Postoperative delirium is associated with decreased recovery of ambulation one-month after surgery.

Autor: Robinson TN; Department of Surgery, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA; Department of Surgery, University of Colorado, Aurora, CO, USA. Electronic address: thomas.robinson@cuanschutz.edu., Kovar A; Department of Surgery, University of Colorado, Aurora, CO, USA., Carmichael H; Department of Surgery, University of Colorado, Aurora, CO, USA., Overbey DM; Department of Surgery, University of Colorado, Aurora, CO, USA., Goode CM; Department of Surgery, University of Colorado, Aurora, CO, USA., Jones TS; Department of Surgery, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA; Department of Surgery, University of Colorado, Aurora, CO, USA.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2021 Apr; Vol. 221 (4), pp. 856-861. Date of Electronic Publication: 2020 Aug 27.
DOI: 10.1016/j.amjsurg.2020.08.031
Abstrakt: Background: We hypothesized that postoperative delirium is associated with diminished recovery toward baseline preoperative ambulation levels one-month postoperatively.
Methods: Patients included were ≥60 years old undergoing inpatient operations. Ambulation was measured as steps/day using an accelerometer worn for ≥3-days preoperatively and ≥28-days postoperatively. Primary outcome was the percent recovery of preoperative steps.
Results: 109 patients were included; 17 (16%) developed postoperative delirium. Recovery of ambulation toward preoperative baseline at postoperative day-28 was decreased in delirium group (34% vs. 69%; p < 0.01). Immediate postoperative ambulation was similar in the delirium vs. no-delirium groups (p = 0.79). Delirium occurred on average on postoperative 3 ± 4 days. Subsequently, ambulation was decreased in the delirium group compared to non-delirium group at postoperative week-1 (p = 0.01), week-2 (p = 0.02), week-3 (p < 0.01) and week-4 (p < 0.01).
Conclusion: Patients undergoing inpatient operations who develop delirium recover only one-third of their baseline steps one-month postoperatively. Postoperative delirium results in a decreased recovery towards baseline ambulation for at least 4-weeks following major operations in comparison to non-delirious patients. The decrease in ambulation in the delirium versus no-delirium groups occurred after the occurrence of postoperative delirium.
Competing Interests: Declaration of competing interest The authors have no conflict of interest to report.
(Published by Elsevier Inc.)
Databáze: MEDLINE
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