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["Publication Type","Authors","Book Authors","Book Editors","Book Group Authors","Author Full Names","Book Author Full Names","Group Authors","Article Title","Source Title","Book Series Title","Book Series Subtitle","Language","Document Type","Conference Title","Conference Date","Conference Location","Conference Sponsor","Conference Host","Author Keywords","Keywords Plus","Abstract","Addresses","Affiliations","Reprint Addresses","Email Addresses","Researcher Ids","ORCIDs","Funding Orgs","Funding Name Preferred","Funding Text","Cited References","Cited Reference Count","Times Cited, WoS Core","Times Cited, All Databases","180 Day Usage Count","Since 2013 Usage Count","Publisher","Publisher City","Publisher Address","ISSN","eISSN","ISBN","Journal Abbreviation","Journal ISO Abbreviation","Publication Date","Publication Year","Volume","Issue","Part Number","Supplement","Special Issue","Meeting Abstract","Start Page","End Page","Article Number","DOI","DOI Link","Book DOI","Early Access Date","Number of Pages","WoS Categories","Web of Science Index","Research Areas","IDS Number","Pubmed Id","Open Access Designations","Highly Cited Status","Hot Paper Status","Date of Export","UT (Unique WOS ID)","Web of Science Record"]
["J","TUNE, LE; HOLLAND, A; FOLSTEIN, MF; DAMLOUJI, NF; GARDNER, TJ; COYLE, JT","","","","TUNE, LE; HOLLAND, A; FOLSTEIN, MF; DAMLOUJI, NF; GARDNER, TJ; COYLE, JT","","","ASSOCIATION OF POSTOPERATIVE DELIRIUM WITH RAISED SERUM LEVELS OF ANTICHOLINERGIC DRUGS","LANCET","","","English","Article","","","","","","","","","JOHNS HOPKINS UNIV,SCH MED,DEPT NEUROSCI,BALTIMORE,MD 21205; JOHNS HOPKINS UNIV,SCH MED,DEPT PSYCHIAT & BEHAV SCI,BALTIMORE,MD 21205; JOHNS HOPKINS UNIV,SCH MED,DEPT CARDIOVASC SURG,BALTIMORE,MD 21205; JOHNS HOPKINS UNIV,SCH MED,DEPT PHARMACOL & EXPTL THERAPEUT,BALTIMORE,MD 21205","Johns Hopkins University; Johns Hopkins University; Johns Hopkins University; Johns Hopkins University","","","","","","","","",15,198,203,1,3,"LANCET LTD","LONDON","42 BEDFORD SQUARE, LONDON, ENGLAND WC1B 3SL","0140-6736","","","LANCET","Lancet","",1981,2,8248,"","","","",651,653,"","","","","",3,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED)","General & Internal Medicine","MH028",6116042,"","","","2023-11-07","WOS:A1981MH02800002","View Full Record in Web of Science"]
["J","WILLIAMSRUSSO, P; URQUHART, BL; SHARROCK, NE; CHARLSON, ME","","","","WILLIAMSRUSSO, P; URQUHART, BL; SHARROCK, NE; CHARLSON, ME","","","POSTOPERATIVE DELIRIUM - PREDICTORS AND PROGNOSIS IN ELDERLY ORTHOPEDIC PATIENTS","JOURNAL OF THE AMERICAN GERIATRICS SOCIETY","","","English","Article","","","","","","","FEMORAL-NECK FRACTURES; MINI-MENTAL STATE; COGNITIVE IMPAIRMENT; GENERAL-ANESTHESIA; HIP FRACTURE; POSTOPERATIVE CONFUSION; MEDICAL INPATIENTS; PSYCHOMOTOR-SKILLS; SPINAL-ANESTHESIA; SURGICAL PATIENTS","Objective: To compare the effect of post-operative analgesia using epidural versus intravenous infusions on the incidence of delirium after bilateral knee replacement surgery in elderly patients. Additional risk factors and impact on post-operative recovery were also assessed. Design: Prospective randomized controlled trial. Setting: Urban referral hospital specializing in elective orthopedic surgery. Patients: 60 consecutive patients undergoing bilateral knee replacement surgery with epidural anesthesia were approached; 51 patients were eligible and consented. The mean age was 68, 55% were women, and there was a high prevalence of comorbid medical disease. No patient was demented pre-operatively. Intervention: Random allocation to either continuous epidural infusion of bupivicaine and fentanyl or continuous intravenous infusion of fentanyl. Infusions were initiated at the first complaint of pain and continued through the 36- to 48-hour stay in the recovery room. Main Outcome Measure: Acute post-operative delirium defined using an algorithm based on DSM III criteria. Results: The overall incidence of acute delirium was 41%, with no difference between types of post-operative analgesia. Predictors of delirium were age, gender, and pre-operative alcohol use. All cases resolved within 1 week, and length of stay and achievement of physical therapy goals were the same for delirious and non-delirious patients. Conclusions: There is a high incidence of post-operative delirium in elderly non-demented patients following bilateral knee replacement, regardless of whether post-operative analgesia is administered by the epidural or intravenous route.","CORNELL UNIV,MED CTR,COLL MED,CORNELL ARTHRITIS & MUSCULOSKELETAL DIS CTR,DEPT ANESTHESIOL,NEW YORK,NY 10021","Cornell University","WILLIAMSRUSSO, P (通讯作者)，CORNELL UNIV,MED CTR,COLL MED,CORNELL ARTHRITIS & MUSCULOSKELETAL DIS CTR,HOSP SPECIAL SURG,NEW YORK,NY 10021, USA.","","","","NIA NIH HHS [R01 AG08562] Funding Source: Medline","NIA NIH HHS(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","","",80,225,233,0,16,"WILLIAMS & WILKINS","BALTIMORE","351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436","0002-8614","","","J AM GERIATR SOC","J. Am. Geriatr. Soc.","AUG",1992,40,8,"","","","",759,767,"","10.1111/j.1532-5415.1992.tb01846.x","http://dx.doi.org/10.1111/j.1532-5415.1992.tb01846.x","","",9,"Geriatrics & Gerontology; Gerontology","Social Science Citation Index (SSCI); Science Citation Index Expanded (SCI-EXPANDED)","Geriatrics & Gerontology","JH344",1634718,"","","","2023-11-07","WOS:A1992JH34400002","View Full Record in Web of Science"]
["J","MARCANTONIO, ER; JUAREZ, G; GOLDMAN, L; MANGIONE, CM; LUDWIG, LE; LIND, L; KATZ, N; COOK, EF; ORAV, EJ; LEE, TH","","","","MARCANTONIO, ER; JUAREZ, G; GOLDMAN, L; MANGIONE, CM; LUDWIG, LE; LIND, L; KATZ, N; COOK, EF; ORAV, EJ; LEE, TH","","","THE RELATIONSHIP OF POSTOPERATIVE DELIRIUM WITH PSYCHOACTIVE MEDICATIONS","JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION","","","English","Article","","","","","","","SURGICAL PATIENTS; ELDERLY PATIENT; ACTIVITY SCALE; RISK-FACTORS; ASSOCIATION; MEPERIDINE; PROGNOSIS; SURGERY","Objective.-To examine the role of medications with known psychoactive properties in the development of postoperative delirium. Design.-Nested case-control study within a prospective cohort study. Setting.-General surgery, orthopedic surgery, and gynecology services at Brigham and Women's Hospital, Boston, Mass. Patients.-Cases (n=91) were patients enrolled in a prospective cohort study who developed delirium during postoperative days 2 through 5. One or two controls (n=154) were matched to each case by the calculated preoperative risk for delirium using a predictive model developed and validated in the prospective cohort study. Main Outcome Measures.-Medication exposures were ascertained from the medical record by a reviewer blinded to the study hypothesis. Exposures to narcotics, benzodiazepines, and anticholinergics were recorded for the 24-hour period before delirium developed in the 91 cases and for the same 24-hour postoperative period for the 154 matched controls. Results.