Short-Form Mini Nutritional Assessment as a useful method of predicting the development of postoperative delirium in elderly patients undergoing orthopedic surgery

Chu, Che‐Sheng; Liang, Chih‐Kuang; Chou, Ming‐Yueh; Lin, Yu‐Te; Hsu, Chien-Jen; Chou, Po-Han; Chu, Chih‐Sheng

doi:10.1016/j.genhosppsych.2015.08.006

Cited by 42 publications

(51 citation statements)

References 49 publications

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“… 18 Elderly patients with hip fracture are often prone to metabolic disorders, low calorie consumption, impaired nutrition and concomitant cerebrovascular disease leading to impaired nutritional intake. 24 The findings of the present study appear to support this as a lower albumin concentration was associated with the risk of PD.…”

Section: Discussionsupporting

confidence: 78%

Prevalence and risk factors of postoperative delirium in elderly hip fracture patients

et al. 2016

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ObjectiveTo explore the risk factors associated with postoperative delirium (PD) in elderly patients following total hip arthroplasty (THA) for hip fracture.MethodsThis prospective study enrolled elderly patients (≥ 65 years) with hip fractures who underwent THA under general anaesthesia, and who had a complete set of postoperative observations. Detailed medical history and perioperative characteristics were recorded. During the postoperative period, patients were assessed twice daily for PD using the Confusion Assessment Method.ResultsA total of 572 patients were eligible for inclusion in the study. Of these, 120 patients (21.0%) were diagnosed with PD and 452 patients (79.0%) did not experience PD. Multivariate stepwise logistic regression analyses showed that older age, a history of stroke, lower albumin, higher blood glucose, higher total bilirubin, higher C-reactive protein, longer surgery duration and higher volume of red blood cell transfusions were independent risk factors for PD.ConclusionsCorrecting the modifiable risk factors might help prevent PD. Strategies might include nutritional support, tight blood glucose control, improvement of liver function, preoperative infection control and minimizing surgical injury or blood loss.

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Section: Discussionsupporting

confidence: 78%

Prevalence and risk factors of postoperative delirium in elderly hip fracture patients

et al. 2016

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“…The MNA-SF detected malnutrition in 14.2% of patients in the current study. Another study found a similar prevalence of malnutrition by the MNA-SF [31].…”

Section: Discussionmentioning

confidence: 60%

“…To date, only one study by Sugita, et al compared different screening tools, including the GNRI, PNI and CONUT, for prediction of delirium in coronary intensive care unit patients and they observed no a significant association between GNRI and delirium [36], which is similar to our study. Recently, Chu et al and Mazzola et al used the MNA-SF as a screening tool among orthopedic surgical patients and detected a significant association between MNA-SF and POD [31,37]. In addition, previous studies have found that the nutritional intervention could reduce the incidence of postoperative delirium and shorten its duration in older surgical patients [10,38,39].…”

Section: Discussionmentioning

confidence: 99%

The geriatric nutrition risk index versus the mini-nutritional assessment short form in predicting postoperative delirium and hospital length of stay among older non-cardiac surgical patients: a prospective cohort study

Zhao

Xie

et al. 2020

BMC Geriatr

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Backgrounds: Malnutrition has been shown to be associated with poor prognosis in older surgical patients. Several tools are available for detecting malnutrition. But little is known about their ability to assess risks of postoperative adverse outcomes. The study aimed to compare the ability of the Geriatric Nutritional Risk Index (GNRI) and the Mini-Nutritional Assessment Short Form (MNA-SF) in predicting postoperative delirium (POD) and length of stay (LOS) among older non-cardiac surgical patients. Methods: Prospective study of 288 older non-cardiac surgical patients from the West China Hospital of Sichuan University. Preoperative nutritional status was assessed using the GNRI and MNA-SF, and patients were followed for the occurrence of POD and LOS. Multivariable logistic regression and linear regression analyses were used to identify predictors of these outcomes. The relative performance of the GNRI and MNA-SF as predictors of these outcomes were determined by Receiver Operating Characteristic curves (ROC) analyses and the area under the curve (AUC). Results: Multivariable analysis revealed that preoperative malnutrition by the MNA-SF was significantly associated with POD. Linear regression analysis showed that preoperative low/high nutritional risk of the GNRI and malnutrition by the MNA-SF were independent predictors of prolonged LOS. Moreover, the area under the curve (AUC) of MNA-SF scores for POD was better than GNRI scores (AUC = 0.

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“…Certain studies have found that delirium incidence is higher in male patients. Similarly male gender was found to be a risk factor for delirium (Chu, et al, 2016). On the contrary, certain other studies have shown no significant association between gender and delirium (Ozbas et al, 2018).…”

Section: Discussionmentioning

confidence: 85%

Incidence and risk factors of post operative delirium in elderly patients who underwent spinal anesthesia in Orotta, Halibet and Sembel Hospitals: A Cross sectional analytic study in ERITREA

Mengistu

Andemeskel

Emehatsion

et al. 2019

Preprint

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BackgroundDelirium is a common but often underdiagnosed set of transient symptomin the elderly patients following surgeries under spinal anesthesia. Delirium can be improved with early recognition and diagnosis based on the established standard criteria. The identification of the possible contributing factors and magnitude of the burden will help in the management of the fragile elderly patients. Managing delirium with environmental, supportive and pharmacological interventions will possibly reduce the incidence, and complication associated with postoperative delirium. The aim of this study is to determine the incidence of postoperative delirium and associated risk factors in elderly patients who did surgery under spinal anesthesia. MethodThis cross sectional study was conducted in the National Referral Hospitals in Eritrea (Orotta and Halibet), including Sembel hospital from February to May, 2019. The study participants were elderly patients (age ≥65 years) having no mental disorder, no history of acute cerebrovascular disease, no known history of delirium and/or dementia. Basic background and clinical characteristics of the patients was collected. To assess the status of cognitive impairment level, the Mini Mental State Examination and Confusion Assessment Method tools were used. Data was collected through an interview method. After the data was entered into SPSS version 22 software, it was conducted with frequency, percentage, bivariate and multivariate logistic regression analysis method as appropriate. P value at<0.05 was considered as statistically significant. ConclusionPostoperative delirium occurred in 14 out of 129 case (10.9%). The multivariate analysis showed that only age was significantly associated with postoperative delirium. The other variables did not significantly influence the occurrence of POD. Therefore, t he incidence of postoperative delirium after spinal anesthesia was relatively high (10.9%). Similarly, old age was found as the risk factor for the development of delirium in those elderly patients who underwent spinal anesthesia. This findings might help to develop preventive strategies to decrease POD through targeted factors.

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Short-Form Mini Nutritional Assessment as a useful method of predicting the development of postoperative delirium in elderly patients undergoing orthopedic surgery

Cited by 42 publications

References 49 publications

Prevalence and risk factors of postoperative delirium in elderly hip fracture patients

Prevalence and risk factors of postoperative delirium in elderly hip fracture patients

The geriatric nutrition risk index versus the mini-nutritional assessment short form in predicting postoperative delirium and hospital length of stay among older non-cardiac surgical patients: a prospective cohort study

Incidence and risk factors of post operative delirium in elderly patients who underwent spinal anesthesia in Orotta, Halibet and Sembel Hospitals: A Cross sectional analytic study in ERITREA

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