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The Risk Factors Associated With Delirium After Lumbar Spine Surgery in Elderly Patients

Authors
 Zhimin Pan  ;  Kai Huang  ;  Wei Huang  ;  Ki Hoon Kim  ;  Hao Wu  ;  Yanghong Yu  ;  Keung Nyun Kim  ;  Seong Yi  ;  Dong Ah Shin  ;  Darshan Vora  ;  Cristian Gragnaniello  ;  Kevin Phan  ;  Anastasia Tasiou  ;  Mark J Winder  ;  Hisashi Koga  ;  Parisa Azimi  ;  Suk Yun Kang  ;  Yoon Ha  ;  AME Spine Surgery Collaborative Group 
Citation
 QUANTITATIVE IMAGING IN MEDICINE AND SURGERY, Vol.9(4) : 700-710, 2019-04 
Journal Title
 QUANTITATIVE IMAGING IN MEDICINE AND SURGERY 
ISSN
 2223-4292 
Issue Date
2019-04
Keywords
Delirium ; elderly patients ; lumbar surgery ; risk factors
Abstract
Background: To prospectively explore the incidence and risk factors for postoperative delirium in elderly patients following lumbar spine surgery. Methods: This prospective study enrolled 148 consecutive patients over the age of 65 who were scheduled to undergo spine surgery. Patients were screened for delirium using the short Confusion Assessment Method (CAM) postoperatively. Patient demographics and relevant medical information were collected. Logistic regression analysis was used to identify the risk factors associated with postoperative delirium. Results: Eighty-three patients (56.1%) who underwent lumbar spine surgery (not coexisting with cervical or thoracic spine surgery) were enrolled in our study. Post-operative delirium was noted in 14.5% of patients over 65 years old. The presence of preoperative Parkinsonism was significantly higher in the delirium group (41.7% vs. 8.5%, P=0.002), as was a higher preoperative C-reactive protein (CRP) (7.0±15.2 vs. 1.3±2.3 mg/L, P=0.017) when compared with the non-delirium group. Of the risk factors, male sex [odds ratio (OR) =0.10, 95% confidence interval (CI): 0.01-0.66, P=0.017], Parkinsonism (OR =5.83, 95% CI: 1.03-32.89, P=0.046), and lower baseline MMSE score (OR =0.71, 95% CI: 0.52-0.97, P=0.032) were independently associated with postoperative delirium in elderly patients undergoing lumbar spine surgery. Conclusions: Post-operative delirium occurred in 14.5% of elderly patients who underwent lumbar spine surgery. Male sex, Parkinsonism, and lower baseline MMSE score were identified as independent risk factors for postoperative delirium in elderly patients following lumbar surgery.
Files in This Item:
T201906305.pdf Download
DOI
10.21037/qims.2019.04.09
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Keung Nyun(김긍년)
Shin, Dong Ah(신동아) ORCID logo https://orcid.org/0000-0002-5225-4083
Yi, Seong(이성)
Ha, Yoon(하윤)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175889
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