-Delirium was significantly associated with postoperative exposure to meperidine (odds ratio [OR], 2.7; 95% confidence interval [Cl], 1.3 to 5.5) and to benzodiazepines (OR, 3.0; 95% Cl, 1.3 to 6.8). Meperidine had similar associations with delirium whether administered via epidural or patient-controlled routes, although only the epidural route reached significance (OR, 2.4; 95% Cl, 1.3 to 4.4; OR, 2.1; 95% Cl, 0.4 to 10.7, respectively). For benzodiazepines, long-acting agents had a trend toward stronger association with delirium than did short-acting agents (OR, 5.4; 95% Cl, 1.0 to 29.2; vs 2.6; 1.1 to 6.5), and high-dose exposures had a trend toward slightly stronger association than low-dose exposures (OR, 3.3; 95% Cl, 1.0 to 11.0; vs 2.6; 0.8 to 9.1). Neither narcotics (OR, 1.4; 95% Cl, 0.5 to 4.3) nor anticholinergic drugs (OR, 1.5; 95% Cl, 0.6 to 3.4) were significantly associated with delirium as a class, although statistical power was limited because of the high use of narcotics and the low use of anticholinergics in the study population. Conclusions.-Clinicians caring for patients at risk for delirium should carefully evaluate the need for meperidine and benzodiazepines in the postoperative period and consider alternative therapies whenever possible.","HARVARD UNIV,BRIGHAM & WOMENS HOSP,SCH MED,CLIN EPIDEMIOL SECT,BOSTON,MA 02115; HARVARD UNIV,BRIGHAM & WOMENS HOSP,SCH MED,DIV GEN MED,BOSTON,MA 02115; HARVARD UNIV,BRIGHAM & WOMENS HOSP,SCH MED,DIV GERONTOL,BOSTON,MA 02115; HARVARD UNIV,BRIGHAM & WOMENS HOSP,SCH MED,DIV CARDIOL,BOSTON,MA 02115; HARVARD UNIV,BRIGHAM & WOMENS HOSP,SCH MED,DEPT MED,BOSTON,MA 02115; HARVARD UNIV,BRIGHAM & WOMENS HOSP,SCH MED,DEPT ANESTHESIA,BOSTON,MA 02115; HARVARD UNIV,BRIGHAM & WOMENS HOSP,SCH MED,CLIN INITIAT DEV PROGRAM,BOSTON,MA 02115; HARVARD UNIV,SCH PUBL HLTH,DEPT EPIDEMIOL,BOSTON,MA 02115; CEDARS SINAI MED CTR,DEPT ANESTHESIA,LOS ANGELES,CA 90048","Harvard University; Brigham & Women's Hospital; Harvard Medical School; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Harvard University; Harvard Medical School; Brigham & Women's Hospital; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Harvard University; Harvard Medical School; Brigham & Women's Hospital; Harvard University; Harvard T.H. Chan School of Public Health; Cedars Sinai Medical Center","","","Marcantonio, Edward R/U-3929-2017","Marcantonio, Edward R/0000-0002-2911-4250","AHRQ HHS [1RO1-HS06573] Funding Source: Medline; BHP HRSA HHS [5T32PE110011-04] Funding Source: Medline","AHRQ HHS(United States Department of Health & Human ServicesAgency for Healthcare Research & Quality); BHP HRSA HHS","","",33,372,387,2,16,"AMER MEDICAL ASSOC","CHICAGO","515 N STATE ST, CHICAGO, IL 60610","0098-7484","","","JAMA-J AM MED ASSOC","JAMA-J. Am. Med. Assoc.","NOV 16",1994,272,19,"","","","",1518,1522,"","10.1001/jama.272.19.1518","http://dx.doi.org/10.1001/jama.272.19.1518","","",5,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","General & Internal Medicine","PQ900",7966844,"","","","2023-11-07","WOS:A1994PQ90000031","View Full Record in Web of Science"]
["J","OKEEFE, ST; NICHONCHUBHAIR, A","","","","OKEEFE, ST; NICHONCHUBHAIR, A","","","POSTOPERATIVE DELIRIUM IN THE ELDERLY","BRITISH JOURNAL OF ANAESTHESIA","","","English","Review","","","","","","PSYCHOLOGICAL RESPONSES, POSTOPERATIVE; RECOVERY, POSTOPERATIVE; ANESTHESIA, GERIATRIC","ACUTE CONFUSIONAL STATES; OPEN-HEART SURGERY; CENTRAL ANTICHOLINERGIC SYNDROME; NERVOUS-SYSTEM COMPLICATIONS; PROLONGED HOSPITAL STAY; FEMORAL-NECK FRACTURES; BYPASS GRAFT-SURGERY; PSYCHIATRIC ASPECTS; GENERAL-ANESTHESIA; SURGICAL PATIENTS","","WHISTON HOSP, DEPT ANAESTHESIA, PRESCOT L35, ENGLAND","Whiston Hospital","OKEEFE, ST (通讯作者)，UNIV LIVERPOOL, ROYAL LIVERPOOL HOSP, DEPT GERIATR MED, POB 147, PRESCOT ST, LIVERPOOL L69 3BX, MERSEYSIDE, ENGLAND.","","","O'Keeffe, Shaun/0000-0002-7682-5004","","","","",182,133,145,0,5,"ELSEVIER SCI LTD","OXFORD","THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND","0007-0912","1471-6771","","BRIT J ANAESTH","Br. J. Anaesth.","NOV",1994,73,5,"","","","",673,687,"","10.1093/bja/73.5.673","http://dx.doi.org/10.1093/bja/73.5.673","","",15,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","PP065",7826799,"hybrid","","","2023-11-07","WOS:A1994PP06500023","View Full Record in Web of Science"]
["J","AAKERLUND, LP; ROSENBERG, J","","","","AAKERLUND, LP; ROSENBERG, J","","","POSTOPERATIVE DELIRIUM - TREATMENT WITH SUPPLEMENTARY OXYGEN","BRITISH JOURNAL OF ANAESTHESIA","","","English","Article","","","","","","PSYCHOLOGICAL RESPONSES, POSTOPERATIVE; HYPOXEMIA; SURGERY, THORACIC","ACUTE CONFUSIONAL STATES; ABDOMINAL OPERATIONS; CONSTANT HYPOXEMIA; SURGICAL PATIENTS; RISK-FACTORS; HYPOXIA; ASSOCIATION; IMPAIRMENT; DISORDERS; PERFUSION","We have assessed postoperative delirium in 24 patients undergoing thoracotomy for pulmonary malignancy throughout their stay in hospital Arterial oxygen saturation was measured with a pulse oximeter on the night before operation and on the second night after operation. Five patients (21%) developed clinically significant postoperative delirium, and delirium occurred in all patients who had inadequate oxygenation. All cases of delirium occurred on day 3 after surgery. Factors which were not associated with delirium were age, intake of alcohol or consumption of drugs before operation, fever, type of operation, duration of surgery, anxiety and psychosocial stress before operation, postoperative metabolic derangement or hypotension during operation. Mean arterial oxygen saturation on the second night after operation (the night preceding delirium) was smaller in patients with delirium than in other patients (median 88% vs 95%, P < 0.05). When patients were delirious, the first treatment of choice was supplementary oxygen and all patients were treated successfully by this simple regimen. in two patients, supplementary treatment with zuclopenthixol 6mg daily was necessary. We conclude that hypoxaemia may be a contributing factor in postoperative brain dysfunction, as postoperative delirium was associated with hypoxaemia and was treated successfully with supplementary oxygen.","BISPEBJERG HOSP, DEPT PSYCHIAT, DK-2400 COPENHAGEN, DENMARK; SUNDBY HOSP, DEPT SURG, DK-2300 COPENHAGEN, DENMARK","University of Copenhagen; Bispebjerg Hospital","AAKERLUND, LP (通讯作者)，BISPEBJERG HOSP, DEPT THORAC SURG, DK-2400 COPENHAGEN, DENMARK.","","","","","","","",46,91,99,2,6,"ELSEVIER SCI LTD","OXFORD","THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND","0007-0912","1471-6771","","BRIT J ANAESTH","Br. J. Anaesth.","MAR",1994,72,3,"","","","",286,290,"","10.1093/bja/72.3.286","http://dx.doi.org/10.1093/bja/72.3.286","","",5,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","NB939",8130045,"hybrid","","","2023-11-07","WOS:A1994NB93900007","View Full Record in Web of Science"]
