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Risk Factors for Delirium after Spine Surgery in Elderly Patients

OBJECTIVE: Postoperative delirium is a common complication in the elderly after surgery but few papers have reported after spinal surgery. We analyzed various risk factors for postoperative delirium after spine surgery. METHODS: Between May 2012 and September 2013, 70 patients over 60 years of age w...

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Autores principales: Seo, Jin Suk, Park, Seung Won, Lee, Young Seok, Chung, Chan, Kim, Young Baeg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Neurosurgical Society 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4185316/
https://www.ncbi.nlm.nih.gov/pubmed/25289122
http://dx.doi.org/10.3340/jkns.2014.56.1.28
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author Seo, Jin Suk
Park, Seung Won
Lee, Young Seok
Chung, Chan
Kim, Young Baeg
author_facet Seo, Jin Suk
Park, Seung Won
Lee, Young Seok
Chung, Chan
Kim, Young Baeg
author_sort Seo, Jin Suk
collection PubMed
description OBJECTIVE: Postoperative delirium is a common complication in the elderly after surgery but few papers have reported after spinal surgery. We analyzed various risk factors for postoperative delirium after spine surgery. METHODS: Between May 2012 and September 2013, 70 patients over 60 years of age were examined. The patients were divided into two groups : Group A with delirium and Group B without delirium. Cognitive function was examined with the Mini-Mental State Examination-Korea (MMSE-K), Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Information was also obtained on the patients' education level, underlying diseases, duration of hospital stay and laboratory findings. Intraoperative assessment included Bispectral index (BIS), type of surgery or anesthesia, blood pressure, fluid balance, estimated blood loss and duration of surgery. RESULTS: Postoperative delirium developed in 17 patients. The preoperative scores for the MMSE, CDR, and GDS in Group A were 19.1±5.4, 0.9±0.6, and 3.3±1.1. These were significantly lower than those of Group B (25.6±3.4, 0.5±0.2, and 2.1±0.7) (p<0.05). BIS was lower in Group A (30.2±6.8 compared to 35.4±5.6 in group B) (p<0.05). The number of BIS <40 were 5.1±3.1 times in Group A, 2.5±2.2 times in Group B (p<0.01). In addition, longer operation time and longer hospital stay were risk factors. CONCLUSION: Precise analysis of risk factors for postoperative delirium seems to be more important in spinal surgery because the surgery is not usually expected to have an effect on brain function. Although no risk factors specific to spinal surgery were identified, the BIS may represent a valuable new intraoperative predictor of the risk of delirium.
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spelling pubmed-41853162014-10-06 Risk Factors for Delirium after Spine Surgery in Elderly Patients Seo, Jin Suk Park, Seung Won Lee, Young Seok Chung, Chan Kim, Young Baeg J Korean Neurosurg Soc Clinical Article OBJECTIVE: Postoperative delirium is a common complication in the elderly after surgery but few papers have reported after spinal surgery. We analyzed various risk factors for postoperative delirium after spine surgery. METHODS: Between May 2012 and September 2013, 70 patients over 60 years of age were examined. The patients were divided into two groups : Group A with delirium and Group B without delirium. Cognitive function was examined with the Mini-Mental State Examination-Korea (MMSE-K), Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Information was also obtained on the patients' education level, underlying diseases, duration of hospital stay and laboratory findings. Intraoperative assessment included Bispectral index (BIS), type of surgery or anesthesia, blood pressure, fluid balance, estimated blood loss and duration of surgery. RESULTS: Postoperative delirium developed in 17 patients. The preoperative scores for the MMSE, CDR, and GDS in Group A were 19.1±5.4, 0.9±0.6, and 3.3±1.1. These were significantly lower than those of Group B (25.6±3.4, 0.5±0.2, and 2.1±0.7) (p<0.05). BIS was lower in Group A (30.2±6.8 compared to 35.4±5.6 in group B) (p<0.05). The number of BIS <40 were 5.1±3.1 times in Group A, 2.5±2.2 times in Group B (p<0.01). In addition, longer operation time and longer hospital stay were risk factors. CONCLUSION: Precise analysis of risk factors for postoperative delirium seems to be more important in spinal surgery because the surgery is not usually expected to have an effect on brain function. Although no risk factors specific to spinal surgery were identified, the BIS may represent a valuable new intraoperative predictor of the risk of delirium. The Korean Neurosurgical Society 2014-07 2014-07-31 /pmc/articles/PMC4185316/ /pubmed/25289122 http://dx.doi.org/10.3340/jkns.2014.56.1.28 Text en Copyright © 2014 The Korean Neurosurgical Society http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Article
Seo, Jin Suk
Park, Seung Won
Lee, Young Seok
Chung, Chan
Kim, Young Baeg
Risk Factors for Delirium after Spine Surgery in Elderly Patients
title Risk Factors for Delirium after Spine Surgery in Elderly Patients
title_full Risk Factors for Delirium after Spine Surgery in Elderly Patients
title_fullStr Risk Factors for Delirium after Spine Surgery in Elderly Patients
title_full_unstemmed Risk Factors for Delirium after Spine Surgery in Elderly Patients
title_short Risk Factors for Delirium after Spine Surgery in Elderly Patients
title_sort risk factors for delirium after spine surgery in elderly patients
topic Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4185316/
https://www.ncbi.nlm.nih.gov/pubmed/25289122
http://dx.doi.org/10.3340/jkns.2014.56.1.28
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