STUDY DESIGN: Retrospective clinical review and prospective report of postoperative delirium after cervical spine surgeries. OBJECTIVE: To investigate factors contributing to the development of delirium after cervical surgery and see whether amended therapeutic protocols could improve or alter postoperative outcomes. SUMMARY OF BACKGROUND DATA: Important consequences of postoperative delirium for the orthopedic patients include impaired recovery and increased morbidity and mortality. Although its risk factors have been reported in orthopedic surgery, there are a very few reports regarding postoperative delirium in spine surgery. METHODS: Eighty-one cervical myelopathy patients were retrospectively examined about the incidence of postoperative delirium and the risk factors. Similarly, 41 patients who received postoperative care under modified protocols were prospectively examined. RESULTS: Postoperative delirium occurred more commonly in patients over 70 years and those with hearing impairment. Patients who received high-dose methylprednisolone (>1000 mg) demonstrated an increased incidence of postoperative delirium. Under modified protocol, we reduced the usage of methylprednisolone and encouraged free body movement with cervical orthosis immediately after surgery. The incidence of postoperative delirium was significantly lower under the modified protocol. CONCLUSION: Early commencement of mobilization after cervical spine surgery would be crucial to the prevention of postoperative delirium in the elderly.
STUDY DESIGN: Retrospective clinical review and prospective report of postoperative delirium after cervical spine surgeries. OBJECTIVE: To investigate factors contributing to the development of delirium after cervical surgery and see whether amended therapeutic protocols could improve or alter postoperative outcomes. SUMMARY OF BACKGROUND DATA: Important consequences of postoperative delirium for the orthopedic patients include impaired recovery and increased morbidity and mortality. Although its risk factors have been reported in orthopedic surgery, there are a very few reports regarding postoperative delirium in spine surgery. METHODS: Eighty-one cervical myelopathypatients were retrospectively examined about the incidence of postoperative delirium and the risk factors. Similarly, 41 patients who received postoperative care under modified protocols were prospectively examined. RESULTS:Postoperative delirium occurred more commonly in patients over 70 years and those with hearing impairment. Patients who received high-dose methylprednisolone (>1000 mg) demonstrated an increased incidence of postoperative delirium. Under modified protocol, we reduced the usage of methylprednisolone and encouraged free body movement with cervical orthosis immediately after surgery. The incidence of postoperative delirium was significantly lower under the modified protocol. CONCLUSION: Early commencement of mobilization after cervical spine surgery would be crucial to the prevention of postoperative delirium in the elderly.
Authors: Matthew P Schreiber; Elizabeth Colantuoni; Oscar J Bienvenu; Karin J Neufeld; Kuan-Fu Chen; Carl Shanholtz; Pedro A Mendez-Tellez; Dale M Needham Journal: Crit Care Med Date: 2014-06 Impact factor: 7.598
Authors: Charles H Brown; Andrew LaFlam; Laura Max; Julie Wyrobek; Karin J Neufeld; Khaled M Kebaish; David B Cohen; Jeremy D Walston; Charles W Hogue; Lee H Riley Journal: J Am Geriatr Soc Date: 2016-10-03 Impact factor: 5.562
Authors: Aladine A Elsamadicy; Lefko T Charalambous; Amanda R Sergesketter; Nicolas Drysdale; Syed M Adil; Issac G Freedman; Theresa Williamson; Adam J Kundishora; Joaquin Camara-Quintana; Muhammad M Abd-El-Barr; C Rory Goodwin; Isaac O Karikari Journal: J Spine Surg Date: 2019-03
Authors: Iosief Abraha; Fabiana Trotta; Joseph M Rimland; Alfonso Cruz-Jentoft; Isabel Lozano-Montoya; Roy L Soiza; Valentina Pierini; Paolo Dessì Fulgheri; Fabrizia Lattanzio; Denis O'Mahony; Antonio Cherubini Journal: PLoS One Date: 2015-06-10 Impact factor: 3.240