["J","DYER, CB; ASHTON, CM; TEASDALE, TA","","","","DYER, CB; ASHTON, CM; TEASDALE, TA","","","POSTOPERATIVE DELIRIUM - A REVIEW OF 80 PRIMARY DATA-COLLECTION STUDIES","ARCHIVES OF INTERNAL MEDICINE","","","English","Article","","","","","","","ACUTE CONFUSIONAL STATES; OPEN-HEART SURGERY; NERVOUS-SYSTEM DYSFUNCTION; FEMORAL-NECK FRACTURES; GENERAL-ANESTHESIA; SURGICAL PATIENTS; ELDERLY PATIENTS; PSYCHIATRIC COMPLICATIONS; POSTCARDIOTOMY DELIRIUM; CARDIOPULMONARY BYPASS","We conducted an on-line search and manual searches for 1966 through 1992 to determine the incidence, diagnosis, risk factors, and treatment of postoperative delirium. Of the 374 citations found, 277 articles were excluded after criteria of relevance were applied. After methodologic criteria for validity were applied to the remaining 80 articles, 26 studies were retained for the final information synthesis. The incidence of postoperative delirium was 36.8% (range, O% to 73.5%). Primary reasons for this disparity were insufficient sam-pie size and inconsistent application of numerous diagnostic tools. One study provided statistically significant data that demonstrated that postoperative delirium is underdiagnosed by physicians and nurses. Four of the articles that met the established criteria provided risk factor data. Although age, preoperative cognitive impairment, and the use of anticholinergic drugs were significantly associated with postoperative delirium, gender, type and route of anesthesia, and sleep deprivation were not. Two studies demonstrated a decreased incidence of postoperative delirium when patients underwent preoperative psychiatric counseling or participated in a structured perioperative program. These findings indicate a need for (1) accurate incidence data with further definition of risk factors and (2) studies that address the diagnosis and treatment of this common postoperative problem.","VET AFFAIRS MED CTR, GERIATR SECT, HOUSTON, TX 77030 USA; VET AFFAIRS MED CTR, HUFFINGTON CTR AGING, HOUSTON, TX 77030 USA; VET AFFAIRS MED CTR, GEN MED SECT, HOUSTON, TX 77030 USA; VET AFFAIRS MED CTR, VET AFFAIRS HLTH SERV RES & DEV FIELD PROGRAM, HOUSTON, TX 77030 USA; BAYLOR COLL MED, DEPT INTERNAL MED, HOUSTON, TX 77030 USA","Baylor College of Medicine; US Department of Veterans Affairs; Veterans Health Administration (VHA); US Department of Veterans Affairs; Veterans Health Administration (VHA); Baylor College of Medicine; Baylor College of Medicine; US Department of Veterans Affairs; Veterans Health Administration (VHA); US Department of Veterans Affairs; Veterans Health Administration (VHA); Baylor College of Medicine; Baylor College of Medicine","","","","","","","","",85,298,314,0,21,"AMER MEDICAL ASSOC","CHICAGO","330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA","0003-9926","1538-3679","","ARCH INTERN MED","Arch. Intern. Med.","MAR 13",1995,155,5,"","","","",461,465,"","10.1001/archinte.155.5.461","http://dx.doi.org/10.1001/archinte.155.5.461","","",5,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","General & Internal Medicine","QL793",7864702,"","","","2023-11-07","WOS:A1995QL79300002","View Full Record in Web of Science"]
["J","PARIKH, SS; CHUNG, F","","","","PARIKH, SS; CHUNG, F","","","POSTOPERATIVE DELIRIUM IN THE ELDERLY","ANESTHESIA AND ANALGESIA","","","English","Article","","","","","","","ACUTE CONFUSIONAL STATES; CLIFTON-ASSESSMENT-PROCEDURES; FEMORAL-NECK FRACTURES; OPEN-HEART SURGERY; COGNITIVE IMPAIRMENT; GENERAL-ANESTHESIA; MENTAL FUNCTION; SPINAL-ANESTHESIA; PULSE OXIMETRY; SURVEY VERSION","","UNIV TORONTO,TORONTO HOSP,DEPT ANESTHESIA,WESTERN DIV,TORONTO,ON M5T 2S8,CANADA","University of Toronto; University Health Network Toronto","","","Chung, Frances/F-5618-2015","Chung, Frances/0000-0001-9576-3606","","","","",104,184,209,0,11,"WILLIAMS & WILKINS","BALTIMORE","351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436","0003-2999","","","ANESTH ANALG","Anesth. Analg.","JUN",1995,80,6,"","","","",1223,1232,"","10.1097/00000539-199506000-00027","http://dx.doi.org/10.1097/00000539-199506000-00027","","",10,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Anesthesiology","RA330",7762856,"","","","2023-11-07","WOS:A1995RA33000027","View Full Record in Web of Science"]
["J","FISHER, BW; FLOWERDEW, G","","","","FISHER, BW; FLOWERDEW, G","","","SIMPLE-MODEL FOR PREDICTING POSTOPERATIVE DELIRIUM IN OLDER PATIENTS UNDERGOING ELECTIVE ORTHOPEDIC-SURGERY","JOURNAL OF THE AMERICAN GERIATRICS SOCIETY","","","English","Note","","","","","","","ACUTE CONFUSIONAL STATES; FEMORAL-NECK FRACTURES; ELDERLY PATIENTS; ALZHEIMERS-DISEASE; RISK-FACTORS; DEMENTIA; ANESTHESIA; PROGNOSIS","OBJECTIVE: To determine the incidence, and severity of postoperative delirium (POD) in older patients undergoing elective orthopedic procedures and to identify potential preoperative risk factors. DESIGN: A prospectively studied cohort of elective orthopedic surgery patients. SETTING: A University teaching hospital. PATIENTS: Eighty patients who attended a preadmission clinic and, subsequently, underwent elective orthopedic surgery. All patients were aged 60 years or older, and all spoke English. MEASUREMENTS: Patients underwent preoperative medical, cognitive, and activities of daily living assessment with standardized instruments and were followed postoperatively with daily visits, telephone interviews with attending nurses using a modified confusion assessment model (CAM), and repeated cognitive testing. Suspected delirium was verified by direct physician assessment. RESULTS: The elective group had 14 (17.5%) cases of POD, of which six (7.5%) were severe. These incidences are low compared with those of nonelective surgery groups reported elsewhere in the literature. Stepwise multiple logistic regression identified two POD risk factors: clock-drawing scores less than or equal to 6 (OR = 9.0, CI, 2.8 to 45.6) and male gender (OR = 5.6, CI 1.9 to 33.8). CONCLUSION: A simple model using clock-drawing scores and male gender for preoperative identification of elective patients at greatest risk for POD appears sensitive, predictive, and practical for the preadmission clinic setting, but it should be validated in a prospective trial.","UNIV ALBERTA,WALTER C MACKENZIE HLTH SCI CTR,DEPT PUBL HLTH SCI,EDMONTON,AB T6G 2R7,CANADA","University of Alberta","FISHER, BW (通讯作者)，UNIV ALBERTA,WALTER C MACKENZIE HLTH SCI CTR,DIV GEN INTERNAL MED,EDMONTON,AB T6G 2R7,CANADA.","","","","","","","",21,87,89,0,4,"WILLIAMS & WILKINS","BALTIMORE","351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436","0002-8614","","","J AM GERIATR SOC","J. Am. Geriatr. Soc.","FEB",1995,43,2,"","","","",175,178,"","10.1111/j.1532-5415.1995.tb06385.x","http://dx.doi.org/10.1111/j.1532-5415.1995.tb06385.x","","",4,"Geriatrics & Gerontology; Gerontology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Geriatrics & Gerontology","QF230",7836644,"","","","2023-11-07","WOS:A1995QF23000014","View Full Record in Web of Science"]
