Postoperative delirium in older patients after undergoing pelvic organ prolapse surgery.
Cognitive impairment
Older females
Pelvic organ prolapse
Perioperative neurocognitive disorders
Postoperative delirium
Surgical outcomes
Journal
International urogynecology journal
ISSN: 1433-3023
Titre abrégé: Int Urogynecol J
Pays: England
ID NLM: 101567041
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
received:
21
12
2021
accepted:
25
02
2022
pubmed:
12
4
2022
medline:
14
1
2023
entrez:
11
4
2022
Statut:
ppublish
Résumé
To determine the 7-day incidence and risk factors of postoperative delirium (POD) occurring after prolapse surgery in women aged ≥60 years. A prospective study of women ≥60 years undergoing prolapse surgery at a large academic center. The primary outcome is positive Confusion Assessment Method delirium screen administered in person or by telephone at the time of hospital discharge and postoperative days 1, 3, 5, and 7. This analysis included 165 patients, mean ± SD age of 72.5 ± 6.1 years, with median (IQR) years of education of 13 (12-16), and baseline Modified Mini-Mental Status (3MS) Exam score of 95 (92-98). Prolapse repair type was vaginal for 70% (n=115) and laparoscopic for 30% (n=50) of patients; most under general anesthesia, 151 (92.1%). The incidence of positive delirium screen during the first week after surgery was 12.1% (n=20). Most of these participants screened positive on postoperative day 0, 8.4% (n=14). In univariate analyses, a positive screen was associated with older age and fewer education years, lower 3MS exam score, greater baseline geriatric depression scale score, and greater frailty score. Lower 3MS score was the only variable that remained significant in the final model (adjusted odds ratio 0.84, 95% CI 0.75-0.95). One in 12 women ≥60 years deemed eligible for discharge on the day of prolapse surgery screens positive for delirium. The 7-day POD incidence is comparable to other elective non-cardiac surgery cohorts. Given the increasing trend toward same day discharge after major prolapse surgery, more research is needed to determine the impact of universal delirium screening as part of discharge assessments.
Identifiants
pubmed: 35403880
doi: 10.1007/s00192-022-05170-0
pii: 10.1007/s00192-022-05170-0
pmc: PMC10320862
mid: NIHMS1900957
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
201-209Subventions
Organisme : NICHD NIH HHS
ID : K12 HD063087
Pays : United States
Organisme : NIA NIH HHS
ID : R03 AG064378
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001857
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022. The International Urogynecological Association.
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