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Postoperative delirium in elderly after elective and acute colorectal surgery: A prospective cohort study.
Int J Surg 2015; 18:216-9IJ

Abstract

OBJECTIVE

To assess the frailty and the incidence of delirium in elderly patients undergoing elective and acute colorectal surgery in correlation with morbidity and mortality.

METHODS

Patients aged 65 years and older having elective and acute colorectal surgery, between April 2013 and December 2013 were included in a prospective database. Patients diagnosed with a colorectal carcinoma or diverticulitis who were operated on were included. Factors that characterize frailty of patients were noted. The incidence rates of delirium after elective and acute surgery were recorded. Delirium was diagnosed using the Delirium Observation Screening Scale (DOSS). Preoperative evaluation, surgical outcome including morbidity, hospital stay and mortality were analyzed.

RESULTS

Patients ≥ 65 years were included, 83 (75%) received elective and 28 (25%) acute surgery. The overall incidence of delirium was 21%, 18% for elective and 29% for patients having urgent surgery (p = 0.24). Patients with delirium were older than the non-delirious patients (median 82 years vs. 74 years; p < 0.001). Delirious patients showed higher incidence of adverse events. Hospital stay, mortality and discharge to a nursing home were significant higher in the delirious compared to the non-delirious group (p = 0.01; 0.01; 0.02 respectively).

CONCLUSION

High incidence of delirium was found in both acute and elective colorectal surgery. Delirium was associated with adverse outcomes.

Authors+Show Affiliations

Department of Surgery, Amphia Hospital, Breda, The Netherlands. Electronic address: JRaats@amphia.nl.Department of Surgery, Amphia Hospital, Breda, The Netherlands.Department of Surgery, Amphia Hospital, Breda, The Netherlands.Department of Surgery, Amphia Hospital, Breda, The Netherlands.Department of Surgery, Amphia Hospital, Breda, The Netherlands.Department of Surgery, Amphia Hospital, Breda, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25937152

Citation

Raats, J W., et al. "Postoperative Delirium in Elderly After Elective and Acute Colorectal Surgery: a Prospective Cohort Study." International Journal of Surgery (London, England), vol. 18, 2015, pp. 216-9.
Raats JW, Steunenberg SL, Crolla RM, et al. Postoperative delirium in elderly after elective and acute colorectal surgery: A prospective cohort study. Int J Surg. 2015;18:216-9.
Raats, J. W., Steunenberg, S. L., Crolla, R. M., Wijsman, J. H., te Slaa, A., & van der Laan, L. (2015). Postoperative delirium in elderly after elective and acute colorectal surgery: A prospective cohort study. International Journal of Surgery (London, England), 18, pp. 216-9. doi:10.1016/j.ijsu.2015.04.080.
Raats JW, et al. Postoperative Delirium in Elderly After Elective and Acute Colorectal Surgery: a Prospective Cohort Study. Int J Surg. 2015;18:216-9. PubMed PMID: 25937152.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postoperative delirium in elderly after elective and acute colorectal surgery: A prospective cohort study. AU - Raats,J W, AU - Steunenberg,S L, AU - Crolla,R M P H, AU - Wijsman,J H H, AU - te Slaa,A, AU - van der Laan,L, Y1 - 2015/04/30/ PY - 2015/01/27/received PY - 2015/04/10/revised PY - 2015/04/23/accepted PY - 2015/5/5/entrez PY - 2015/5/6/pubmed PY - 2016/1/29/medline KW - Acute surgery KW - Colorectal surgery KW - Post-operative delirium SP - 216 EP - 9 JF - International journal of surgery (London, England) JO - Int J Surg VL - 18 N2 - OBJECTIVE: To assess the frailty and the incidence of delirium in elderly patients undergoing elective and acute colorectal surgery in correlation with morbidity and mortality. METHODS: Patients aged 65 years and older having elective and acute colorectal surgery, between April 2013 and December 2013 were included in a prospective database. Patients diagnosed with a colorectal carcinoma or diverticulitis who were operated on were included. Factors that characterize frailty of patients were noted. The incidence rates of delirium after elective and acute surgery were recorded. Delirium was diagnosed using the Delirium Observation Screening Scale (DOSS). Preoperative evaluation, surgical outcome including morbidity, hospital stay and mortality were analyzed. RESULTS: Patients ≥ 65 years were included, 83 (75%) received elective and 28 (25%) acute surgery. The overall incidence of delirium was 21%, 18% for elective and 29% for patients having urgent surgery (p = 0.24). Patients with delirium were older than the non-delirious patients (median 82 years vs. 74 years; p < 0.001). Delirious patients showed higher incidence of adverse events. Hospital stay, mortality and discharge to a nursing home were significant higher in the delirious compared to the non-delirious group (p = 0.01; 0.01; 0.02 respectively). CONCLUSION: High incidence of delirium was found in both acute and elective colorectal surgery. Delirium was associated with adverse outcomes. SN - 1743-9159 UR - https://www.unboundmedicine.com/medline/citation/25937152/Postoperative_delirium_in_elderly_after_elective_and_acute_colorectal_surgery:_A_prospective_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1743-9191(15)00207-1 DB - PRIME DP - Unbound Medicine ER -