["J","Lynch, EP; Lazor, MA; Gellis, JE; Orav, J; Goldman, L; Marcantonio, ER","","","","Lynch, EP; Lazor, MA; Gellis, JE; Orav, J; Goldman, L; Marcantonio, ER","","","The impact of postoperative pain on the development of postoperative delirium","ANESTHESIA AND ANALGESIA","","","English","Article; Proceedings Paper","American-Society-of-Anesthesiologists Annual Meeting","OCT 15-22, 1994","SAN FRANCISCO, CALIFORNIA","Amer Soc Anesthesiologists","","","RANDOMIZED TRIAL; ELDERLY PATIENTS; OLDER ADULTS; ANESTHESIA; CONFUSION","We performed a prospective observational study to examine the role of postoperative pain and its treatment on the development of postoperative delirium. Pain was measured in direct patient interviews using a visual analog scale (VAS) and was assessed for pain at rest, pain with movement, and maximal pain over the previous 24 h. Postoperative delirium was diagnosed during these interviews by using the confusion assessment method (CAM) and/or by using data from the medical record and the hospital's nursing intensity index. The method of postoperative analgesia, type of opioid, and cumulative opioid dose were also recorded. After controlling for known preoperative risk factors for delirium (age, alcohol abuse, cognitive function, physical function, serum chemistries, and type of surgery), higher pain scores at rest was associated with an increased risk of delirium over the first 3 postoperative days (adjusted risk ratio 1.20, P = 0.04). Pain with movement and maximal pain were not associated with delirium. Method of postoperative analgesia, type of opioid, and cumulative opioid dose were not associated with an increased risk of delirium. We conclude that more effective control of postoperative pain reduces the incidence of postoperative delirium. Implications: We performed daily interviews in a large population of patients undergoing noncardiac surgery to measure their level of pain and development of delirium. We found an association between higher pain levels at rest and the development of delirium. Our results suggest that better control of postoperative pain may reduce this serious complication.","Harvard Univ, Sch Med, Dept Anesthesia, Boston, MA 02115 USA; Harvard Univ, Sch Med, Dept Biostat, Boston, MA 02115 USA; Harvard Univ, Sch Med, Dept Med, Boston, MA 02115 USA; Anesthesia Associates New Mexico, Dept Anesthesiol, Albuquerque, NM USA; Univ Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA","Harvard University; Harvard Medical School; Harvard University; Harvard Medical School; Harvard University; Harvard Medical School; University of California System; University of California San Francisco","Lynch, EP (通讯作者)，Brigham & Womens Hosp, Dept Anesthesia, 75 Francis St, Boston, MA 02115 USA.","","Marcantonio, Edward R/U-3929-2017","Marcantonio, Edward R/0000-0002-2911-4250","PHS HHS [R01-H506573] Funding Source: Medline","PHS HHS(United States Department of Health & Human ServicesUnited States Public Health Service)","","",18,303,310,0,7,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 USA","0003-2999","","","ANESTH ANALG","Anesth. Analg.","APR",1998,86,4,"","","","",781,785,"","","","","",5,"Anesthesiology","Conference Proceedings Citation Index - Science (CPCI-S); Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","ZE795",9539601,"","","","2023-11-07","WOS:000072831700019","View Full Record in Web of Science"]
["J","Marcantonio, ER; Goldman, L; Orav, EJ; Cook, EF; Lee, TE","","","","Marcantonio, ER; Goldman, L; Orav, EJ; Cook, EF; Lee, TE","","","The association of intraoperative factors with the development of postoperative delirium","AMERICAN JOURNAL OF MEDICINE","","","English","Article","","","","","","","REGIONAL ANESTHESIA; GENERAL-ANESTHESIA; SURGERY; TRIAL; CONFUSION; PROGNOSIS; CARE","PURPOSE: To examine the association of intraoperative factors, including route of anesthesia, hemodynamic complications, and blood loss, with the development of postoperative delirium. PATIENTS AND METHODS: We studied 1,341 patients 50 years of age and older admitted for major elective noncardiac surgery at an academic medical center. Data on route of anesthesia, intraoperative hypotension, bradycardia and tachycardia, blood loss, number of blood transfusions, and lowest postoperative hematocrit were obtained from the medical record. Delirium was diagnosed by using daily interviews with the Confusion Assessment Method, as well as from the medical record and the hospital's nursing intensity index. RESULTS: Postoperative delirium occurred in 117 (9%) patients. Route of anesthesia and intraoperative hemodynamic complications were not associated with delirium. Delirium was associated with greater intraoperative blood loss, more postoperative blood transfusions, and postoperative hematocrit <30%. After adjusting for preoperative risk factors, postoperative hematocrit <30% was associated with an increased risk of delirium (odds ratio = 1.7, 95% confidence interval 1.1-2.7). CONCLUSIONS: Further study is required to determine whether transfusion to keep postoperative hematocrit above 30% can reduce the incidence of postoperative delirium. (C) 1998 by Excerpta Medica, Inc.","Harvard Univ, Brigham & Womens Hosp, Sch Med,Dept Med, Div Gen Med,Sect Clin Epidemiol, Boston, MA USA; Harvard Univ, Brigham & Womens Hosp, Sch Med,Dept Med, Div Gen Med,Sect Gerontol, Boston, MA USA; Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA; Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA; Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA","Harvard University; Harvard Medical School; Brigham & Women's Hospital; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Harvard University; Harvard T.H. Chan School of Public Health; Harvard University; Harvard T.H. Chan School of Public Health; University of California System; University of California San Francisco","Marcantonio, ER (通讯作者)，Hebrew Rehabil Ctr Aged, Res & Training Inst, 1200 Ctr St, Boston, MA 02131 USA.","","Marcantonio, Edward R/U-3929-2017","Marcantonio, Edward R/0000-0002-2911-4250","AHRQ HHS [R01-HS06573] Funding Source: Medline; BHP HRSA HHS [5T32PE110011-04] Funding Source: Medline","AHRQ HHS(United States Department of Health & Human ServicesAgency for Healthcare Research & Quality); BHP HRSA HHS","","",29,273,286,0,15,"EXCERPTA MEDICA INC","NEW YORK","245 WEST 17TH STREET, NEW YORK, NY 10011 USA","0002-9343","","","AM J MED","Am. J. Med.","NOV",1998,105,5,"","","","",380,384,"","10.1016/S0002-9343(98)00292-7","http://dx.doi.org/10.1016/S0002-9343(98)00292-7","","",5,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED)","General & Internal Medicine","139WX",9831421,"","","","2023-11-07","WOS:000077055200004","View Full Record in Web of Science"]
