS-R) and one 41 used the patient's medical history as a cognitive assessment preoperatively. For POD assessment, the most used tools were CAM, 22,23,25,…”

“…Preoperative cognitive impairment defined as low MMSE score 22,25,26,[28][29][30][31][32][33]35,42,50,51,53,61,63,65,66 or abnormal Mini-Cog test result (≤3; 34, 45-47, 64) significantly predicted POD in cancer surgeries. Also, some studies excluded patients who had preoperative cognitive impairment with Alzheimer's disease, dementia, 23,25,37,38,40,44,57,58,64,67,68 or indicated by low MMSE scores, 26,30,36,40,42,[55][56][57][58]68 and patients of younger age (usually <60 years old) were excluded, 22,[25][26][27][28][29][31][32][33][34]…”