Ken Sugimoto
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of General Geriatric Medicine,
   Position   Professor
Article types 原著
Language English
Peer review Peer reviewed
Title Risk Evaluation of Postoperative Delirium Using Comprehensive Geriatric Assessment in Elderly Patients with Esophageal Cancer.
Journal Formal name：World journal of surgery
Abbreviation：World J Surg
ISSN code：14322323/03642313
Domestic / ForeginForegin
Volume, Issue, Page 40(11),pp.2705-2712
Author and coauthor 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
Publication date 2016/11
Summary 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