["J","Litaker, D; Locala, J; Franco, K; Bronson, DL; Tannous, Z","","","","Litaker, D; Locala, J; Franco, K; Bronson, DL; Tannous, Z","","","Preoperative risk factors for postoperative delirium","GENERAL HOSPITAL PSYCHIATRY","","","English","Article","","","","","","delirium; postoperative complications; risk assessment","","The objective of this article was to estimate the incidence of delirium in a sample of patients undergoing elective surgery and to identify the preoperative factors most closely associated with developing this complication. Consecutive patients (n=500) underwent a full preoperative medical evaluation including assessment of cognitive and functional status, Daily evaluation on postoperative days 1 through 4 included medical record review and direct standardized patient interviews. logistic regression was used to explore the associations between preoperative factors and postoperative delirium. Delirium was detected in 57 (11.4%) patients. Univariate factors associated with delirium included age greater than or equal to 70 years (RR=3.1 [1.75,5.55]), preexisting cognitive impairment (RR=3.1 [1.73, 5.43]). greater preoperative functional limitations (RR 1.57 [1.27, 1.94]), and a history of prior delirium (RR 4.1 [1.98 to 8.27]. Adjusting for other factors, previous delirium (OR=4.08 [1.85, 9.0]). age greater than or equal to 70 years (OR=3.2 [1.6, 6.0], and preexisting cognitive impairment [OR=2.16 [1,15, 4.0] remained predictive of delirium. Patients' perceptions that alcohol had affected their health (OR=6.53 [1.58 to 28.1]) and use of narcotic analgesics just prior to admission (OR=2.7 [1.37 to 5.3]) were also significantly associated with delirium postoperatively. Several easily obtained preoperative clinical factors can be used to identify patients at risk for postoperative delirium, This approach, when combined with specialized delirium teams using established guidelines, may be more. effective in targeting patients tit risk, thus reducing the number of episodes and days of delirium. (C) 2001 Elsevier Science Inc. All rights reserved.","Cleveland Clin Fdn, Dept Psychiat, Cleveland, OH 44195 USA; Cleveland Clin Fdn, Dept Gen Internal Med, Cleveland, OH 44195 USA","Cleveland Clinic Foundation; Cleveland Clinic Foundation","Franco, K (通讯作者)，Cleveland Clin Fdn, Dept Psychiat, 9500 Euclid Ave, Cleveland, OH 44195 USA.","","","Litaker, David/0000-0003-2676-7990","","","","",0,192,201,2,10,"ELSEVIER SCIENCE INC","NEW YORK","655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA","0163-8343","","","GEN HOSP PSYCHIAT","Gen. Hosp. Psych.","MAR-APR",2001,23,2,"","","","",84,87,"","10.1016/S0163-8343(01)00117-7","http://dx.doi.org/10.1016/S0163-8343(01)00117-7","","",4,"Psychiatry","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Psychiatry","423CP",11313076,"","","","2023-11-07","WOS:000168158100007","View Full Record in Web of Science"]
["J","Shigeta, H; Yasui, A; Nimura, Y; Machida, N; Kageyama, MO; Menjo, M; Ikeda, K","","","","Shigeta, H; Yasui, A; Nimura, Y; Machida, N; Kageyama, MO; Menjo, M; Ikeda, K","","","Postoperative delirium and melatonin levels in elderly patients","AMERICAN JOURNAL OF SURGERY","","","English","Article","","","","","","delirium; operation; melatonin; elderly","N-ACETYLTRANSFERASE ACTIVITY; NOCTURNAL SERUM MELATONIN; PINEAL MELATONIN; SLEEP; ASSOCIATION; SURGERY; HEMORRHAGE; MECHANISM; CONFUSION; RELEASE","Background: Melatonin, a hormone produced in the pineal gland, is involved in circadian rhythms and the sleep-wake cycle. Postoperative delirium is encountered frequently in elderly patients after major surgery; whether changes in the pattern of melatonin secretion are associated is unclear. Methods: Plasma samples were obtained every 2 hours from 19 patients without delirium and 10 with delirium after major abdominal surgery. Postoperative delirium was determined using the Confusion Assessment Method in the Practice Guideline of the American Psychiatric Association. Results: All patients without delirium showed nearly identical preoperative and postoperative melatonin secretion for 24 hours, although peak values were significantly lower in patients more than 80 years old (7.2 +/- 2.3 pg/mL) than in patients younger than 80 years (24.4 +/- 4.1 pg/mL, P = 0.022). Patients with delirium showed two different abnormal postoperative patterns: in 5 patients without complications, melatonin levels were lower than preoperative values (11.0 +/- 5.8 versus 6.5 +/- 4.2 pg/mL, P = 0.079); and in 5 patients with complications, melatonin levels were markedly increased (21.1 +/- 4.5 versus 58.8 +/- 12.4 pg/mL, P = 0.043). Conclusions: Abnormal melatonin secretion may be involved in postoperative sleep disturbances, which triggered delirium in elderly patients.","Natl Chubu Hosp, Dept Surg, Aichi 4748511, Japan; Nagoya Univ, Sch Med, Dept Surg 1, Nagoya, Aichi 466, Japan; Mitsubushi Kagaku Bioclin Labs Inc, Dept Res & Dev, Tokyo, Japan; Natl Inst Longev Sci, Dept Geriatr Res, Obu, Japan","Nagoya University","Yasui, A (通讯作者)，Natl Chubu Hosp, Dept Surg, 36-3 Gengo Morioka, Aichi 4748511, Japan.","","","","","","","",37,126,134,0,14,"EXCERPTA MEDICA INC","NEW YORK","650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA","0002-9610","","","AM J SURG","Am. J. Surg.","NOV",2001,182,5,"","","","",449,454,"","10.1016/S0002-9610(01)00761-9","http://dx.doi.org/10.1016/S0002-9610(01)00761-9","","",6,"Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Surgery","506YL",11754849,"","","","2023-11-07","WOS:000172999300003","View Full Record in Web of Science"]
["J","Schneider, F; Böhner, H; Habel, U; Salloum, JB; Stierstorfer, A; Hummel, TC; Miller, C; Friedrichs, R; Müller, EE; Sandmann, W","","","","Schneider, F; Böhner, H; Habel, U; Salloum, JB; Stierstorfer, A; Hummel, TC; Miller, C; Friedrichs, R; Müller, EE; Sandmann, W","","","Risk factors for postoperative delirium in vascular surgery","GENERAL HOSPITAL PSYCHIATRY","","","English","Article","","","","","","vascular surgery; postoperative delirium; psychiatric symptoms; depression; risk factors","ELDERLY HOSPITALIZED-PATIENTS; SCALE","The aim of this study was to identify psychiatric and somatic risk factors associated with the development, severity and duration of postoperative delirium after vascular surgery. Forty-seven patients underwent aortic, carotid artery and peripheral artery surgery. Both, surgeon and psychiatrist, monitored patients preoperatively with daily follow up. Preoperative psychiatric assessment included standardized psychopathological scales for the detection of psychiatric symptoms and cognitive deficits. We diagnosed delirium using DSM IV criteria. Delirium Rating Scale was used to estimate delirium severity. Surgical parameters included patient history, diagnoses, medication and laboratory parameters. A statistical analysis was performed using multivariate regression analyses to find factors significantly associated with delirium development, severity, and duration. Thirty-six percent of the patients developed postoperative delirium after surgery. Comparison of different parameters revealed that especially preoperative depression symptoms and perioperative transfusions/infusions had significant predictive value for the development as well as for the severity of postoperative delirium. (C) 2002 Elsevier Science Inc. All rights reserved.","Univ Dusseldorf, Dept Psychiat & Psychotherapy, D-40629 Dusseldorf, Germany; Univ Dusseldorf, Dept Vasc Surg, D-40629 Dusseldorf, Germany; Univ Dusseldorf, Dept Anesthesiol, D-40629 Dusseldorf, Germany","Heinrich Heine University Dusseldorf; Heinrich Heine University Dusseldorf; Heinrich Heine University Dusseldorf","Schneider, F (通讯作者)，Univ Dusseldorf, Dept Psychiat & Psychotherapy, Berg Landstr 2, D-40629 Dusseldorf, Germany.","frank.schneider@uni-duesseldorf.de","","Habel, Ute/0000-0003-0703-7722; Schneider, Frank/0000-0003-1557-7956","","","","",19,98,104,0,4,"ELSEVIER SCIENCE INC","NEW YORK","360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA","0163-8343","1873-7714","","GEN HOSP PSYCHIAT","Gen. Hosp. Psych.","JAN-FEB",2002,24,1,"","","","",28,34,"","10.1016/S0163-8343(01)00168-2","http://dx.doi.org/10.1016/S0163-8343(01)00168-2","","",7,"Psychiatry","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Psychiatry","518YG",11814531,"","","","2023-11-07","WOS:000173695400005","View Full Record in Web of Science"]
