Postoperative delirium following gastrointestinal surgery in elderly patients |
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Authors: | Tetsuya Kaneko Sadamu Takahashi Takuji Naka Yasuaki Hirooka Yuichi Inoue Nobuaki Kaibara |
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Institution: | (1) First Department of Surgery, Tottori University, 36-1 Nishi-machi, 683 Yonago, Japan;(2) Department of Neuropsychiatry, Faculty of Medicine, Tottori University, 36-1 Nishi-machi, 683 Yonago, Japan |
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Abstract: | Postoperative delirium is a common complication which can interfere with the surgical treatment and recovery of elderly patients,
and is likely to prolong their hospitalization. Unfortunately, there is as yet no completely effective pre- and/or post operative
technique of patient care to reduce or prevent postoperative delirium. In this study, 36 patients aged over 70 years undergoing
gastrointestinal operations were assessed to examine the relationships between the preoperative cognitive state, the postoperative
sleep cycle, and the occurrence of postoperative delirium. All patients were evaluated preoperatively using the revised version
of Hasegawa's dementia scale (HDS-R). We correlated those test results and assessed the sleep-wakefulness disturbance postoperatively,
to obtain a clinical DMS-III diagnosis of postoperative delirium. The incidence of postoperative delirium was 17% (6/36).
The patients who developed postoperative delirium demonstrated preoperative cognitive impairment, and had a short sleep period
during the night and a long sleep period during the day. Postoperatively, these results suggest that HDS-R is a useful method
of evaluating preoperative cognition in elderly patients. Considering that sleep deficiency is likely to predispose elderly
patients to postoperative delirium, techniques to prevent sleep deprivation may be of considerable value in minimizing the
incidence of postoperative delirium. |
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Keywords: | postoperative delirium geriatric surgery cognitive impairment sleep cycle |
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