Gabriele Melegari1, Giovanna Albertini2, Andrea Romani3, Silvio Malaguti4, Francesca Traccitto3, Enrico Giuliani5, Gian Maria Cavallini6, Elisabetta Bertellini2, Alberto Barbieri4. 1. Anaesthesia and Intensive Care, Policlinico Teaching Hospital, Azienda Ospedaliero-Universitaria di Modena, via del Pozzo 71, 41124, Modena, MO, Italy. melegari.gabriele@gmail.com. 2. Anaesthesia and Intensive Care, Policlinico Teaching Hospital, Azienda Ospedaliero-Universitaria di Modena, via del Pozzo 71, 41124, Modena, MO, Italy. 3. MD Lt, Italian Army, Rome, Italy. 4. School of Anaesthesia and Intensive Care, University of Modena and Reggio Emilia, Modena, Italy. 5. Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. 6. Department of Head-Neck Surgery, Policlinico Teaching Hospital, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.
Abstract
BACKGROUND: Delirium is a severe condition that can arise in many contexts during hospitalization. The aim of this research was to measure the incidence of postoperative delirium in patients aged 75 years or older, with the exclusion of those with preexisting neurocognitive disorders (NCD), who underwent fast-track, moderate surgery. METHODS: We conducted a prospective cohort study with patients ≥ 75 years of age who were eligible for fast-track, moderate surgery, without severe dementia, with a planned hospitalization of 24 h and with a physical status varying from very fit to vulnerable. The 4-item confusion assessment method (CAM4) was used to measure delirium. RESULTS: Of the 209 eligible patients, 195 subjects were enrolled in the study. The percentage of the population with a CAM4 score above 0 before surgery was 2.56%; after surgery, the percentage was 10.25%; and on the following day, the percentage was 4.61%. There was a statistically significant difference in the CAM4 scores between immediately after surgery and at 24 h after surgery (p = 0.0172). CONCLUSION: The data from this study support an enhanced recovery approach for elderly patients, in which after a minor surgical procedure with anaesthesia, a recovery period of one night in the hospital can contribute to normalizing the CAM4 score and reducing the incidence of delirium.
BACKGROUND:Delirium is a severe condition that can arise in many contexts during hospitalization. The aim of this research was to measure the incidence of postoperative delirium in patients aged 75 years or older, with the exclusion of those with preexisting neurocognitive disorders (NCD), who underwent fast-track, moderate surgery. METHODS: We conducted a prospective cohort study with patients ≥ 75 years of age who were eligible for fast-track, moderate surgery, without severe dementia, with a planned hospitalization of 24 h and with a physical status varying from very fit to vulnerable. The 4-item confusion assessment method (CAM4) was used to measure delirium. RESULTS: Of the 209 eligible patients, 195 subjects were enrolled in the study. The percentage of the population with a CAM4 score above 0 before surgery was 2.56%; after surgery, the percentage was 10.25%; and on the following day, the percentage was 4.61%. There was a statistically significant difference in the CAM4 scores between immediately after surgery and at 24 h after surgery (p = 0.0172). CONCLUSION: The data from this study support an enhanced recovery approach for elderly patients, in which after a minor surgical procedure with anaesthesia, a recovery period of one night in the hospital can contribute to normalizing the CAM4 score and reducing the incidence of delirium.
Entities:
Keywords:
Delirium; Elderly patients; Perioperative management; Surgery
Authors: Tommaso Verdina; Fabio Stiro; Francesco Bruni; Giorgio Alfredo Spedicato; Rodolfo Mastropasqua; Gian Maria Cavallini Journal: Aging Clin Exp Res Date: 2021-09-10 Impact factor: 3.636
Authors: Gabriele Melegari; Veronica Rivi; Gabriele Zelent; Vincenzo Nasillo; Elena De Santis; Alessandra Melegari; Claudia Bevilacqua; Michele Zoli; Stefano Meletti; Alberto Barbieri Journal: Int J Environ Res Public Health Date: 2021-04-01 Impact factor: 3.390