Risk Evaluation of Postoperative Delirium Using Comprehensive Geriatric Assessment in Elderly Patients with Esophageal Cancer

Masaaki Yamamoto, Makoto Yamasaki, Ken Sugimoto, Yoshihiro Maekawa, Yasuhiro Miyazaki, Tomoki Makino, Tsuyoshi Takahashi, Yukinori Kurokawa, Kiyokazu Nakajima, Shuji Takiguchi, Hiromi Rakugi, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: The number of geriatric patients with esophageal cancer is increasing in step with the aging of the population. Geriatric patients have a higher risk of postoperative complications, including delirium that can cause a fall or impact survival. Therefore, it is very important that we evaluate risks of postoperative complications before surgery. The aim of this study was to predict postoperative delirium in elderly patients. Methods: We retrospectively reviewed the medical records of 91 patients aged 75 years and over who underwent esophagectomy between January 2006 and December 2014. We investigated the association between postoperative delirium and clinicopathological factors, including comprehensive geriatric assessment (CGA). Results: Postoperative delirium developed in 24 (26 %) patients. Postoperative delirium was significantly associated with low mini-mental state examination (MMSE) and high Geriatric Depression Scale 15 (GDS15), which are components of CGA, and psychiatric disorder (P < 0.0001, P = 0.002, and P = 0.017, respectively). With multiple logistic regression analysis, MMSE (odds ratio [OR], 1.4; 95 % confidence interval [CI], 1.2–1.6; P < 0.0001] and GDS15 (OR, 1.3; 95 % CI, 1.1–1.6; P = 0.004) were independently associated with postoperative delirium. Conclusions: Preoperative CGA, especially MMSE and GDS15, was useful for predicting postoperative delirium in elderly patients undergoing esophagectomy for esophageal cancer. Intervention by a multidisciplinary team using CGA might help prevent postoperative delirium.

Original languageEnglish
Pages (from-to)2705-2712
Number of pages8
JournalWorld journal of surgery
Volume40
Issue number11
DOIs
Publication statusPublished - Nov 1 2016

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Geriatric Assessment
Delirium
Esophageal Neoplasms
Geriatrics
Esophagectomy
Depression
Odds Ratio
Confidence Intervals
Geriatric Psychiatry
Medical Records
Logistic Models
Regression Analysis
Survival

All Science Journal Classification (ASJC) codes

  • Surgery

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Risk Evaluation of Postoperative Delirium Using Comprehensive Geriatric Assessment in Elderly Patients with Esophageal Cancer. / Yamamoto, Masaaki; Yamasaki, Makoto; Sugimoto, Ken; Maekawa, Yoshihiro; Miyazaki, Yasuhiro; Makino, Tomoki; Takahashi, Tsuyoshi; Kurokawa, Yukinori; Nakajima, Kiyokazu; Takiguchi, Shuji; Rakugi, Hiromi; Mori, Masaki; Doki, Yuichiro.

In: World journal of surgery, Vol. 40, No. 11, 01.11.2016, p. 2705-2712.

Research output: Contribution to journalArticle

Yamamoto, M, Yamasaki, M, Sugimoto, K, Maekawa, Y, Miyazaki, Y, Makino, T, Takahashi, T, Kurokawa, Y, Nakajima, K, Takiguchi, S, Rakugi, H, Mori, M & Doki, Y 2016, 'Risk Evaluation of Postoperative Delirium Using Comprehensive Geriatric Assessment in Elderly Patients with Esophageal Cancer', World journal of surgery, vol. 40, no. 11, pp. 2705-2712. https://doi.org/10.1007/s00268-016-3602-2
Yamamoto, Masaaki ; Yamasaki, Makoto ; Sugimoto, Ken ; Maekawa, Yoshihiro ; Miyazaki, Yasuhiro ; Makino, Tomoki ; Takahashi, Tsuyoshi ; Kurokawa, Yukinori ; Nakajima, Kiyokazu ; Takiguchi, Shuji ; Rakugi, Hiromi ; Mori, Masaki ; Doki, Yuichiro. / Risk Evaluation of Postoperative Delirium Using Comprehensive Geriatric Assessment in Elderly Patients with Esophageal Cancer. In: World journal of surgery. 2016 ; Vol. 40, No. 11. pp. 2705-2712.
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abstract = "Background: The number of geriatric patients with esophageal cancer is increasing in step with the aging of the population. Geriatric patients have a higher risk of postoperative complications, including delirium that can cause a fall or impact survival. Therefore, it is very important that we evaluate risks of postoperative complications before surgery. The aim of this study was to predict postoperative delirium in elderly patients. Methods: We retrospectively reviewed the medical records of 91 patients aged 75 years and over who underwent esophagectomy between January 2006 and December 2014. We investigated the association between postoperative delirium and clinicopathological factors, including comprehensive geriatric assessment (CGA). Results: Postoperative delirium developed in 24 (26 {\%}) patients. Postoperative delirium was significantly associated with low mini-mental state examination (MMSE) and high Geriatric Depression Scale 15 (GDS15), which are components of CGA, and psychiatric disorder (P < 0.0001, P = 0.002, and P = 0.017, respectively). With multiple logistic regression analysis, MMSE (odds ratio [OR], 1.4; 95 {\%} confidence interval [CI], 1.2–1.6; P < 0.0001] and GDS15 (OR, 1.3; 95 {\%} CI, 1.1–1.6; P = 0.004) were independently associated with postoperative delirium. Conclusions: Preoperative CGA, especially MMSE and GDS15, was useful for predicting postoperative delirium in elderly patients undergoing esophagectomy for esophageal cancer. Intervention by a multidisciplinary team using CGA might help prevent postoperative delirium.",
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AU - Yamamoto, Masaaki