["J","Hanania, M; Kitain, E","","","","Hanania, M; Kitain, E","","","Melatonin for treatment and prevention of postoperative delirium","ANESTHESIA AND ANALGESIA","","","English","Article","","","","","","","ELDERLY PATIENTS; SLEEP; SECRETION; THERAPY; BRAIN","","Long Isl Jewish Med Ctr, Dept Anesthesiol, Albert Einstein Coll Med, New Hyde Pk, NY 11040 USA","Northwell Health; Yeshiva University","Hanania, M (通讯作者)，Long Isl Jewish Med Ctr, Dept Anesthesiol, Albert Einstein Coll Med, Long Island Campus, New Hyde Pk, NY 11040 USA.","mhanania@lij.edu","","","","","","",18,92,104,0,9,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-2999","","","ANESTH ANALG","Anesth. Analg.","FEB",2002,94,2,"","","","",338,339,"","10.1097/00000539-200202000-00019","http://dx.doi.org/10.1097/00000539-200202000-00019","","",2,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","515PT",11812694,"Bronze","","","2023-11-07","WOS:000173505100020","View Full Record in Web of Science"]
["J","Kain, ZN; Caldwell-Andrews, AA; Maranets, I; McClain, B; Gaal, D; Mayes, LC; Feng, R; Zhang, HP","","","","Kain, ZN; Caldwell-Andrews, AA; Maranets, I; McClain, B; Gaal, D; Mayes, LC; Feng, R; Zhang, HP","","","Preoperative anxiety and emergence delirium and postoperative maladaptive behaviors","ANESTHESIA AND ANALGESIA","","","English","Article","","","","","","","PARENTAL PRESENCE; CHILDREN; ANESTHESIA; INDUCTION; HALOTHANE","Based on previous studies, we hypothesized that the clinical phenomena of preoperative anxiety, emergence delirium, and postoperative maladaptive behavioral changes were closely related. We examined this issue using data obtained by our laboratory over the past 6 years. Only children who underwent surgery and general anesthesia using sevoflurane/O-2,/N2O and who did not receive midazolam were recruited. Children's anxiety was assessed preoperatively with the modified Yale Preoperative Anxiety Scale (mYPAS), emergence delirium was assessed in the postanesthesia care unit, and behavioral changes were assessed with the Post Hospital Behavior Questionnaire (PHBQ) on postoperative days 1, 2, 3, 7, and 14. Regression analysis showed that the odds of having marked symptoms of emergence delirium increased by 10% for each increment of 10 points in the child's state anxiety score (mYPAS). The odds ratio of having new-onset postoperative maladaptive behavior changes was 1.43 for children with marked emergence status as compared with children with no symptoms of emergence delirium. A 10-point increase in state anxiety scores led to a 12.5% increase in the odds that the child would have a new-onset maladaptive behavioral change after the surgery. This finding is highly significant to practicing clinicians, who can now predict the development of adverse postoperative phenomena, such as emergence delirium and postoperative behavioral changes, based on levels of preoperative anxiety.","Yale Univ, Sch Med, Dept Anesthesiol, New Haven, CT 06510 USA; Yale Univ, Sch Med, Dept Pediat, New Haven, CT 06510 USA; Yale Univ, Sch Med, Dept Child & Adolescent Psychiat, New Haven, CT 06510 USA; Yale Univ, Sch Med, Ctr Advancement Perioperat Hlth, New Haven, CT 06510 USA; Yale Univ, Sch Publ Hlth, Dept Epidemiol, New Haven, CT USA","Yale University; Yale University; Yale University; Yale University; Yale University","Kain, ZN (通讯作者)，Yale Univ, Sch Med, Dept Anesthesiol, 333 Cedar St, New Haven, CT 06510 USA.","zeev.kain@yale.edu","Caldwell-Andrews, Alison/CDJ-6872-2022","Caldwell-Andrews, Alison/0000-0002-2853-1677","NICHD NIH HHS [R01HD37007-01] Funding Source: Medline; NIDA NIH HHS [R01DA12468] Funding Source: Medline","NICHD NIH HHS(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)); NIDA NIH HHS(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Drug Abuse (NIDA))","","",20,378,416,4,35,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-2999","","","ANESTH ANALG","Anesth. Analg.","DEC",2004,99,6,"","","","",1648,1654,"","10.1213/01.ANE.0000136471.36680.97","http://dx.doi.org/10.1213/01.ANE.0000136471.36680.97","","",7,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","874HN",15562048,"","","","2023-11-07","WOS:000225341600014","View Full Record in Web of Science"]
["J","Edelstein, DM; Aharonoff, GB; Karp, A; Capla, EL; Zuckerman, JD; Koval, KJ","","","","Edelstein, DM; Aharonoff, GB; Karp, A; Capla, EL; Zuckerman, JD; Koval, KJ","","","Effect of postoperative delirium on outcome after hip fracture","CLINICAL ORTHOPAEDICS AND RELATED RESEARCH","","","English","Article","","","","","","","ACUTE CONFUSIONAL STATES; ELDERLY-PATIENTS; FUNCTIONAL RECOVERY; MORTALITY; RISK; COMPLICATIONS; PREDICTORS; AMBULATION; SURVIVAL","Nine-hundred twenty-one community-dwelling patients 65 years of age or older, who sustained an operatively treated hip fracture from July 1, 1987 to June 30, 1998 were followed up for the development of postoperative delirium. The outcomes examined in the current study were postoperative complication rates, in-hospital mortality, hospital length of stay, hospital discharge status, 1-year mortality rate, place of residence, recovery of ambulatory ability, and activities of daily living 1 year after surgery. Forty-seven (5.1 %) patients were diagnosed with postoperative delirium. Patients who had delirium develop were more likely to be male, have a history of mild dementia, and have had surgery under general anesthesia. Patients who had postoperative delirium develop had a significantly longer length of hospitalization. They also had significantly higher rates of mortality at 1 year, were less likely to recover their prefracture level of ambulation, and were more likely to show a decline in level of independence in basic activities of daily living at the 1-year followup. There was no difference in the rate of postoperative complications, in-hospital mortality, discharge residence, and recovery of instrumental activities of daily living at 1 year.","Hosp Joint Dis & Med Ctr, Dept Orthopaed Surg, New York, NY 10003 USA","NYU Langone Medical Center; Hospital for Joint Disease NYULMC","Koval, KJ (通讯作者)，Hosp Joint Dis & Med Ctr, Dept Orthopaed Surg, 301 E 17th St, New York, NY 10003 USA.","kjkmd@yahoo.com","","Karp, Adam/0000-0002-6472-1195","","","","",38,128,138,0,8,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0009-921X","1528-1132","","CLIN ORTHOP RELAT R","Clin. Orthop. Rel. Res.","MAY",2004,"",422,"","","","",195,200,"","10.1097/01.blo.0000128649.59959.0c","http://dx.doi.org/10.1097/01.blo.0000128649.59959.0c","","",6,"Orthopedics; Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Orthopedics; Surgery","824XW",15187857,"","","","2023-11-07","WOS:000221721500033","View Full Record in Web of Science"]
