Ability of postoperative delirium to predict intermediate-term postoperative cognitive function in patients undergoing elective surgery at an academic medical centre: protocol for a prospective cohort study

Aranake-Chrisinger, A.; Cheng, Jenny Zhao; Muench, Maxwell; Tang, Rose; Mickle, Angela; Maybrier, Hannah; Lin, Nan; Wildes, Troy S.; Lenze, Eric J.; Avidan, Michael S.

doi:10.1136/bmjopen-2017-017079

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…Postoperative delirium (POD) is a common complication of the central nerve system after surgical operations in elderly patients, usually characterized by a fluctuating course of altered consciousness, disordered thinking, and inattention [1]. The incidence of POD is 4% to 65% among adult noncardiovascular surgical patients, 35% to 65% in patients undergoing hip fracture surgery, and 9% to 15% in patients receiving elective orthopedic surgery [2].…”

Section: Introductionmentioning

confidence: 99%

Elevated Level of Serum C‐reactive Protein Predicts Postoperative Delirium among Patients Receiving Cervical or Lumbar Surgery

Ren

Wen

Wang

et al. 2020

BioMed Research International

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Objective. To explore the relationship between elevated serum C-reactive protein (CRP) level and postoperative delirium (POD). Methods. 206 patients scheduled to receive cervical or lumbar vertebra surgery under general anesthesia for more than 2 hours in a single medical center were observed and analyzed. Patients’ serum CRP, delirious status (using the confusion assessment method (CAM)), and delirious score (using the memorial delirium assessment scale (MDAS)) were examined before surgery and 1-2 days after surgery. The association of a serum CRP elevation value from before to after surgery (D-CRP) with delirium occurrence within 2 days after surgery was assessed with a binary logistic regression model, while the association of D-CRP with the postoperative delirious score was assessed with a linear regression model. The effect of D-CRP on predicting delirium occurrence was evaluated with the area under the receiver operating characteristic (ROC) curve (AUC). Results. D-CRP was significantly positively associated with postoperative delirium occurrence (OR=1.047, 95%CI=1.013, 1.082), and D-CRP was also significantly linearly associated with the postoperative delirious score (β=0.014, 95%CI=0.006, 0.023). AUC of ROC was 0.711 (P=0.014), suggesting that D-CRP had moderate efficacy on predicting postoperative delirium occurrence (P<0.05). Conclusions. Elevated serum CRP after surgery may be a risk factor for and a predictor of postoperative delirium.

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Section: Introductionmentioning

confidence: 99%

Elevated Level of Serum C‐reactive Protein Predicts Postoperative Delirium among Patients Receiving Cervical or Lumbar Surgery

Ren

Wen

Wang

et al. 2020

BioMed Research International

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“…17 Further validation of initiatives around frailty assessment to ascertain readiness for surgical treatment or guide perioperative treatment are ongoing. 27 Presumably, mitigating the incidence and extent of PND through these initiatives in individuals deemed to be at higher risk may reduce expenditure and merits consideration.…”

Section: Discussionmentioning

confidence: 99%

“…Relatively recent advancements in the study of aging have led to the concept of the frailty syndrome, a state of depleted physiologic reserve and clinical risk that is associated with, but variably present with, advancing age . Further validation of initiatives around frailty assessment to ascertain readiness for surgical treatment or guide perioperative treatment are ongoing . Presumably, mitigating the incidence and extent of PND through these initiatives in individuals deemed to be at higher risk may reduce expenditure and merits consideration.…”

Section: Discussionmentioning

confidence: 99%

Economic Burden of Postoperative Neurocognitive Disorders Among US Medicare Patients

et al. 2020

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IMPORTANCE Postoperative neurocognitive disorders (PNDs) after surgical procedures are common and may be associated with increased health care expenditures. OBJECTIVE To quantify the economic burden associated with a PND diagnosis in 1 year following surgical treatment among older patients in the United States. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used claims data from the Bundled Payments for Care Improvement Advanced Model from 4285 hospitals that submitted Medicare Fee-for-service (FFS) claims between January 2013 and December 2016. All Medicare patients aged 65 years or older who underwent an inpatient hospital admission associated with a surgical procedure, did not experience a PND before index admission, and were not undergoing dialysis or concurrently enrolled in Medicaid were included. Data were analyzed from October 2019 and May 2020. EXPOSURES PND, defined as an International Classification of Diseases, Ninth or Tenth Revision, diagnosis of delirium, mild cognitive impairment, or dementia within 1 year of discharge from the index surgical admission. MAIN OUTCOMES AND MEASURES The primary outcome was total inflation-adjusted Medicare postacute care payments within 1 year after the index surgical procedure. RESULTS A total of 2 380 473 patients (mean [SD] age, 75.36 (7.31) years; 1 336 736 [56.1%] women) who underwent surgical procedures were included, of whom 44 974 patients (1.9%) were diagnosed with a PND. Among all patients, most were White (2 142 157 patients [90.0%]), presenting for orthopedic surgery (1 523 782 patients [64.0%]) in urban medical centers (2 179 893 patients [91.6%]) that were private nonprofits (1 798 749 patients [75.6%]). Patients with a PND, compared with those without a PND, experienced a significantly longer hospital length of stay (mean [SD], 5.91 [6.01] days vs 4.29 [4.18] days; P < .001), were less likely to be discharged home (9947 patients [22.1%] vs 914 925 patients [39.2%]; P < .001), and had a higher incidence of mortality at 1 year after treatment (4580 patients [10.2%] vs 103 767 patients [4.4%]; P < .

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“…This diagnostic scale is known to be superior to other similar tests because it is short, easy-to-understand, and based on simple scoring system [11]. It has been also shown that BOMC test has a high sensitivity rate in detecting cognitive dysfunction [19]. The other potential pitfall of the previous studies is the variable demographic characteristics of the patient cohorts.…”

Section: Discussionmentioning

confidence: 99%

Role of anesthesia type on cognitive functions in adults undergoing cataract surgery

Kılıç¹,

Bilgeç²,

Sarioğlan³

et al. 2020

Journal of Surgery and Medicine

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All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments. Etik Kurul Onayı: Bu çalışma için onay Osmangazi Üniversitesi Etik Kurulu'ndan alınmıştır (no: 24; 10.10.2019). İnsan katılımcıların katıldığı çalışmalardaki tüm prosedürler, 1964 Helsinki Deklarasyonu ve daha sonra yapılan değişiklikler uyarınca gerçekleştirilmiştir.

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Ability of postoperative delirium to predict intermediate-term postoperative cognitive function in patients undergoing elective surgery at an academic medical centre: protocol for a prospective cohort study

Cited by 5 publications

References 33 publications

Elevated Level of Serum C‐reactive Protein Predicts Postoperative Delirium among Patients Receiving Cervical or Lumbar Surgery

Elevated Level of Serum C‐reactive Protein Predicts Postoperative Delirium among Patients Receiving Cervical or Lumbar Surgery

Economic Burden of Postoperative Neurocognitive Disorders Among US Medicare Patients

Role of anesthesia type on cognitive functions in adults undergoing cataract surgery

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