Postoperative Delirium in Elderly Patients Undergoing Major Spinal Surgery: Role of Cerebral Oximetry

Sarah Soh, Jae Kwang Shim, Jong Wook Song, Keung Nyun Kim, Hyun Young Noh, Young Lan Kwak

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Perioperative cerebral hypoperfusion/ischemia is a major inciting factor of postoperative delirium, which is coupled with adverse outcome in elderly patients. Cerebral oximetry enables noninvasive assessment of the regional cerebral oxygen saturation (rSO2). This study aimed to investigate whether perioperative rSO 2 variations were linked to delirium in elderly patients after spinal surgery. Materials and Methods: Postoperative delirium was assessed for 48 hours postsurgery in 109 patients aged over 60 years without a prior history of cerebrovascular or psychiatric diseases by the Confusion Assessment Method for the intensive care unit and the intensive care delirium screening checklist. The rSO2 values immediately before and throughout surgery were acquired. The preoperative cognitive functions, patient characteristics, and perioperative data were recorded. Results: During the 48-h postoperative period, 9 patients (8%) exhibited delirium. The patients with delirium showed similar perioperative rSO2 values as those without, in terms of the median lowest rSO 2 values (55% vs. 56%; P=0.876) and incidence (22%, both) and duration of decline of rSO 2<80% of the baseline values. The serially assessed hemodynamic variables, hematocrit levels, and blood gas analysis variables were also similar between the groups, except for the number of hypotensive events per patient, which was higher in the patients with delirium than in those without (4, interquartile range [IQR] 3 to 6 vs. 2, IQR: 1to 3; P=0.014). Conclusions: The degree and duration of decrease of the perioperative rSO 2 measurements were not associated with delirium in elderly patients after spinal surgery.

Original languageEnglish
Pages (from-to)426-432
Number of pages7
JournalJournal of Neurosurgical Anesthesiology
Volume29
Issue number4
DOIs
Publication statusPublished - 2017 Jan 1

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Oximetry
Delirium
Confusion
Blood Gas Analysis
Critical Care
Brain Ischemia
Checklist
Hematocrit
Postoperative Period
Cognition
Intensive Care Units
Psychiatry
Hemodynamics
Oxygen
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Soh, Sarah ; Shim, Jae Kwang ; Song, Jong Wook ; Kim, Keung Nyun ; Noh, Hyun Young ; Kwak, Young Lan. / Postoperative Delirium in Elderly Patients Undergoing Major Spinal Surgery : Role of Cerebral Oximetry. In: Journal of Neurosurgical Anesthesiology. 2017 ; Vol. 29, No. 4. pp. 426-432.
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abstract = "Background: Perioperative cerebral hypoperfusion/ischemia is a major inciting factor of postoperative delirium, which is coupled with adverse outcome in elderly patients. Cerebral oximetry enables noninvasive assessment of the regional cerebral oxygen saturation (rSO2). This study aimed to investigate whether perioperative rSO 2 variations were linked to delirium in elderly patients after spinal surgery. Materials and Methods: Postoperative delirium was assessed for 48 hours postsurgery in 109 patients aged over 60 years without a prior history of cerebrovascular or psychiatric diseases by the Confusion Assessment Method for the intensive care unit and the intensive care delirium screening checklist. The rSO2 values immediately before and throughout surgery were acquired. The preoperative cognitive functions, patient characteristics, and perioperative data were recorded. Results: During the 48-h postoperative period, 9 patients (8{\%}) exhibited delirium. The patients with delirium showed similar perioperative rSO2 values as those without, in terms of the median lowest rSO 2 values (55{\%} vs. 56{\%}; P=0.876) and incidence (22{\%}, both) and duration of decline of rSO 2<80{\%} of the baseline values. The serially assessed hemodynamic variables, hematocrit levels, and blood gas analysis variables were also similar between the groups, except for the number of hypotensive events per patient, which was higher in the patients with delirium than in those without (4, interquartile range [IQR] 3 to 6 vs. 2, IQR: 1to 3; P=0.014). Conclusions: The degree and duration of decrease of the perioperative rSO 2 measurements were not associated with delirium in elderly patients after spinal surgery.",
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Postoperative Delirium in Elderly Patients Undergoing Major Spinal Surgery : Role of Cerebral Oximetry. / Soh, Sarah; Shim, Jae Kwang; Song, Jong Wook; Kim, Keung Nyun; Noh, Hyun Young; Kwak, Young Lan.

In: Journal of Neurosurgical Anesthesiology, Vol. 29, No. 4, 01.01.2017, p. 426-432.

Research output: Contribution to journalArticle

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T1 - Postoperative Delirium in Elderly Patients Undergoing Major Spinal Surgery

T2 - Role of Cerebral Oximetry

AU - Soh, Sarah

AU - Shim, Jae Kwang

AU - Song, Jong Wook

AU - Kim, Keung Nyun

AU - Noh, Hyun Young

AU - Kwak, Young Lan

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N2 - Background: Perioperative cerebral hypoperfusion/ischemia is a major inciting factor of postoperative delirium, which is coupled with adverse outcome in elderly patients. Cerebral oximetry enables noninvasive assessment of the regional cerebral oxygen saturation (rSO2). This study aimed to investigate whether perioperative rSO 2 variations were linked to delirium in elderly patients after spinal surgery. Materials and Methods: Postoperative delirium was assessed for 48 hours postsurgery in 109 patients aged over 60 years without a prior history of cerebrovascular or psychiatric diseases by the Confusion Assessment Method for the intensive care unit and the intensive care delirium screening checklist. The rSO2 values immediately before and throughout surgery were acquired. The preoperative cognitive functions, patient characteristics, and perioperative data were recorded. Results: During the 48-h postoperative period, 9 patients (8%) exhibited delirium. The patients with delirium showed similar perioperative rSO2 values as those without, in terms of the median lowest rSO 2 values (55% vs. 56%; P=0.876) and incidence (22%, both) and duration of decline of rSO 2<80% of the baseline values. The serially assessed hemodynamic variables, hematocrit levels, and blood gas analysis variables were also similar between the groups, except for the number of hypotensive events per patient, which was higher in the patients with delirium than in those without (4, interquartile range [IQR] 3 to 6 vs. 2, IQR: 1to 3; P=0.014). Conclusions: The degree and duration of decrease of the perioperative rSO 2 measurements were not associated with delirium in elderly patients after spinal surgery.

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