A Systematic Review and Meta-analysis Examining the Impact of Incident Postoperative Delirium on Mortality

Hamilton, G. M.; Wheeler, Krista K.; Michele, Joseph Di; Lalu, Manoj M.; McIsaac, Daniel I.

doi:10.1097/01.sa.0000527544.63660.11

Cited by 19 publications

(24 citation statements)

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“…The current study reported that patients who had postoperative delirium would have a higher mortality rate even after controlling for age-adjusted Charlson comorbidities and preoperative cognitive status. Consistently, most studies supported that patients who developed delirium were at an increased risk of death 14 and that delirium was associated with 6-month, 15 12-month, 16 and 5-yr 42 postoperative mortality. These results suggest that efforts should be implemented in the elderly population at high risk of developing postoperative delirium after orthopedic surgery.…”

Section: Discussionmentioning

confidence: 64%

“…bias as evidenced by a recent systematic review. 14 Although most studies reported that postoperative delirium was associated with an increased risk of death, 15,16 a few other studies have indicated that the association was not apparent after adjusting for adequate confounders. 17,18 Therefore, the associations among postoperative delirium, the longterm activities of daily living, and mortality remain to be determined.…”

Section: Postoperative Delirium and Activities Of Daily Livingmentioning

confidence: 99%

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Postoperative Delirium Is Associated with Long-term Decline in Activities of Daily Living

Shi

Mei

et al. 2019

Anesthesiology

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Background: Postoperative delirium is one of the most common complications in the elderly surgical population. However, its long-term outcomes remain largely to be determined. Therefore a prospective cohort study was conducted to determine the association between postoperative delirium and long-term decline in activities of daily living and postoperative mortality. The hypothesis in the present study was that postoperative delirium was associated with a greater decline in activities of daily living and higher mortality within 24 to 36 months after anesthesia and surgery. Methods: The participants (at least 65 yr old) having the surgeries of (1) proximal femoral nail, (2) hip replacement, or (3) open reduction and internal fixation under general anesthesia were enrolled. The Confusion Assessment Method algorithm was administered to diagnose delirium before and on the first, second, and fourth days after the surgery. Activities of daily living were evaluated by using the Chinese version of the activities of daily living scale (range, 14 to 56 points), and preoperative cognitive function was assessed by using the Chinese Mini-Mental State Examination (range, 0 to 30 points). The follow-up assessments, including activities of daily living and mortality, were conducted between 24 and 36 months after anesthesia and surgery.

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Section: Discussionmentioning

confidence: 64%

Section: Postoperative Delirium and Activities Of Daily Livingmentioning

confidence: 99%

Postoperative Delirium Is Associated with Long-term Decline in Activities of Daily Living

Shi

Mei

et al. 2019

Anesthesiology

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“…Our results are similar to those of previous studies. Hamilton et al 9 reviewed 34 of 4968 screened citations and found that delirium was associated with a four-fold increase in the risk of death. Mosk et al 7 reported that delirium was correlated with a longer hospital stay, increased associated with complications, institutionalization, and 6-month mortality by observing 566 patients with hip fractures who were over the age of 70.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have demonstrated a correlation between POD and length of stay (LOS), as well as hospital costs [6][7][8] . Recently Hamilton et al reported that POD could increase the postoperative mortality of patients who underwent non-cardiac surgery 9 . However, studies focusing on possible relationships between POD and short-term prognosis in geriatric patients with hip fractures are lacking.…”

Section: Introductionmentioning

confidence: 99%

Impact of Delirium on Short-term Prognosis in Geriatric Patients with Hip Fracture

Feng

et al. 2020

Preprint

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Background: To explore the effect of delirium on postoperative early prognosis of geriatric patients with hip fracture. Methods: According to whether postoperative delirium (POD) appeared in elderly patients with hip fracture, all cases were divided into two groups: delirium and non-delirium. General parameters, operative parameters, length of stay (LOS), and perioperative complications were recorded. Recurrent fracture, new stroke, and mortality within 1 year postoperatively were followed up and compared between the two groups. Results: Of 358 cases, 55 (15.4%) developed delirium. Compared with the non-delirium group, the delirium group had longer operative times (P=0.031); increased platelet (P=0.002) and C-reactive protein (P<0.001) levels; and reduced hemoglobin (P<0.001), calcium (P=0.040), albumin (P<0.001), prealbumin (P<0.001), and total cholesterol (P=0.019) levels. Complications occurred to some extent in 196 cases (54.7%). In the delirium group, complication rates of pulmonary infection (P=0.005), hypoalbuminemia (P<0.001), electrolyte disorder (P<0.001), dyspepsia (P=0.027), bedsore (P=0.012) and anemia (P=0.007) were higher. In addition, LOS was significantly longer (15.71 ± 4.72 vs 14.00 ± 5.30 days; P=0.026) in the delirium group. Within 1 year postoperatively, 31 individuals (8.7%) had died, 13 were treated for recurrent fracture, and 42 had a new stroke. In the delirium group, mortality within 1 year postoperatively was higher (27.3% vs 5.3%, P<0.001). Conclusions: The morbidity of POD is high in geriatric patients with hip fractures. There was longer surgery delay, higher complication rate, longer LOS, and increased mortality in the delirium group. Early intervention of POD has important clinical significance.

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“…Despite considerable efforts to improve surgical outcomes in the elderly population, postoperative cognitive complications remain a common issue associated with morbidity, mortality and substantial healthcare costs . Postoperative delirium is defined as a disturbance in attention and awareness developing over a short period of time (acute change from baseline), which tends to fluctuate in severity during the course of the day and can present with an additional disturbance in cognition (such as memory deficit, disorientation, language, visuospatial ability or perception) .…”

Section: Introductionmentioning

confidence: 99%

Intraoperative ketamine administration to prevent delirium or postoperative cognitive dysfunction: A systematic review and meta‐analysis

Hovaguimian

Tschopp

Beck‐Schimmer

et al. 2018

Acta Anaesthesiol Scand

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A Systematic Review and Meta-analysis Examining the Impact of Incident Postoperative Delirium on Mortality

Cited by 19 publications

References 0 publications

Postoperative Delirium Is Associated with Long-term Decline in Activities of Daily Living

Postoperative Delirium Is Associated with Long-term Decline in Activities of Daily Living

Impact of Delirium on Short-term Prognosis in Geriatric Patients with Hip Fracture

Intraoperative ketamine administration to prevent delirium or postoperative cognitive dysfunction: A systematic review and meta‐analysis

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