Cargando…

Preoperative medication use and development of postoperative delirium and cognitive dysfunction

Postoperative delirium (POD) and postoperative (neuro‐)cognitive disorder (POCD) are frequent and serious complications after operations. We aim to investigate the association between pre‐operative polypharmacy and potentially inappropriate medications and the development of POD/POCD in elderly pati...

Descripción completa

Detalles Bibliográficos
Autores principales: Heinrich, Maria, Nottbrock, Anja, Borchers, Friedrich, Mörgeli, Rudolf, Kruppa, Jochen, Winterer, Georg, Slooter, Arjen J. C., Spies, Claudia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504833/
https://www.ncbi.nlm.nih.gov/pubmed/33934508
http://dx.doi.org/10.1111/cts.13031
_version_ 1784581402573930496
author Heinrich, Maria
Nottbrock, Anja
Borchers, Friedrich
Mörgeli, Rudolf
Kruppa, Jochen
Winterer, Georg
Slooter, Arjen J. C.
Spies, Claudia
author_facet Heinrich, Maria
Nottbrock, Anja
Borchers, Friedrich
Mörgeli, Rudolf
Kruppa, Jochen
Winterer, Georg
Slooter, Arjen J. C.
Spies, Claudia
author_sort Heinrich, Maria
collection PubMed
description Postoperative delirium (POD) and postoperative (neuro‐)cognitive disorder (POCD) are frequent and serious complications after operations. We aim to investigate the association between pre‐operative polypharmacy and potentially inappropriate medications and the development of POD/POCD in elderly patients. This investigation is part of the European BioCog project (www.biocog.eu), a prospective multicenter observational study with elderly surgical patients. Patients with a Mini‐Mental State Examination score less than or equal to 23 points were excluded. POD was assessed up to 7 days after surgery using the Nursing Delirium Screening Scale, Confusion Assessment Method (for the intensive care unit [ICU]), and a patient chart review. POCD was assessed 3 months after surgery with a neuropsychological test battery. Pre‐operative long‐term medication was evaluated in terms of polypharmacy (≥5 agents) and potentially inappropriate medication (defined by the PRISCUS and European list of potentially inappropriate medications [EU(7)‐PIM] lists), and associations with POD and POCD were analyzed using logistic regression analysis. Eight hundred thirty‐seven participants were included for analysis of POD and 562 participants for POCD. Of these, 165 patients (19.7%) fulfilled the criteria of POD and 60 (10.7%) for POCD. After adjusting for confounders, pre‐operative polypharmacy and intake of potentially inappropriate medications could not be shown to be associated with the development of POD nor POCD. We found no associations between pre‐operative polypharmacy and potentially inappropriate medications and development of POD and POCD. Future studies should focus on the evaluation of drug interactions to determine whether patients benefit from a pre‐operative adjustment.
format Online
Article
Text
id pubmed-8504833
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-85048332021-10-18 Preoperative medication use and development of postoperative delirium and cognitive dysfunction Heinrich, Maria Nottbrock, Anja Borchers, Friedrich Mörgeli, Rudolf Kruppa, Jochen Winterer, Georg Slooter, Arjen J. C. Spies, Claudia Clin Transl Sci Research Postoperative delirium (POD) and postoperative (neuro‐)cognitive disorder (POCD) are frequent and serious complications after operations. We aim to investigate the association between pre‐operative polypharmacy and potentially inappropriate medications and the development of POD/POCD in elderly patients. This investigation is part of the European BioCog project (www.biocog.eu), a prospective multicenter observational study with elderly surgical patients. Patients with a Mini‐Mental State Examination score less than or equal to 23 points were excluded. POD was assessed up to 7 days after surgery using the Nursing Delirium Screening Scale, Confusion Assessment Method (for the intensive care unit [ICU]), and a patient chart review. POCD was assessed 3 months after surgery with a neuropsychological test battery. Pre‐operative long‐term medication was evaluated in terms of polypharmacy (≥5 agents) and potentially inappropriate medication (defined by the PRISCUS and European list of potentially inappropriate medications [EU(7)‐PIM] lists), and associations with POD and POCD were analyzed using logistic regression analysis. Eight hundred thirty‐seven participants were included for analysis of POD and 562 participants for POCD. Of these, 165 patients (19.7%) fulfilled the criteria of POD and 60 (10.7%) for POCD. After adjusting for confounders, pre‐operative polypharmacy and intake of potentially inappropriate medications could not be shown to be associated with the development of POD nor POCD. We found no associations between pre‐operative polypharmacy and potentially inappropriate medications and development of POD and POCD. Future studies should focus on the evaluation of drug interactions to determine whether patients benefit from a pre‐operative adjustment. John Wiley and Sons Inc. 2021-05-02 2021-09 /pmc/articles/PMC8504833/ /pubmed/33934508 http://dx.doi.org/10.1111/cts.13031 Text en © 2021 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of the American Society for Clinical Pharmacology and Therapeutics https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research
Heinrich, Maria
Nottbrock, Anja
Borchers, Friedrich
Mörgeli, Rudolf
Kruppa, Jochen
Winterer, Georg
Slooter, Arjen J. C.
Spies, Claudia
Preoperative medication use and development of postoperative delirium and cognitive dysfunction
title Preoperative medication use and development of postoperative delirium and cognitive dysfunction
title_full Preoperative medication use and development of postoperative delirium and cognitive dysfunction
title_fullStr Preoperative medication use and development of postoperative delirium and cognitive dysfunction
title_full_unstemmed Preoperative medication use and development of postoperative delirium and cognitive dysfunction
title_short Preoperative medication use and development of postoperative delirium and cognitive dysfunction
title_sort preoperative medication use and development of postoperative delirium and cognitive dysfunction
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504833/
https://www.ncbi.nlm.nih.gov/pubmed/33934508
http://dx.doi.org/10.1111/cts.13031
work_keys_str_mv AT heinrichmaria preoperativemedicationuseanddevelopmentofpostoperativedeliriumandcognitivedysfunction
AT nottbrockanja preoperativemedicationuseanddevelopmentofpostoperativedeliriumandcognitivedysfunction
AT borchersfriedrich preoperativemedicationuseanddevelopmentofpostoperativedeliriumandcognitivedysfunction
AT morgelirudolf preoperativemedicationuseanddevelopmentofpostoperativedeliriumandcognitivedysfunction
AT kruppajochen preoperativemedicationuseanddevelopmentofpostoperativedeliriumandcognitivedysfunction
AT winterergeorg preoperativemedicationuseanddevelopmentofpostoperativedeliriumandcognitivedysfunction
AT slooterarjenjc preoperativemedicationuseanddevelopmentofpostoperativedeliriumandcognitivedysfunction
AT spiesclaudia preoperativemedicationuseanddevelopmentofpostoperativedeliriumandcognitivedysfunction
AT preoperativemedicationuseanddevelopmentofpostoperativedeliriumandcognitivedysfunction