スギモト　ケン   Ken Sugimoto   杉本　研    所属   川崎医科大学  医学部 臨床医学　総合老年医学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Risk Evaluation of Postoperative Delirium Using Comprehensive Geriatric Assessment in Elderly Patients with Esophageal Cancer.
掲載誌名	正式名：World journal of surgery 略　 称：World J Surg ISSNコード：14322323/03642313
掲載区分	国外
巻・号・頁	40(11),pp.2705-2712
著者・共著者	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
発行年月	2016/11
概要	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.
DOI	10.1007/s00268-016-3602-2
PMID	27272271