["J","Bitsch, MS; Foss, NB; Kristensen, BB; Kehlet, H","","","","Bitsch, MS; Foss, NB; Kristensen, BB; Kehlet, H","","","Pathogenesis of and management strategies for postoperative delirium after hip fracture - A review","ACTA ORTHOPAEDICA SCANDINAVICA","","","English","Review","","","","","","","ACUTE CONFUSIONAL STATES; MINI-MENTAL-STATE; ELDERLY-PATIENTS; PSYCHIATRIC-ILLNESS; SURGERY; PROGRAM; ANESTHESIA; RECOVERY; PROFILE; REDUCE","Background Postoperative delirium is a frequent and serious complication in elderly patients following operation for hip fracture, leading to an increased risk of complications. The pathophysiological mechanisms are unresolved, but probably multifactorial. The purpose of this review is to summarize current knowledge about the pathogenesis of postoperative delirium with a view to finding strategies for prevention and management. Method We conducted an Internet search through the Medline database (1966-March 2003) and supplemented it with a manual search. We included 12 studies which specifically discussed pathogenic factors or interventions against postoperative delirium following operation for hip fracture. Results 1823 patients were included with an average incidence of delirium of 35%. We concentrated on pre-, intra-, and postoperative risk factors. Only advanced age and dementia met our fixed criterion of strong evidence for a significant association. Hence, from the studies that we reviewed we were unable to find intraoperative or postoperative factors with strong evidence for a significant association with delirium. Interpretation Postoperative delirium is a serious complication. The pathophysiology leading to delirium after hip fracture surgery still remains to be clarified and no single drug or surgical regimen has proven to be preventive. This calls for more detailed investigations of the differential role of different pathogenic mechanisms, as well as an aggressive multimodal approach to enhance recovery and reduce morbidity, as has proven to be successful in a variety of elective surgical procedures. Such multimodal interventional studies represent a major task for orthopedic departments in collaboration with anesthesiologists, geriatricians, physiotherapists and nursing staff.","Hvidovre Univ Hosp, Dept Anesthesiol, DK-2650 Hvidovre, Denmark; Hvidovre Univ Hosp, Dept Surg Gastroenterol, DK-2650 Hvidovre, Denmark","University of Copenhagen; University of Copenhagen","Bitsch, MS (通讯作者)，Hvidovre Univ Hosp, Dept Anesthesiol, DK-2650 Hvidovre, Denmark.","msbitsch@hotmail.com","","","","","","",53,118,131,1,22,"TAYLOR & FRANCIS AS","OSLO","KARL JOHANS GATE 5, NO-0154 OSLO, NORWAY","0001-6470","","","ACTA ORTHOP SCAND","Acta Orthop. Scand.","AUG",2004,75,4,"","","","",378,389,"","10.1080/00016470410001123","http://dx.doi.org/10.1080/00016470410001123","","",12,"Orthopedics","Science Citation Index Expanded (SCI-EXPANDED)","Orthopedics","852HD",15370579,"Bronze","","","2023-11-07","WOS:000223745500002","View Full Record in Web of Science"]
["J","Olin, K; Eriksdotter-Jönhagen, M; Jansson, A; Herrington, MK; Kristiansson, M; Permert, J","","","","Olin, K; Eriksdotter-Jönhagen, M; Jansson, A; Herrington, MK; Kristiansson, M; Permert, J","","","Postoperative delirium in elderly patients after major abdominal surgery","BRITISH JOURNAL OF SURGERY","","","English","Article","","","","","","","PITUITARY-ADRENAL AXIS; GASTROINTESTINAL SURGERY; ACETYLCHOLINE-RELEASE; MICRODIALYSIS; RATS","Background: The aim of this study was to investigate the occurrence of postoperative delirium (POD) in elderly patients undergoing major abdominal surgery and to identify factors associated with delirium in this population. Methods: Data were collected prospectively from 51 patients aged 65 years or more. Delirium was diagnosed by the Confusion Assessment Method and from the medical records. The Mini Mental State Examination (MMSE) was used to identify cognitive impairment. Results: POD occurred in 26 of 51 patients. Delirium lasted for 1-2 days in 14 patients (short POD group) and 3 days or more in 12 patients (long POD group). The latter patients had significantly greater intraoperative blood loss and intravenous fluid infusion, a higher rate of postoperative complications, a lower MMSE score on postoperative day 4 and a longer hospital stay than patients without POD. Patients in the short POD group were significantly older than those in the long POD group and those who did not develop delirium. Conclusion: Approximately half of the elderly patients in this study developed POD. Bleeding was found to be an important risk factor for delirium.","Karolinska Univ Hosp, Karolinska Inst, Surg Sci Ctr, S-14186 Huddinge, Sweden; Karolinska Univ Hosp, Karolinska Inst, Neurotec Dept, Sect Clin Geriatr, S-14186 Huddinge, Sweden; Karolinska Inst, Dept Forens Psychiat, Neurotec, Stockholm, Sweden; Adams State Coll, Dept Biol, Alamosa, CO USA","Karolinska Institutet; Karolinska University Hospital; Karolinska Institutet; Karolinska University Hospital; Karolinska Institutet","Olin, K (通讯作者)，Karolinska Univ Hosp, Karolinska Inst, Surg Sci Ctr, Gastroctr K53, S-14186 Huddinge, Sweden.","kemal.olin@karolinska.se","Eriksdotter, Maria/I-5427-2015","Eriksdotter, Maria/0000-0003-2498-4000; Kristiansson, Marianne/0000-0002-9448-7643","","","","",31,111,120,1,12,"JOHN WILEY & SONS LTD","CHICHESTER","THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND","0007-1323","","","BRIT J SURG","Br. J. Surg.","DEC",2005,92,12,"","","","",1559,1564,"","10.1002/bjs.5053","http://dx.doi.org/10.1002/bjs.5053","","",6,"Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Surgery","994MZ",16231283,"","","","2023-11-07","WOS:000234037200017","View Full Record in Web of Science"]