AU - Yamasaki, Makoto

AU - Sugimoto, Ken

AU - Maekawa, Yoshihiro

AU - Miyazaki, Yasuhiro

AU - Makino, Tomoki

AU - Takahashi, Tsuyoshi

AU - Kurokawa, Yukinori

AU - Nakajima, Kiyokazu

AU - Takiguchi, Shuji

AU - Rakugi, Hiromi

AU - Mori, Masaki

AU - Doki, Yuichiro

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N2 - Background: The number of geriatric patients with esophageal cancer is increasing in step with the aging of the population. Geriatric patients have a higher risk of postoperative complications, including delirium that can cause a fall or impact survival. Therefore, it is very important that we evaluate risks of postoperative complications before surgery. The aim of this study was to predict postoperative delirium in elderly patients. Methods: We retrospectively reviewed the medical records of 91 patients aged 75 years and over who underwent esophagectomy between January 2006 and December 2014. We investigated the association between postoperative delirium and clinicopathological factors, including comprehensive geriatric assessment (CGA). Results: Postoperative delirium developed in 24 (26 %) patients. Postoperative delirium was significantly associated with low mini-mental state examination (MMSE) and high Geriatric Depression Scale 15 (GDS15), which are components of CGA, and psychiatric disorder (P < 0.0001, P = 0.002, and P = 0.017, respectively). With multiple logistic regression analysis, MMSE (odds ratio [OR], 1.4; 95 % confidence interval [CI], 1.2–1.6; P < 0.0001] and GDS15 (OR, 1.3; 95 % CI, 1.1–1.6; P = 0.004) were independently associated with postoperative delirium. Conclusions: Preoperative CGA, especially MMSE and GDS15, was useful for predicting postoperative delirium in elderly patients undergoing esophagectomy for esophageal cancer. Intervention by a multidisciplinary team using CGA might help prevent postoperative delirium.

AB - Background: The number of geriatric patients with esophageal cancer is increasing in step with the aging of the population. Geriatric patients have a higher risk of postoperative complications, including delirium that can cause a fall or impact survival. Therefore, it is very important that we evaluate risks of postoperative complications before surgery. The aim of this study was to predict postoperative delirium in elderly patients. Methods: We retrospectively reviewed the medical records of 91 patients aged 75 years and over who underwent esophagectomy between January 2006 and December 2014. We investigated the association between postoperative delirium and clinicopathological factors, including comprehensive geriatric assessment (CGA). Results: Postoperative delirium developed in 24 (26 %) patients. Postoperative delirium was significantly associated with low mini-mental state examination (MMSE) and high Geriatric Depression Scale 15 (GDS15), which are components of CGA, and psychiatric disorder (P < 0.0001, P = 0.002, and P = 0.017, respectively). With multiple logistic regression analysis, MMSE (odds ratio [OR], 1.4; 95 % confidence interval [CI], 1.2–1.6; P < 0.0001] and GDS15 (OR, 1.3; 95 % CI, 1.1–1.6; P = 0.004) were independently associated with postoperative delirium. Conclusions: Preoperative CGA, especially MMSE and GDS15, was useful for predicting postoperative delirium in elderly patients undergoing esophagectomy for esophageal cancer. Intervention by a multidisciplinary team using CGA might help prevent postoperative delirium.

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