Does postoperative delirium following elective noncardiac surgery predict long-term mortality?
| Autor: | Laura P. Sands, Christopher Tang, Jacqueline M. Leung, Jiafeng Zhu, Nathan Ziman |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Aging
medicine.medical_specialty National Death Index 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors 030202 anesthesiology Internal medicine medicine Humans Prospective Studies 030212 general & internal medicine Myocardial infarction Prospective cohort study Aged Framingham Risk Score Vascular disease business.industry Delirium General Medicine Odds ratio medicine.disease Confidence interval Elective Surgical Procedures Geriatrics and Gerontology medicine.symptom business Research Paper |
| Zdroj: | Age Ageing |
| ISSN: | 1468-2834 0002-0729 |
| DOI: | 10.1093/ageing/afaa047 |
| Popis: | Objective to determine whether incident postoperative delirium in elective older surgical patient was associated with increased risk for mortality, controlling for covariates of 5-year mortality. Design secondary analysis of prospective cohort studies. Setting academic Medical Center. Subjects patients ≥65 years of age undergoing elective non-cardiac surgery. Outcomes postoperative assessments of delirium measured using the Confusion Assessment Method (CAM), mortality within 5 years of the index surgery was determined from National Death Index records. Results postoperative delirium occurred in 332/1,315 patients (25%). Five years after surgery, 175 patients (13.3%) were deceased. Older age was associated with an increased odds of mortality [odds ratio (OR) 1.90, 95% confidence interval (CI) 1.20–2.70] for those aged 70–79 years compared to those aged 80 years. Other variables associated with 5-year mortality on bi-variate analyses were white race, self-rated functional status, lower preoperative cognitive status, higher risk score as measured by the American Society of Anesthesiologists (ASA) classification, higher surgical risk score, history of congestive heart failure, myocardial infarction, renal disease, cancer, peripheral vascular disease and postoperative delirium. However, postoperative delirium was not associated with 5-year mortality on multi-variate logistic regression (OR 1.18, 95% CI 0.85–1.65). Conclusions our results showed that delirium was not associated with 5-year mortality in elective surgical patients after consideration of co-variates of mortality. Our results suggest the importance of accounting for known preoperative risks for mortality when investigating the relationship between delirium and long-term mortality. |
| Databáze: | OpenAIRE |
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