Risk Factors for Delirium after Spine Surgery: An Age-Matched Analysis

Tadao Morino; Masayuki Hino; Shintaro Yamaoka; Hiroshi Misaki; Tadanori Ogata; Hiroshi Imai; Hiromasa Miura

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자료유형: 학술저널

저자정보: Tadao Morino (Ehime University School of Medicine) Masayuki Hino (Ehime University School of Medicine) Shintaro Yamaoka (Ehime University School of Medicine) Hiroshi Misaki (Ehime University School of Medicine) Tadanori Ogata (Ehime University School of Medicine) Hiroshi Imai (Ehime University School of Medicine) Hiromasa Miura (Ehime University School of Medicine)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.12 No.4

발행연도: 2018.1

수록면: 703 - 709 (7page)

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Study Design: A retrospective cohort study. Purpose: To investigate the risk factors for postoperative delirium after spine surgery, excluding older age, which has already been established as a strong risk factor. Overview of Literature: More than 30 risk factors have been reported for delirium after spine surgery, making it challenging to identify which factors should be prioritized. We hypothesized that risk factors could not be prioritized to date because the factor of older age is very strong and influenced other factors. To eliminate the influence of older age, we performed an age-matched group comparison analysis for the investigation of other risk factors. Methods: This study involved 532 patients who underwent spine surgery. Two patients of the same age without delirium (delirium negative group) were matched to each patient with delirium (delirium positive group). Differences in suspected risk factors for postoperative delirium between the two groups identified from previous reports were analyzed using univariate analysis. Multivariate analysis was performed for factors that showed a significant difference between the two groups in the univariate analysis. Results: Fifty-nine (11.1%) of 532 patients developed postoperative delirium after spine surgery. Large amounts of intraoperative bleeding, low preoperative concentration of serum Na, high postoperative (day after surgery) serum level of C-reactive protein, low hematocrit level, low concentration of albumin, and high body temperature were detected as significant risk factors in the univariate analysis. Large amounts of intraoperative bleeding remained a risk factor for postoperative delirium in the multivariate analysis. Conclusions: We should pay attention to and take precautions against the occurrence of postoperative delirium after spine surgery in patients of older age or those who experience severe intraoperative bleeding.

참고문헌 (21)

참고문헌 신청

American Psychiatric Association / 2013 / Diagnostic and statistical manual of mental disorders. 5th ed

Brown C 4th / 2016 / Perioperative cognitive protection / Br J Anaesth 117(suppl 3):iii52~iii61

Koster S / 2011 / Risk factors of delirium after cardiac surgery: a systematic review / Eur J Cardiovasc Nurs 10:197~204

Oh ES / 2015 / Preoperative risk factors for postoperative delirium following hip fracture repair: a systematic review / Int J Geriatr Psychiatry 30:900~910

Bin Abd Razak HR / 2015 / Postoperative delirium in patients undergoing total joint arthroplasty: a systematic review / J Arthroplasty 30:1414~1417

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