Pain, Opioid Intake, and Delirium Symptoms in Adults Following Joint Replacement Surgery

Denny, Dawn L.; Lindseth, Glenda

doi:10.1177/0193945919849096

Cited by 18 publications

(18 citation statements)

References 38 publications

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“…In this study, the incidence of POD and SSD was 18.8%, compared to the 58.1-67.9% that was reported previously [6,16,17]. Moreover, the incidence was low in comparison to ranges from 11-51% as the common incidence of POD in older patients [2].…”

Section: Discussioncontrasting

confidence: 46%

“…The rst reason would be the characteristics of the department for patient treatment. Participants of prior studies underwent joint replacement surgery [16,17]. Patients with joint disorders tend to have joint pain and limited mobility, that may limit the preoperative ADL, which is a risk factor for SSD [13,31].…”

Section: Discussionmentioning

confidence: 99%

“…The umbrella term "functioning" that refers to all body functions, activities, and participation is an aspect of the aforementioned risk factors [12]). In contrast, only three risk factors for SSD have been identi ed in the general ward in previous studies: higher pain level, a recent history of falls within the past 6 months, and a longer preoperative fasting time [16,17]. We predicted that there are more risk factors of SSD particular to the general ward, e.g.…”

mentioning

confidence: 93%

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Risk factors for postoperative delirium and subsyndromal delirium in older surgical patients in the general ward: a prospective observational study

Kanno

Doi

Kubota

et al. 2020

Preprint

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Background Postoperative delirium (POD) among older patients is a common, serious disease and is associated with a high incidence of negative outcomes. For early detection of POD and subsyndromal delirium (SSD), this study was conducted to identify risk factors of POD and SSD in older patients in a general ward who were scheduled for surgery. Methods This was a prospective observational study. Study participants were older than 65 years, underwent urology surgery, and were hospitalized in the general ward between April and September 2019. Both POD and SSD were assessed by using the Confusion Assessment Method on the preoperative day, the day of surgery, and postoperative days 1–3. Personal characteristics, clinical data, cognitive function, physical functions, laboratory test results, medication use, type of surgery and anesthesia, and use of restraints were collected from medical records. Univariate and multivariate analyses were conducted to identify the risk factors for POD and SSD. Results A total of 101 participants (mean age 74.9 years) were enrolled; 19 (18.8%) developed POD and SSD. The use of bed sensors (odds ratio 10.2, p = .001) and preoperative level of C-reactive protein (CRP; odds ratio 1.5, p = .054) were identified as risk factors for POD and SSD. Conclusions POD and SSD among older patients in general wards were related to bed sensor use and the preoperative CRP level. Therefore, this study suggests that in order prevent POD and SSD for older patients in general wards, it is necessary to avoid bed sensor use as restraints and to assess the preoperative CRP level.

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Section: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 93%

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Risk factors for postoperative delirium and subsyndromal delirium in older surgical patients in the general ward: a prospective observational study

Kanno

Doi

Kubota

et al. 2020

Preprint

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“…The literature consistently suggests an association between pain and delirium, even after controlling for potential confounders of this relationship such as age [9] comorbidity [10] and severity of dementia. Some authors have noted a "dose-response" gradient in this association, with increasing pain severity increasing the risk of both sub-syndromal [11] and full-syndromal delirium [12], although this is not a consistent finding.…”

Section: The Association Between Pain and Deliriummentioning

confidence: 93%

Pain and delirium: mechanisms, assessment, and management

2020

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Aim To provide a clinical overview of the association between pain and delirium, the mechanisms which may underlie this and how pain can be detected and managed in delirium. Findings There are few studies in this field. It is likely that pain is a key cause of delirium but this relationship is complex and mediated by many factors. Observational tools may help diagnose pain in delirium but need further testing. Message Pain is a potentially treatable cause of delirium and future research in how to better detect and managed this is required.

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“…These factors are important aspects for assessing of the living function in older adults. In contrast, only three risk factors for SSD have been identi ed in the surgical ward in previous studies: higher pain level, a recent history of falls within the past 6 months, and a longer preoperative fasting time [12,13]. We predicted that there are more risk factors of SSD, similar to POD, such as cognitive state, ADL, and anxiety.…”

Section: Introductionmentioning

confidence: 91%

Risk factors for postoperative delirium and subsyndromal delirium in older surgical patients in the surgical ward: a prospective observational study

Kanno

Doi

Kubota

et al. 2020

Preprint

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Background: Postoperative delirium (POD) among older patients is a common, serious disease and is associated with a high incidence of negative outcomes. For early detection of POD and subsyndromal delirium (SSD), this study was conducted to identify risk factors of POD and SSD in older patients who were scheduled for surgery in a surgical ward.Methods: This was a prospective observational study. Study participants were older than 65 years, underwent urology surgery, and were hospitalized in the surgical ward between April and September 2019. Both POD and SSD were assessed by using the Confusion Assessment Method (CAM) on the preoperative day, the day of surgery, and postoperative days 1–3 by the surgical ward nurses. SSD was defined as the presence of one or more CAM criteria and the absence of a diagnosis of delirium based on the CAM algorithm. Personal characteristics, clinical data, cognitive function, physical functions, laboratory test results, medication use, type of surgery and anesthesia, and use of physical restraint were collected from medical records. Logistic regression analyses were conducted to identify the risk factors for POD and SSD.Results: A total of 101 participants (mean age 74.9 years) were enrolled; 19 (18.8%) developed POD and SSD. The use of bed sensors (odds ratio 10.2, p=.001) were identified as risk factors for POD and SSD.Conclusions: Our study shows that the use of bed sensors might be related to the development of POD and SSD among older patients in surgical wards.

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Pain, Opioid Intake, and Delirium Symptoms in Adults Following Joint Replacement Surgery

Cited by 18 publications

References 38 publications

Risk factors for postoperative delirium and subsyndromal delirium in older surgical patients in the general ward: a prospective observational study

Risk factors for postoperative delirium and subsyndromal delirium in older surgical patients in the general ward: a prospective observational study

Pain and delirium: mechanisms, assessment, and management

Risk factors for postoperative delirium and subsyndromal delirium in older surgical patients in the surgical ward: a prospective observational study

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