Postoperative delirium after colorectal surgery in older patients

Mangnall, LT; Gallagher, R; Stein-Parbury, J

Postoperative delirium after colorectal surgery in older patients

Mangnall, LT Gallagher, R

Stein-Parbury, J

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Publication Type:: Journal Article
Citation:: American Journal of Critical Care, 2011, 20 (1), pp. 45 - 55
Issue Date:: 2011-01-01

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Field	Value	Language
dc.contributor.author	Mangnall, LT	en_US
dc.contributor.author	Gallagher, R https://orcid.org/0000-0001-5588-9351	en_US
dc.contributor.author	Stein-Parbury, J https://orcid.org/0000-0002-0018-3236	en_US
dc.date.issued	2011-01-01	en_US
dc.identifier.citation	American Journal of Critical Care, 2011, 20 (1), pp. 45 - 55	en_US
dc.identifier.issn	1062-3264	en_US
dc.identifier.uri	http://hdl.handle.net/10453/15587
dc.description.abstract	Background: Postoperative delirium in older patients results in worse outcomes and increased costs. The prevalence and predictors of postoperative delirium in patients undergoing major colorectal surgery are not clear. Objectives: To determine the prevalence and predictors of postoperative delirium in older patients after major colorectal surgery. Methods: Patients older than 50 years, without preexisting cognitive impairment, were recruited before surgery. These patients were assessed after surgery for delirium daily for 3 days by using the Confusion Assessment Method. Regression analysis was used to determine independent predictors of postoperative delirium. Results: Patients (n=118) had a mean age of 71.81 years, and approximately half were women (54%). Most participants (64%) were married, and comorbid conditions were common. Delirium developed in 35% of the patients in the 3 days after surgery and in 21% in the first 24 hours. New cases of delirium were identified on each of the 3 days after surgery, and a few patients (7%) had delirium for the entire 3 days. Odds for delirium in the first 24 hours were increased for patients who had early admission (odds ratio [OR]=4.48; P=.06) and decreased for patients who were married (OR=0.25; P=.01). Odds for delirium in the first 3 days after surgery were increased for men (OR=4.27; P=.02), older patients (OR=1.05; P=.04), and patients who stayed overnight in the critical care unit (OR=2.97; P=.06). Conclusions: Postoperative delirium is common and persistent in older patients in the first 3 days after colorectal surgery. © 2010 American Association of Critical-Care Nurses.	en_US
dc.relation.ispartof	American Journal of Critical Care	en_US
dc.relation.isbasedon	10.4037/ajcc2010902	en_US
dc.subject.classification	Nursing	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Delirium	en_US
dc.subject.mesh	Postoperative Complications	en_US
dc.subject.mesh	Regression Analysis	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Mental Status Schedule	en_US
dc.subject.mesh	Colorectal Surgery	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	New South Wales	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Postoperative delirium after colorectal surgery in older patients	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	20	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	20	en_US

Abstract:

Background: Postoperative delirium in older patients results in worse outcomes and increased costs. The prevalence and predictors of postoperative delirium in patients undergoing major colorectal surgery are not clear. Objectives: To determine the prevalence and predictors of postoperative delirium in older patients after major colorectal surgery. Methods: Patients older than 50 years, without preexisting cognitive impairment, were recruited before surgery. These patients were assessed after surgery for delirium daily for 3 days by using the Confusion Assessment Method. Regression analysis was used to determine independent predictors of postoperative delirium. Results: Patients (n=118) had a mean age of 71.81 years, and approximately half were women (54%). Most participants (64%) were married, and comorbid conditions were common. Delirium developed in 35% of the patients in the 3 days after surgery and in 21% in the first 24 hours. New cases of delirium were identified on each of the 3 days after surgery, and a few patients (7%) had delirium for the entire 3 days. Odds for delirium in the first 24 hours were increased for patients who had early admission (odds ratio [OR]=4.48; P=.06) and decreased for patients who were married (OR=0.25; P=.01). Odds for delirium in the first 3 days after surgery were increased for men (OR=4.27; P=.02), older patients (OR=1.05; P=.04), and patients who stayed overnight in the critical care unit (OR=2.97; P=.06). Conclusions: Postoperative delirium is common and persistent in older patients in the first 3 days after colorectal surgery. © 2010 American Association of Critical-Care Nurses.

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http://hdl.handle.net/10453/15587