Preoperative Risk Assessment for Delirium After Hepatic Resection in the Elderly: a Prospective Multicenter Study

Background Hepatic resection often results in delirium in preoperatively self-sufficient elderly people. The association of frailty with postoperative delirium remains unclear, and preoperative risk assessment, including frailty, of postoperative delirium has not been established. Methods This prosp...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2021, Vol.25 (1), p.134-144
Main Authors: Ishihara, Atsushi, Tanaka, Shogo, Ueno, Masaki, Iida, Hiroya, Kaibori, Masaki, Nomi, Takeo, Hirokawa, Fumitoshi, Ikoma, Hisashi, Nakai, Takuya, Eguchi, Hidetoshi, Shinkawa, Hiroji, Hayami, Shinya, Maehira, Hiromitsu, Shibata, Toshihiko, Kubo, Shoji
Format: Article
Language:English
Subjects:
Aged
Delirium
Delirium - diagnosis
Delirium - epidemiology
Delirium - etiology
Frailty
Gastroenterology
Geriatric Assessment
Humans
Liver
Medicine
Medicine & Public Health
Older people
Original Article
Postoperative Complications - diagnosis
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Prospective Studies
Risk Assessment
Risk Factors
Surgery
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Summary:Background Hepatic resection often results in delirium in preoperatively self-sufficient elderly people. The association of frailty with postoperative delirium remains unclear, and preoperative risk assessment, including frailty, of postoperative delirium has not been established. Methods This prospective multicenter study included 295 independently living patients aged ≥ 65 years scheduled for initial hepatic resection. All patients answered the phenotypic frailty index Kihon Checklist, which is a self-reporting list of 25 questions, within a week before surgery. The risk factors for postoperative delirium were investigated. Patients who scored ≥ 4 in the Intensive Care Delirium Screening Checklist were designated as having postoperative delirium. Results Delirium developed after liver resection in 22 of 295 patients (7.5%). Total Kihon Checklist score (≥ 6 points), age (≥ 75 years), and serum albumin concentration (≤ 3.7 g/dL) were the independent risk factors for postoperative delirium. The proportion of patients with postoperative delirium was 0% in those with no applicable risk factors, 3.2% in those with one applicable risk factor, 12.0% in those with two applicable risk factors, and 40.9% in those with all three factors ( p  
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-020-04562-1