The risk factors associated with delirium after lumbar spine surgery in elderly patients

AME Spine Surgery Collaborative Group

Research output: Contribution to journalArticle

Abstract

Background: To prospectively explore the incidence and risk factors for postoperative delirium in elderly patients following lumbar spine surgery. Methods: This prospective study enrolled 148 consecutive patients over the age of 65 who were scheduled to undergo spine surgery. Patients were screened for delirium using the short Confusion Assessment Method (CAM) postoperatively. Patient demographics and relevant medical information were collected. Logistic regression analysis was used to identify the risk factors associated with postoperative delirium. Results: Eighty-three patients (56.1%) who underwent lumbar spine surgery (not coexisting with cervical or thoracic spine surgery) were enrolled in our study. Post-operative delirium was noted in 14.5% of patients over 65 years old. The presence of preoperative Parkinsonism was significantly higher in the delirium group (41.7% vs. 8.5%, P=0.002), as was a higher preoperative C-reactive protein (CRP) (7.0±15.2 vs. 1.3±2.3 mg/L, P=0.017) when compared with the non-delirium group. Of the risk factors, male sex [odds ratio (OR) =0.10, 95% confidence interval (CI): 0.01-0.66, P=0.017], Parkinsonism (OR =5.83, 95% CI: 1.03-32.89, P=0.046), and lower baseline MMSE score (OR =0.71, 95% CI: 0.52-0.97, P=0.032) were independently associated with postoperative delirium in elderly patients undergoing lumbar spine surgery. Conclusions: Post-operative delirium occurred in 14.5% of elderly patients who underwent lumbar spine surgery. Male sex, Parkinsonism, and lower baseline MMSE score were identified as independent risk factors for postoperative delirium in elderly patients following lumbar surgery.

Original languageEnglish
Pages (from-to)700-710
Number of pages11
JournalQuantitative Imaging in Medicine and Surgery
Volume9
Issue number4
DOIs
Publication statusPublished - 2019 Jan 1

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Delirium
Spine
Parkinsonian Disorders
Odds Ratio
Confidence Intervals
Confusion
Sex Ratio
C-Reactive Protein
Thoracic Surgery
Logistic Models
Regression Analysis
Demography
Prospective Studies
Incidence

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

@article{e3b395fac1e741069f135e76e604016f,
title = "The risk factors associated with delirium after lumbar spine surgery in elderly patients",
abstract = "Background: To prospectively explore the incidence and risk factors for postoperative delirium in elderly patients following lumbar spine surgery. Methods: This prospective study enrolled 148 consecutive patients over the age of 65 who were scheduled to undergo spine surgery. Patients were screened for delirium using the short Confusion Assessment Method (CAM) postoperatively. Patient demographics and relevant medical information were collected. Logistic regression analysis was used to identify the risk factors associated with postoperative delirium. Results: Eighty-three patients (56.1{\%}) who underwent lumbar spine surgery (not coexisting with cervical or thoracic spine surgery) were enrolled in our study. Post-operative delirium was noted in 14.5{\%} of patients over 65 years old. The presence of preoperative Parkinsonism was significantly higher in the delirium group (41.7{\%} vs. 8.5{\%}, P=0.002), as was a higher preoperative C-reactive protein (CRP) (7.0±15.2 vs. 1.3±2.3 mg/L, P=0.017) when compared with the non-delirium group. Of the risk factors, male sex [odds ratio (OR) =0.10, 95{\%} confidence interval (CI): 0.01-0.66, P=0.017], Parkinsonism (OR =5.83, 95{\%} CI: 1.03-32.89, P=0.046), and lower baseline MMSE score (OR =0.71, 95{\%} CI: 0.52-0.97, P=0.032) were independently associated with postoperative delirium in elderly patients undergoing lumbar spine surgery. Conclusions: Post-operative delirium occurred in 14.5{\%} of elderly patients who underwent lumbar spine surgery. Male sex, Parkinsonism, and lower baseline MMSE score were identified as independent risk factors for postoperative delirium in elderly patients following lumbar surgery.",
author = "{AME Spine Surgery Collaborative Group} and Zhimin Pan and Kai Huang and Wei Huang and Kim, {Ki Hoon} and Hao Wu and Yanghong Yu and Kim, {Keung Nyun} and Seong Yi and DongAh Shin and Darshan Vora and Cristian Gragnaniello and Kevin Phan and Anastasia Tasiou and Winder, {Mark J.} and Hisashi Koga and Parisa Azimi and Kang, {Suk Yun} and Yoon Ha",
year = "2019",
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doi = "10.21037/qims.2019.04.09",
language = "English",
volume = "9",
pages = "700--710",
journal = "Quantitative Imaging in Medicine and Surgery",
issn = "2223-4292",
publisher = "AME Publishing Company",
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The risk factors associated with delirium after lumbar spine surgery in elderly patients. / AME Spine Surgery Collaborative Group.

