Antanas Budėnas1, Šarūnas Tamašauskas1, Albertas Šliaužys1, Ieva Navickaitė2, Miglė Sidaraitė2, Aistė Pranckevičienė1,3, Vytenis Pranas Deltuva1,3, Arimantas Tamašauskas1,3, Adomas Bunevičius4,5,6. 1. Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania. 2. Lithuanian University of Health Sciences, Kaunas, Lithuania. 3. Neuroscience Institute, Lithuanian University of Health Sciences, Eiveniu str 2, LT-50009, Kaunas, Lithuania. 4. Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania. adomas.bunevicius@lsmuni.lt. 5. Neuroscience Institute, Lithuanian University of Health Sciences, Eiveniu str 2, LT-50009, Kaunas, Lithuania. adomas.bunevicius@lsmuni.lt. 6. Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. adomas.bunevicius@lsmuni.lt.
Abstract
BACKGROUND: Delirium is an acute and reversible deterioration of mental state. Postoperative delirium (POD) can develop after surgical procedures and is associated with impaired health status and worse recovery. So far, there is little data about postoperative delirium after brain surgery. The aim of this study was to evaluate frequency, risk factors, and prognostic value of POD in predicting short-term postoperative outcomes after brain tumor surgery. METHODS: Five-hundred and twenty-two patients who underwent elective brain tumor surgery in 2010-2017 were included in this prospective study. Patients were monitored for POD using the Confusion Assessment Method for the ICU (CAM-ICU) for 2 to 7 days after the surgery. At hospital discharge, outcomes were evaluated using the Glasgow Outcome Scale (GOS). RESULTS: POD was diagnosed in 22 (4.2%) patients. Risk factors of POD were low level of hemoglobin, poor functional status at time of admission, low education level and older age (65 years and older). POD incidence was not associated with brain tumor laterality, location, extent of resection, histological diagnosis, or affected brain lobe. POD was associated with greater risk for unfavorable outcomes at hospital discharge (OR = 5.3; 95% CI [2.1-13.4], p = 0.001). CONCLUSIONS: POD is not a common complication after elective brain tumor surgery. Older age, poor functional status, low education level and anemia are associated with greater POD risk. Extent of surgical intervention and brain tumor location are not associated with POD risk. POD is associated with worse outcome at hospital discharge.
BACKGROUND: Delirium is an acute and reversible deterioration of mental state. Postoperative delirium (POD) can develop after surgical procedures and is associated with impaired health status and worse recovery. So far, there is little data about postoperative delirium after brain surgery. The aim of this study was to evaluate frequency, risk factors, and prognostic value of POD in predicting short-term postoperative outcomes after brain tumor surgery. METHODS: Five-hundred and twenty-two patients who underwent elective brain tumor surgery in 2010-2017 were included in this prospective study. Patients were monitored for POD using the Confusion Assessment Method for the ICU (CAM-ICU) for 2 to 7 days after the surgery. At hospital discharge, outcomes were evaluated using the Glasgow Outcome Scale (GOS). RESULTS: POD was diagnosed in 22 (4.2%) patients. Risk factors of POD were low level of hemoglobin, poor functional status at time of admission, low education level and older age (65 years and older). POD incidence was not associated with brain tumor laterality, location, extent of resection, histological diagnosis, or affected brain lobe. POD was associated with greater risk for unfavorable outcomes at hospital discharge (OR = 5.3; 95% CI [2.1-13.4], p = 0.001). CONCLUSIONS: POD is not a common complication after elective brain tumor surgery. Older age, poor functional status, low education level and anemia are associated with greater POD risk. Extent of surgical intervention and brain tumor location are not associated with POD risk. POD is associated with worse outcome at hospital discharge.
Authors: P R Kappen; E Kakar; C M F Dirven; M van der Jagt; M Klimek; R J Osse; A P J E Vincent Journal: Neurosurg Rev Date: 2021-08-16 Impact factor: 2.800
Authors: Pablo Kappen; Johannes Jeekel; Clemens M F Dirven; M Klimek; Steven A Kushner; Robert-Jan Osse; Michiel Coesmans; Marten J Poley; Arnaud J P E Vincent Journal: BMJ Open Date: 2021-10-01 Impact factor: 2.692