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Risk factors for emergence agitation during the awakening period in elderly patients after total joint arthroplasty: a retrospective cohort study

OBJECTIVES: This study aimed to explore the incidence and risk factors for emergence agitation (EA) in elderly patients who underwent total joint arthroplasty (TJA) under general anaesthesia, and to assess their predictive values. DESIGN: Single-centre retrospective cohort study. SETTING: A 1600-bed...

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Autores principales: Wang, Naigeng, Hao, Jianhong, Zhang, Jie, Du, Jing, Luo, Zhenguo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10174031/
https://www.ncbi.nlm.nih.gov/pubmed/37164475
http://dx.doi.org/10.1136/bmjopen-2022-068284
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author Wang, Naigeng
Hao, Jianhong
Zhang, Jie
Du, Jing
Luo, Zhenguo
author_facet Wang, Naigeng
Hao, Jianhong
Zhang, Jie
Du, Jing
Luo, Zhenguo
author_sort Wang, Naigeng
collection PubMed
description OBJECTIVES: This study aimed to explore the incidence and risk factors for emergence agitation (EA) in elderly patients who underwent total joint arthroplasty (TJA) under general anaesthesia, and to assess their predictive values. DESIGN: Single-centre retrospective cohort study. SETTING: A 1600-bed general tertiary hospital in China. PARTICIPANTS: This study enrolled 421 elderly patients scheduled for elective primary TJA under general anaesthesia. PRIMARY AND SECONDARY OUTCOME MEASURES: EA was assessed using the Richmond Agitation Sedation Scale during the awakening period after surgery in the post-anaesthesia care unit. Risk factors for EA were identified using univariate and multivariable logistic analyses. The receiver operating characteristic (ROC) curve was used to assess the predictive values of the risk factors for EA. RESULTS: The incidence of EA in elderly patients who underwent TJA was 37.6%. According to the multivariable logistic analysis, postoperative pain (95% CI: 1.951 to 3.196), male sex (95% CI: 1.781 to 6.435), catheter-related bladder discomfort (CRBD) (95% CI: 4.001 to 15.392) and longer fasting times for solids (95% CI: 1.260 to 2.301) and fluids (95% CI: 1.263 to 2.365) were independent risk factors for EA. As shown by the ROC analysis, postoperative pain and fasting times for solids and fluids had good predictive values, with areas under the ROC curve equalling 0.769, 0.753 and 0.768, respectively. CONCLUSIONS: EA is a common complication after TJA in elderly patients. Some risk factors, including postoperative pain, male sex, CRBD and longer fasting times, can increase the incidence of EA. These risk factors may contribute to identifying high-risk patients, which facilitates the development of effective strategies to prevent and treat EA. TRIAL REGISTRATION NUMBER: ChiCTR1800020193.
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spelling pubmed-101740312023-05-12 Risk factors for emergence agitation during the awakening period in elderly patients after total joint arthroplasty: a retrospective cohort study Wang, Naigeng Hao, Jianhong Zhang, Jie Du, Jing Luo, Zhenguo BMJ Open Anaesthesia OBJECTIVES: This study aimed to explore the incidence and risk factors for emergence agitation (EA) in elderly patients who underwent total joint arthroplasty (TJA) under general anaesthesia, and to assess their predictive values. DESIGN: Single-centre retrospective cohort study. SETTING: A 1600-bed general tertiary hospital in China. PARTICIPANTS: This study enrolled 421 elderly patients scheduled for elective primary TJA under general anaesthesia. PRIMARY AND SECONDARY OUTCOME MEASURES: EA was assessed using the Richmond Agitation Sedation Scale during the awakening period after surgery in the post-anaesthesia care unit. Risk factors for EA were identified using univariate and multivariable logistic analyses. The receiver operating characteristic (ROC) curve was used to assess the predictive values of the risk factors for EA. RESULTS: The incidence of EA in elderly patients who underwent TJA was 37.6%. According to the multivariable logistic analysis, postoperative pain (95% CI: 1.951 to 3.196), male sex (95% CI: 1.781 to 6.435), catheter-related bladder discomfort (CRBD) (95% CI: 4.001 to 15.392) and longer fasting times for solids (95% CI: 1.260 to 2.301) and fluids (95% CI: 1.263 to 2.365) were independent risk factors for EA. As shown by the ROC analysis, postoperative pain and fasting times for solids and fluids had good predictive values, with areas under the ROC curve equalling 0.769, 0.753 and 0.768, respectively. CONCLUSIONS: EA is a common complication after TJA in elderly patients. Some risk factors, including postoperative pain, male sex, CRBD and longer fasting times, can increase the incidence of EA. These risk factors may contribute to identifying high-risk patients, which facilitates the development of effective strategies to prevent and treat EA. TRIAL REGISTRATION NUMBER: ChiCTR1800020193. BMJ Publishing Group 2023-05-10 /pmc/articles/PMC10174031/ /pubmed/37164475 http://dx.doi.org/10.1136/bmjopen-2022-068284 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Anaesthesia
Wang, Naigeng
Hao, Jianhong
Zhang, Jie
Du, Jing
Luo, Zhenguo
Risk factors for emergence agitation during the awakening period in elderly patients after total joint arthroplasty: a retrospective cohort study
title Risk factors for emergence agitation during the awakening period in elderly patients after total joint arthroplasty: a retrospective cohort study
title_full Risk factors for emergence agitation during the awakening period in elderly patients after total joint arthroplasty: a retrospective cohort study
title_fullStr Risk factors for emergence agitation during the awakening period in elderly patients after total joint arthroplasty: a retrospective cohort study
title_full_unstemmed Risk factors for emergence agitation during the awakening period in elderly patients after total joint arthroplasty: a retrospective cohort study
title_short Risk factors for emergence agitation during the awakening period in elderly patients after total joint arthroplasty: a retrospective cohort study
title_sort risk factors for emergence agitation during the awakening period in elderly patients after total joint arthroplasty: a retrospective cohort study
topic Anaesthesia
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10174031/
https://www.ncbi.nlm.nih.gov/pubmed/37164475
http://dx.doi.org/10.1136/bmjopen-2022-068284
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