Incidence and risk factors of delirium in patients post pancreaticoduodenectomy
| Autor: | Aimee O'Farrell, Donal Maguire, Sarah McErlean, Oscar Traynor, Justin Geoghegan, Tom K. Gallagher, Kevin C. Conlon, Emir Hoti |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Databases Factual medicine.medical_treatment behavioral disciplines and activities Pancreaticoduodenectomy Hospitals University Risk Factors mental disorders medicine Odds Ratio Humans Intensive care medicine Aged Retrospective Studies Aged 80 and over Chi-Square Distribution Hepatology business.industry Incidence (epidemiology) Incidence Age Factors Gastroenterology Delirium Retrospective cohort study Odds ratio Original Articles Length of Stay Middle Aged nervous system diseases Treatment Outcome Multivariate Analysis Female medicine.symptom business Complication Chi-squared distribution Ireland Abdominal surgery |
| Zdroj: | HPB. 16(9):864-869 |
| ISSN: | 1365-182X |
| DOI: | 10.1111/hpb.12266 |
| Popis: | BackgroundPost-operative delirium is an important and common complication of major abdominal surgery characterized by acute confusion with fluctuating consciousness. The aim of this study was to establish the incidence of post-operative delirium in patients undergoing a pancreaticoduodenectomy and to determine the risk factors for its development.MethodsFrom a prospectively maintained database, a retrospective cohort analysis was performed of 50 consecutive patients who underwent a pancreaticoduodenectomy at the National Surgical Centre for Pancreatic Cancer in St. Vincent's University Hospital, Dublin and whose entire post-operative stay was in this institution, between July 2011 and December 2012. Two independent medical practitioners assessed all data and delirium was diagnosed according to criteria of the Diagnostic and Statistical Manual Disorder (DSM), fourth edition. Univariate and multivariate analyses were performed.ResultsSeven patients (14%) developed post-operative delirium. The median onset was on the second post-operative day. Older age was predictive of an increased risk of delirium post-operatively. Those who developed delirium had a significantly increased length of stay (LOS) as well as a significantly increased risk of developing at least a grade 3 complication (Clavien-Dindo classification).ConclusionThis study demonstrates that post-operative delirium is associated with a more complicated recovery after a pancreaticoduodenectomy and that older age is independently predictive of its development. Focused screening may allow targeted preventative strategies to be used in the peri-operative period to reduce complications and costs associated with delirium. |
| Databáze: | OpenAIRE |
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