| Motor subtypes of postoperative delirium in older adults. | |
| | |
MedLine Citation:
|
PMID: 21422360 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
HYPOTHESIS: Increased knowledge about motor subtypes of delirium may aid clinicians in the management of postoperative geriatric patients. DESIGN: Prospective cohort study defining preoperative risk factors, outcomes, and adverse events related to motor subtypes of postoperative delirium. SETTING: Referral medical center. PATIENTS: Persons 50 years and older with planned postoperative intensive care unit (ICU) admission following an elective operation were recruited. MAIN OUTCOME MEASURES: Before surgery, a standardized frailty assessment was performed. After surgery, delirium and its motor subtypes were measured using the validated tools of the Confusion Assessment Method-ICU and the Richmond Agitation-Sedation Scale. Statistical analysis included the univariate t and χ(2) tests and analysis of variance with post hoc analysis. RESULTS: Delirium occurred in 43.0% (74 of 172) of patients, representing 67.6% (50 of 74) hypoactive, 31.1% (23 of 74) mixed, and 1.4% (1 of 74) hyperactive motor subtypes. Compared with those having mixed delirium, patients having hypoactive delirium were older (mean [SD] age, 71 [9] vs 65 [9] years) and more anemic (mean [SD] hematocrit, 36% [8%] vs 41% [6%]) (P = .002 for both). Patients with hypoactive delirium had higher 6-month mortality (32.0% [16 of 50] vs 8.7% [2 of 23], P = .04). Delirium-related adverse events occurred in 24.3% (18 of 74) of patients with delirium; inadvertent tube or line removals occurred more frequently in the mixed group (P = .006), and sacral skin breakdown was more common in the hypoactive group (P = .002). CONCLUSIONS: Motor subtypes of delirium alert clinicians to differing prognosis and adverse event profiles in postoperative geriatric patients. Hypoactive delirium is the most common motor subtype and is associated with worse prognosis (6-month mortality, 1 in 3 patients). Knowledge of differing adverse event profiles can modify clinicians' management of older patients with postoperative delirium. |
| | |
Authors:
|
Thomas N Robinson; Christopher D Raeburn; Zung V Tran; Lisa A Brenner; Marc Moss |
Publication Detail:
|
Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Archives of surgery (Chicago, Ill. : 1960) Volume: 146 ISSN: 1538-3644 ISO Abbreviation: Arch Surg Publication Date: 2011 Mar |
Date Detail:
|
Created Date: 2011-03-22 Completed Date: 2011-05-25 Revised Date: 2012-09-24 |
Medline Journal Info:
|
Nlm Unique ID: 9716528 Medline TA: Arch Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 295-300 Citation Subset: AIM; IM |
Affiliation:
|
Department of Surgery, University of Colorado at Denver School of Medicine, 12631 E 17th Ave., Aurora, CO 80045, USA. thomas.robinson@ucdenver.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Age Factors Aged Analysis of Variance Cohort Studies Delirium / classification*, diagnosis*, mortality Female Geriatric Assessment Humans Incidence Male Middle Aged Postoperative Complications / diagnosis, mortality Preoperative Care / methods Prospective Studies Psychomotor Agitation / classification*, diagnosis*, mortality Risk Assessment Surgical Procedures, Elective / methods, mortality* Survival Analysis |
| Grant Support | |
ID/Acronym/Agency:
|
K23 AG034632-01A1/AG/NIA NIH HHS; K24 HL089223-04/HL/NHLBI NIH HHS; K24-HL-089223/HL/NHLBI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Racial disparities in survival after lung transplantation.
Next Document: Trends in central line-associated bloodstream infections in a trauma-surgical intensive care unit.