Impaired Mobility, ASA Status and Administration of Tramadol are Risk Factors for Postoperative Delirium in Patients Aged 75 Years or More After Major Abdominal Surgery

Brouquet, Antoine; Cudennec, Tristan; Benoist, Stéphane; Moulias, Sophie; Beauchet, Alain; Penna, Christophe; Teillet, Laurent; Nordlinger, Bernard

doi:10.1097/sla.0b013e3181c1cfc9

Cited by 212 publications

(171 citation statements)

References 38 publications

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“…In the study by Koebrugge et al, 29 the incidence of postoperative delirium after abdominal surgery was 24%. Brouquet et al 30 showed the same incidence of 24% of postoperative delirium in their study of elderly patients more than 75 years undergoing elective major abdominal surgery. In our study, poor preoperative mental state was not an exclusion criteria.…”

Section: Discussionmentioning

confidence: 68%

Postoperative Course After Emergency Colorectal Surgery for Secondary Peritonitis in the Elderly Is Often Complicated by Delirium

Engelberger

Zürcher

Schuld

et al. 2012

International Surgery

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Postoperative delirium, morbidity, and mortality in our elderly patients with secondary perionitis of colorectal origin is described. This is a chart-based retrospective analysis of 63 patients who were operated on at the University Hospital Basel from April 2001 to May 2004. Postoperative delirium occurred in 33%. Overall morbidity was 71.4%. Surgery-related morbidity was 43.4%. Mortality was 14.4%. There was no statistical significance between delirium, morbidity and mortality (P = 0.279 and P = 0.364). There was no statistically significant correlation between the analyzed scores (American Society of Anesthesiologists classification, Mannheimer Peritonitis Index, Acute Physiology and Chronic Health Evaluation score II, physiological and operative surgical severity and enumeration of morbidity and mortality score' or short 'cr-POSSUM') and postoperative delirium, morbidity or mortality. Postoperative delirium occurred in one-third of the patients, who seem to have a trend to higher morbidity. Even if the different scores already had proven to be predictive in terms of morbidity and mortality, they do not help the risk stratification of postoperative delirium, morbidity, or mortality in our collective population.

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Section: Discussionmentioning

confidence: 68%

Postoperative Course After Emergency Colorectal Surgery for Secondary Peritonitis in the Elderly Is Often Complicated by Delirium

Engelberger

Zürcher

Schuld

et al. 2012

International Surgery

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“…In the older population, tramadol may cause fewer respiratory and gastrointestinal side-effects than other opioids, but is associated with delirium [58], and cannot be tolerated by a third of patients, due to nausea, vomiting, sweating, dizziness, tremors and headaches.…”

Section: Tramadolmentioning

confidence: 99%

The assessment and management of peri‐operative pain in older adults

Schofield

2013

Anaesthesia

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SummaryA number of recent reports have highlighted the inadequate provision of pain relief for older inpatients. Despite the availability of numerous validated pain measures, pain remains poorly assessed in some cases and, particularly, in the cognitively impaired. Without proper assessment, patients may receive inadequate or inappropriate analgesia, both of which can worsen outcome. Most drugs and techniques that are used for analgesia in younger patients are also suitable for older patients, although dosages may have to be adjusted to avoid the side‐effects that are consequent upon age‐related changes in drug pharmacokinetics and pharmacodynamics, co‐morbidity, frailty, cognitive impairment and polypharmacy. This paper reviews current guidelines and methods of assessing pain in the older adult, and describes the use of, and problems with, mild, moderate, strong, adjuvant and local anaesthetic drugs in the older population for analgesia, advocating multimodal intervention to reduce dose‐related side‐effects, particularly of opioids.

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“…In this study using ICDSC, considered very sensitive tool for screening of delirium, we found a POD incidence slightly inferior of that found by other authors. [18][19][20][21][22][23][24] . This lower incidence may be explained by the demographic characteristics of the study population with younger patients and a better preoperative status (patients with lower ASA-PS and lower RCRI).…”

Section: Discussionmentioning

confidence: 99%