In: Quantitative Imaging in Medicine and Surgery, Vol. 9, No. 4, 01.01.2019, p. 700-710.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The risk factors associated with delirium after lumbar spine surgery in elderly patients

AU - AME Spine Surgery Collaborative Group

AU - Pan, Zhimin

AU - Huang, Kai

AU - Huang, Wei

AU - Kim, Ki Hoon

AU - Wu, Hao

AU - Yu, Yanghong

AU - Kim, Keung Nyun

AU - Yi, Seong

AU - Shin, DongAh

AU - Vora, Darshan

AU - Gragnaniello, Cristian

AU - Phan, Kevin

AU - Tasiou, Anastasia

AU - Winder, Mark J.

AU - Koga, Hisashi

AU - Azimi, Parisa

AU - Kang, Suk Yun

AU - Ha, Yoon

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: To prospectively explore the incidence and risk factors for postoperative delirium in elderly patients following lumbar spine surgery. Methods: This prospective study enrolled 148 consecutive patients over the age of 65 who were scheduled to undergo spine surgery. Patients were screened for delirium using the short Confusion Assessment Method (CAM) postoperatively. Patient demographics and relevant medical information were collected. Logistic regression analysis was used to identify the risk factors associated with postoperative delirium. Results: Eighty-three patients (56.1%) who underwent lumbar spine surgery (not coexisting with cervical or thoracic spine surgery) were enrolled in our study. Post-operative delirium was noted in 14.5% of patients over 65 years old. The presence of preoperative Parkinsonism was significantly higher in the delirium group (41.7% vs. 8.5%, P=0.002), as was a higher preoperative C-reactive protein (CRP) (7.0±15.2 vs. 1.3±2.3 mg/L, P=0.017) when compared with the non-delirium group. Of the risk factors, male sex [odds ratio (OR) =0.10, 95% confidence interval (CI): 0.01-0.66, P=0.017], Parkinsonism (OR =5.83, 95% CI: 1.03-32.89, P=0.046), and lower baseline MMSE score (OR =0.71, 95% CI: 0.52-0.97, P=0.032) were independently associated with postoperative delirium in elderly patients undergoing lumbar spine surgery. Conclusions: Post-operative delirium occurred in 14.5% of elderly patients who underwent lumbar spine surgery. Male sex, Parkinsonism, and lower baseline MMSE score were identified as independent risk factors for postoperative delirium in elderly patients following lumbar surgery.

AB - Background: To prospectively explore the incidence and risk factors for postoperative delirium in elderly patients following lumbar spine surgery. Methods: This prospective study enrolled 148 consecutive patients over the age of 65 who were scheduled to undergo spine surgery. Patients were screened for delirium using the short Confusion Assessment Method (CAM) postoperatively. Patient demographics and relevant medical information were collected. Logistic regression analysis was used to identify the risk factors associated with postoperative delirium. Results: Eighty-three patients (56.1%) who underwent lumbar spine surgery (not coexisting with cervical or thoracic spine surgery) were enrolled in our study. Post-operative delirium was noted in 14.5% of patients over 65 years old. The presence of preoperative Parkinsonism was significantly higher in the delirium group (41.7% vs. 8.5%, P=0.002), as was a higher preoperative C-reactive protein (CRP) (7.0±15.2 vs. 1.3±2.3 mg/L, P=0.017) when compared with the non-delirium group. Of the risk factors, male sex [odds ratio (OR) =0.10, 95% confidence interval (CI): 0.01-0.66, P=0.017], Parkinsonism (OR =5.83, 95% CI: 1.03-32.89, P=0.046), and lower baseline MMSE score (OR =0.71, 95% CI: 0.52-0.97, P=0.032) were independently associated with postoperative delirium in elderly patients undergoing lumbar spine surgery. Conclusions: Post-operative delirium occurred in 14.5% of elderly patients who underwent lumbar spine surgery. Male sex, Parkinsonism, and lower baseline MMSE score were identified as independent risk factors for postoperative delirium in elderly patients following lumbar surgery.

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JO - Quantitative Imaging in Medicine and Surgery

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