Incidence and Risk Factors for Postoperative Delirium in Patients After Hepatectomy

Park, Sung Ae; Tomimaru, Yoshito; Shibata, Asuka; Miyagawa, Shinichi; Noguchi, Kozo; Dono, Keizo

doi:10.1007/s00268-017-4079-3

Cited by 36 publications

(46 citation statements)

References 28 publications

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“…It was reported that an advanced age, low serum albumin level and a high probability of preoperative cerebrovascular disorders were independent risk factors for post‐operative delirium in patients after liver resection, while these features were also observed in the current meta‐analysis (Table ). Perioperative intervention, including psychiatric consultation, albumin level tests and perioperative risk evaluation and monitoring, should be strongly considered for the prevention and early treatment of post‐operative delirium …”

Section: Discussionsupporting

confidence: 55%

“…Post‐operative delirium occurred at a high rate of 33.1% among super‐elderly patients in the current meta‐analysis, which was also higher than the reported rates ranging from 8.4 to 22% among patients of a younger age, ranging from 65 to 71 years, after liver resection . It was reported that an advanced age, low serum albumin level and a high probability of preoperative cerebrovascular disorders were independent risk factors for post‐operative delirium in patients after liver resection, while these features were also observed in the current meta‐analysis (Table ). Perioperative intervention, including psychiatric consultation, albumin level tests and perioperative risk evaluation and monitoring, should be strongly considered for the prevention and early treatment of post‐operative delirium …”

Section: Discussionsupporting

confidence: 41%

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Does an extreme age (≥80 years) affect outcomes in patients after liver cancer surgery? A meta‐analysis

Wei

2018

ANZ Journal of Surgery

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Section: Discussionsupporting

confidence: 55%

Section: Discussionsupporting

confidence: 41%

Does an extreme age (≥80 years) affect outcomes in patients after liver cancer surgery? A meta‐analysis

Wei

2018

ANZ Journal of Surgery

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“…In the past, many studies focused on the mortality and long-term survival of the patients after hepatectomy [25–27]. However, limited studies have been developed to determine which perioperative parameters were the risk factors influencing the postoperative complications of liver resection [14–16, 28]. The Surgical Apgar Score (SAS), which was first proposed in 2007 by Gawande et al [29], is a 10-point model made up of three intraoperative parameters: mean arterial pressure (MAP), heart rate (HR), and estimated blood loss (EBL).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, more and more studies have been focused on the strategies not only to prevent the mortality but also to predict the nonlethal postoperative complications. Many studies have been proposed to identify risk factors of postoperative complications and then to help patients not at high risk of poor outcome after surgery [14–16].…”

Section: Introductionmentioning

confidence: 99%

Effective prediction of postoperative complications for patients after open hepatectomy: a simplified scoring system based on perioperative parameters

et al. 2019

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Background The aim of the study was to develop a scoring system for the prediction of postoperative complications of open hepatectomy. Method All consecutive patients receiving open hepatectomy from 2015 to 2017 were included in the study. Univariate and multivariate analyses were used to confirm the risk factors for postoperative complications. Afterwards, a novel scoring system was developed to predict the postoperative complications. Results The study included a total of 207 patients. For the test dataset, multivariate analysis indicated that diabetes, scale of surgery, serum potassium, and blood loss versus body weight were independent risk factors of the postoperative complications. The area under the curve (AUC) of the novel scoring system we proposed for prediction of postoperative complications of hepatectomy was 0.803, which is comparable with the AUCs of previous scoring systems. Furthermore, in the validation dataset, the corresponding AUC of the new scoring system was 0.717. Conclusion This novel and simplified scoring system can effectively predict the postoperative complications of open hepatectomy and could help identify patients who are at high risk of postoperative complications. Electronic supplementary material The online version of this article (10.1186/s12893-019-0597-2) contains supplementary material, which is available to authorized users.

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“…Another study found that a postoperative hemoglobin level of <11 g/dl, which is similar in nature to intraoperative blood loss of ≥1000 ml, was a risk factor for postoperative delirium [ 6 ]. Two previous studies have reported that a low serum albumin level is a risk factor for postoperative delirium [ 4 , 5 ]. However, no such finding was obtained in the present study.…”

Section: Discussionmentioning

confidence: 99%

Preventative effects of ramelteon against postoperative delirium after elective liver resection

et al. 2020

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Background Postoperative delirium was reported to be associated with increased postoperative mortality after liver resection. Therefore, it is crucial to prevent postoperative delirium in such cases. Ramelteon, an agonist of melatonin receptor has been suggested to be useful for preventing delirium. The aim of this study was to examine whether ramelteon is effective at preventing delirium after elective liver resection. Methods The cases of patients who underwent liver resection at Nara Medical University (Nara, Japan) between January 2014 and August 2018 were analyzed. During the period from January 2017 to August 2018, ramelteon was prospectively administered to patients who underwent liver resection [8 mg/day on the day before surgery and on postoperative days 1 to 3] (ramelteon group), whereas ramelteon was not administered during the period from January 2014 to December 2016 (control group). The perioperative outcomes of the two groups were compared. Results There were 120 patients in the ramelteon group and 186 patients in the control group. No significant intergroup differences in background factors, including age, gender, and preoperative serological laboratory data, were detected. The incidence of postoperative delirium was significantly lower in the ramelteon group (5.8% vs. 15.1%, P = 0.035). Multivariate analysis revealed that being aged ≥75 (P = 0.002), being male (P = 0.020), cardiovascular disease (P = 0.023), blood loss ≥1000ml (P = 0.001) and the absence of ramelteon treatment (P = 0.046) were independent risk factors for postoperative delirium. Conclusion The administration of ramelteon might reduce the risk of postoperative delirium after elective liver resection.

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Incidence and Risk Factors for Postoperative Delirium in Patients After Hepatectomy

Abstract: This study clarified the incidence and risk factors for delirium after liver resection. These results would contribute to prediction and treatment of delirium.

Cited by 36 publications

References 28 publications

Does an extreme age (≥80 years) affect outcomes in patients after liver cancer surgery? A meta‐analysis

Does an extreme age (≥80 years) affect outcomes in patients after liver cancer surgery? A meta‐analysis

Effective prediction of postoperative complications for patients after open hepatectomy: a simplified scoring system based on perioperative parameters

Preventative effects of ramelteon against postoperative delirium after elective liver resection

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