Marco Bandini1,2,3, Michele Marchioni1,2,4, Felix Preisser1,2,5, Sebastiano Nazzani1,2,6, Zhe Tian1,2, Markus Graefen5, Francesco Montorsi3, Fred Saad1,2, Shahrokh F Shariat7, Luigi Schips4, Alberto Briganti3, Pierre I Karakiewicz1,2. 1. Cancer Prognostics and Health Outcomes Unit, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada. 2. Centre de recherche du Centre Hospitalier de l'Université de Montréal and Division of Urology, CHUM, Montreal, QC, Canada. 3. Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, and Vita-Salute San Raffaele University, Milan, Italy. 4. Department of Urology, SS Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy. 5. Martini Klinik, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. 6. Academic Department of Urology, IRCCS Policlinico San Donato, University of Milan, Milan, Italy. 7. Department of Urology, Medical University of Vienna, Vienna, Austria.
Abstract
INTRODUCTION: Very few population-based assessments of delirium have been performed to date. These have not assessed the implications of delirium after major surgical oncology procedures (MSOPs). We examined the temporal trends of delirium following 10 MSOPs, as well as patient and hospital delirium risk factors. Finally, we examined the effect of delirium on length of stay, inhospital mortality, and hospital charges. METHODS: We retrospectively identified patients who underwent prostatectomy, colectomy, cystectomy, mastectomy, gastrectomy, hysterectomy, nephrectomy, oophorectomy, lung resection, or pancreatectomy within the Nationwide Inpatient Sample (2003-2013). We yielded a weighted estimate of 3 431 632 patients. Multivariable logistic regression (MLR) analyses identified the determinants of postoperative delirium, as well as the effect of delirium on length of stay, in-hospital mortality, and hospital charges. RESULTS: Between 2003 and 2013, annual delirium rate increased from 0.7 to 1.2% (+6.0%; p<0.001). Delirium rates were highest after cystectomy (predicted probability [PP] 3.1%) and pancreatectomy (PP 2.6%), and lowest after prostatectomy (PP 0.15%) and mastectomy (PP 0.13%). Advanced age (odds ratio [OR] 3.80), maleness (OR 1.38), and higher Charlson comorbidity index (OR 1.20), as well as postoperative complications represent risk factors for delirium after MSOPs. Delirium after MSOP was associated with prolonged length of stay (OR 3.00), higher mortality (OR 1.15), and increased in-hospital charges (OR 1.13). CONCLUSIONS: No contemporary population-based assessments of delirium after MSOP have been reported. According to our findings, delirium after MSOP has a profound impact on patient outcomes that ranges from prolonged length of stay to higher mortality and increased in-hospital charges.
INTRODUCTION: Very few population-based assessments of delirium have been performed to date. These have not assessed the implications of delirium after major surgical oncology procedures (MSOPs). We examined the temporal trends of delirium following 10 MSOPs, as well as patient and hospital delirium risk factors. Finally, we examined the effect of delirium on length of stay, inhospital mortality, and hospital charges. METHODS: We retrospectively identified patients who underwent prostatectomy, colectomy, cystectomy, mastectomy, gastrectomy, hysterectomy, nephrectomy, oophorectomy, lung resection, or pancreatectomy within the Nationwide Inpatient Sample (2003-2013). We yielded a weighted estimate of 3 431 632 patients. Multivariable logistic regression (MLR) analyses identified the determinants of postoperative delirium, as well as the effect of delirium on length of stay, in-hospital mortality, and hospital charges. RESULTS: Between 2003 and 2013, annual delirium rate increased from 0.7 to 1.2% (+6.0%; p<0.001). Delirium rates were highest after cystectomy (predicted probability [PP] 3.1%) and pancreatectomy (PP 2.6%), and lowest after prostatectomy (PP 0.15%) and mastectomy (PP 0.13%). Advanced age (odds ratio [OR] 3.80), maleness (OR 1.38), and higher Charlson comorbidity index (OR 1.20), as well as postoperative complications represent risk factors for delirium after MSOPs. Delirium after MSOP was associated with prolonged length of stay (OR 3.00), higher mortality (OR 1.15), and increased in-hospital charges (OR 1.13). CONCLUSIONS: No contemporary population-based assessments of delirium after MSOP have been reported. According to our findings, delirium after MSOP has a profound impact on patient outcomes that ranges from prolonged length of stay to higher mortality and increased in-hospital charges.
Authors: Sebastiano Nazzani; Felix Preisser; Elio Mazzone; Zhe Tian; Francesco A Mistretta; Shahrokh F Shariat; Fred Saad; Markus Graefen; Derya Tilki; Emanuele Montanari; Stefano Luzzago; Alberto Briganti; Luca Carmignani; Pierre I Karakiewicz Journal: Eur J Surg Oncol Date: 2018-05-09 Impact factor: 4.424
Authors: Sebastiano Nazzani; Marco Bandini; Felix Preisser; Elio Mazzone; Michele Marchioni; Zhe Tian; Robert Stubinski; Maria Chiara Clementi; Fred Saad; Shahrokh F Shariat; Emanuele Montanari; Alberto Briganti; Luca Carmignani; Pierre I Karakiewicz Journal: Surg Oncol Date: 2019-01-29 Impact factor: 3.279
Authors: Vincent Q Trinh; Pierre I Karakiewicz; Jesse Sammon; Maxine Sun; Shyam Sukumar; Mai-Kim Gervais; Shahrokh F Shariat; Zhe Tian; Simon P Kim; Keith J Kowalczyk; Jim C Hu; Mani Menon; Quoc-Dien Trinh Journal: JAMA Surg Date: 2014-01 Impact factor: 14.766
Authors: Jesse D Sammon; Dane E Klett; Akshay Sood; Kola Olugbade; Marianne Schmid; Simon P Kim; Mani Menon; Quoc-Dien Trinh Journal: J Surg Res Date: 2014-07-24 Impact factor: 2.192