The Role of Delirium and Other Risk Factors on Mortality in Elderly Patients with Critical Limb Ischemia Undergoing Major Lower Limb Amputation.

Autor:	Roijers JP; Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands. Electronic address: joostroijers@hotmail.com., Hopmans CJ; Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands., Janssen TL; Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands., Mulder PGH; Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands., Buimer MG; Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands., Ho GH; Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands., de Groot HGW; Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands., Veen EJ; Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands., van der Laan L; Department of Surgery, Amphia Hospital Breda, Breda, The Netherlands.
Jazyk:	angličtina
Zdroj:	Annals of vascular surgery [Ann Vasc Surg] 2019 Oct; Vol. 60, pp. 270-278.e2. Date of Electronic Publication: 2019 May 08.
DOI:	10.1016/j.avsg.2019.02.014
Abstrakt:	Background: Delirium in patients with critical limb ischemia (CLI) is associated with increased mortality. The main goal of this study was to investigate the association between delirium and mortality in patients undergoing major lower limb amputation for CLI. In addition, other risk factors associated with mortality were analyzed. Methods: An observational cohort study was conducted including all patients aged ≥70 years with CLI undergoing a major lower limb amputation between January 2014 and July 2017. Delirium was scored using the Delirium Observation Screening Score in combination with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Risk factors for mortality were analyzed by calculating hazard ratios using a Cox proportional hazards model. Results: In total, 95 patients were included; of which, 29 (31%) patients developed a delirium during admission. Delirium was not associated with an increased risk of mortality (hazard ratio [HR] = 0.84; 95 % confidence interval [CI]: 0.51-1.73; P = 0.84). Variables independently associated with an increased risk of mortality were age (HR 1.1; 95% CI 1.0-1.1), cardiac history (HR 3.3; 95% CI 1.8-6.1), current smoking (HR 2.9; 95% CI 1.6-5.5), preoperative anemia (HR 2.8; 95% CI 1.1-7.2), and living in a nursing home (HR 2.2; 95% CI 1.1-4.4). Conclusion: Delirium was not associated with an increased mortality risk in elderly patients with CLI undergoing a major lower limb amputation. Factors related to an increased mortality risk were age, cardiac history, current smoking, preoperative anemia, and living in a nursing home. (Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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