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The risk factors associated with delirium after lumbar spine surgery in elderly patients

  
@article{QIMS25319,
	author = {Zhimin Pan and Kai Huang and Wei Huang and Ki Hoon Kim and Hao Wu and Yanghong Yu and Keung Nyun Kim and Seong Yi and Dong Ah Shin and Darshan Vora and Cristian Gragnaniello and Kevin Phan and Anastasia Tasiou and Mark J. Winder and Hisashi Koga and Parisa Azimi and Suk Yun Kang and Yoon Ha and written on behalf of the AME Spine Surgery Collaborative Group},
	title = {The risk factors associated with delirium after lumbar spine surgery in elderly patients},
	journal = {Quantitative Imaging in Medicine and Surgery},
	volume = {9},
	number = {4},
	year = {2019},
	keywords = {},
	abstract = {Background: To prospectively explore the incidence and risk factors for postoperative delirium in elderly patients following lumbar spine surgery.
Methods: This prospective study enrolled 148 consecutive patients over the age of 65 who were scheduled to undergo spine surgery. Patients were screened for delirium using the short Confusion Assessment Method (CAM) postoperatively. Patient demographics and relevant medical information were collected. Logistic regression analysis was used to identify the risk factors associated with postoperative delirium.
Results: Eighty-three patients (56.1%) who underwent lumbar spine surgery (not coexisting with cervical or thoracic spine surgery) were enrolled in our study. Post-operative delirium was noted in 14.5% of patients over 65 years old. The presence of preoperative Parkinsonism was significantly higher in the delirium group (41.7% vs. 8.5%, P=0.002), as was a higher preoperative C-reactive protein (CRP) (7.0±15.2 vs. 1.3±2.3 mg/L, P=0.017) when compared with the non-delirium group. Of the risk factors, male sex [odds ratio (OR) =0.10, 95% confidence interval (CI): 0.01–0.66, P=0.017], Parkinsonism (OR =5.83, 95% CI: 1.03–32.89, P=0.046), and lower baseline MMSE score (OR =0.71, 95% CI: 0.52–0.97, P=0.032) were independently associated with postoperative delirium in elderly patients undergoing lumbar spine surgery.
Conclusions: Post-operative delirium occurred in 14.5% of elderly patients who underwent lumbar spine surgery. Male sex, Parkinsonism, and lower baseline MMSE score were identified as independent risk factors for postoperative delirium in elderly patients following lumbar surgery.},
	issn = {2223-4306},	url = {https://qims.amegroups.org/article/view/25319}
}