["J","Sockalingam, S; Parekh, N; Bogoch, II; Sun, J; Mahtani, R; Beach, C; Bollegalla, N; Turzanski, S; Seto, E; Kim, J; Dulay, P; Scarrow, S; Bhalerao, S","","","","Sockalingam, S; Parekh, N; Bogoch, II; Sun, J; Mahtani, R; Beach, C; Bollegalla, N; Turzanski, S; Seto, E; Kim, J; Dulay, P; Scarrow, S; Bhalerao, S","","","Delirium in the postoperative cardiac patient: A review","JOURNAL OF CARDIAC SURGERY","","","English","Review","","","","","","","OPEN-HEART-SURGERY; DOSE INTRAVENOUS HALOPERIDOL; PSYCHIATRIC COMPLICATIONS; POSTCARDIOTOMY DELIRIUM; INDUCED PSYCHOSIS; TERM SEDATION; OFF-PUMP; ON-PUMP; PERSONALITY; PREDICTION","Background and aim of review. Cardiac surgery is increasingly common and relatively safe, but there are frequent reports of neuropsychiatric sequelae occurring in the postoperative period. One of the most common neuropsychiatric presentations of cardiac surgery is delirium, also called postcardiotomy delirium (PCD). Despite the vast numbers of cardiac surgeries performed today, there is a paucity of data on risk factors and management options of PCD available to the clinician. This review aims to summarize available information, increase clinicians' awareness of PCD and suggest effective management of this illness. Methods: Our literature search was completed using the databases Medline and CINAHL; it was limited to human and English language studies from 1964 to the present. Search terms included delirium, agitation, postoperative, cardiac, neuropsychiatric, neuroleptics, psychosis, surgery, treatment,. postcardiotomy, and pharmacotherapy. Results: Our review of the literature revealed several risk factors for PCD, as well as various options for its pharmacological management. Conclusions: A multifactorial model should be applied when considering risk stratification for and prevention of delirium postoperatively. Pharmacologically, conventional antipsychotic agents, such as haloperidol, have long been used to manage delirium. In light of haloperidol's side effects, particularly those applicable to the cardiac patient, further research is required into the role of second generation antipsychotics. These agents are common in clinical use, and may be the preferred medications.","Univ Toronto, Toronto, ON, Canada","University of Toronto","Bhalerao, S (通讯作者)，St Michaels Hosp, Med Psychiat Serv, 30 Bond St,Victoria Wing,17046 Toronto, Toronto, ON M5B 1W8, Canada.","bhaleraos@smh.toronto.on.ca","Bogoch, Isaac/AAS-9631-2020; Sockalingam, Sanjeev/I-7212-2016","Sockalingam, Sanjeev/0000-0002-9626-1509","","","","",87,99,105,0,8,"WILEY-HINDAWI","LONDON","ADAM HOUSE, 3RD FL, 1 FITZROY SQ, LONDON, WIT 5HE, ENGLAND","0886-0440","1540-8191","","J CARDIAC SURG","J. Card. Surg.","NOV-DEC",2005,20,6,"","","","",560,567,"","10.1111/j.1540-8191.2005.00134.x","http://dx.doi.org/10.1111/j.1540-8191.2005.00134.x","","",8,"Cardiac & Cardiovascular Systems; Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Cardiovascular System & Cardiology; Surgery","987TZ",16309412,"","","","2023-11-07","WOS:000233541500014","View Full Record in Web of Science"]
["J","Sharma, PT; Sieber, FE; Zakriya, KJ; Pauldine, RW; Gerold, KB; Hang, J; Smith, TH","","","","Sharma, PT; Sieber, FE; Zakriya, KJ; Pauldine, RW; Gerold, KB; Hang, J; Smith, TH","","","Recovery room delirium predicts postoperative delirium after hip-fracture repair","ANESTHESIA AND ANALGESIA","","","English","Article","","","","","","","MINI-MENTAL STATE; ISOFLURANE; SURGERY","In this study, we sought to determine the incidence of recovery room delirium in elderly patients having hip-fracture repair under general anesthesia and to discover whether recovery room delirium is associated with continuing postoperative delirium. In this prospective study, patients undergoing hip-fracture repair were anesthetized using a standardized protocol. In addition, postoperative pain management was standardized in both the postoperative anesthesia care unit and in the hospital ward. The presence of delirium was determined using the confusion assessment method (CAM) score. Recovery room delirium was assessed by obtaining a CAM score at 60 min after discontinuation of isoflurane. Postoperative delirium was assessed by obtaining a daily CAM score during the postoperative in-hospital recovery period. Fifty patients consented to the study and 47 patients were included in the analysis (surgery cancelled postinduction n = 1; nonadherence to protocol n = 2). Average patient age was 77 +/- 1 (mean +/- SE) yr (range, 56-98 yr). Seventy-seven percent of the study patients were ASA class III or more. The prevalence of recovery room delirium was 45%. The prevalence of postoperative delirium was 36%. Recovery room delirium predicted postoperative delirium (P < 0.001, Fisher's exact test) with a sensitivity of 100% and a specificity of 85%. Analgesic doses administered in the postoperative anesthesia care unit and ward were similar in patients with or without postoperative delirium: Results of this study show that recovery room delirium is a strong predictor of postoperative delirium.","Johns Hopkins Bayview Med Ctr, Dept Anesthesiol & Crit Care Med, Baltimore, MD 21224 USA","Johns Hopkins University; Johns Hopkins Medicine","Sharma, PT (通讯作者)，Johns Hopkins Bayview Med Ctr, Dept Anesthesiol & Crit Care Med, 4940 Eastern Ave, Baltimore, MD 21224 USA.","PSharma6@JHMI.edu","","","","","","",23,92,94,0,11,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","530 WALNUT ST, PHILADELPHIA, PA 19106-3261 USA","0003-2999","","","ANESTH ANALG","Anesth. Analg.","OCT",2005,101,4,"","","","",1215,1220,"","10.1213/01.ane.0000167383.44984.e5","http://dx.doi.org/10.1213/01.ane.0000167383.44984.e5","","",6,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","967TZ",16192548,"Bronze","","","2023-11-07","WOS:000232115400052","View Full Record in Web of Science"]
["J","Leung, JM; Sands, LP; Mullen, EA; Wang, Y; Vaurio, L","","","","Leung, JM; Sands, LP; Mullen, EA; Wang, Y; Vaurio, L","","","Are preoperative depressive symptoms associated with postoperative delirium in geriatric surgical patients?","JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES","","","English","Article","","","","","","","CONFUSION ASSESSMENT METHOD; RISK-FACTORS; COGNITIVE DYSFUNCTION; FUNCTIONAL RECOVERY; GENERAL-ANESTHESIA; MAJOR DEPRESSION; MORTALITY; HEALTH","Background. Delirium is common in older surgical patients and predicts negative health Outcomes. Whether depressive symptoms are prevalent and predict the development of postoperative delirium in elderly surgical patients has not been investigated. Our study aimed to examine the prevalence and prognostic importance of preoperative depressive symptoms in older surgical patients. Methods. Patients at least 65 years of age who were scheduled for major noncardiac surgery were recruited. Preoperatively, patients were screened for symptoms of depression using the 15-point Geriatric Depression Scale (GDS). Postoperative delirium was measured using the Confusion Assessment Method. The associations between covariates and preoperative depression. and postoperative delirium were determined by multivariate logistic regression. Results. In the 219 patients studied, the mean age was 73.6 +/- 16 years, 12% of patients reported six or more depressive symptoms. and 32% reported three to five depressive symptoms. By multivariate logistic regression, patient characteristics associated with six or more symptoms of depression included < 12 Years of education, Moderate to severe limitation in functional status, and drinking more than two alcoholic beverages per day. Postoperatively, 46% of patients developed delirium. Patients with a greater number of preoperative depressive symptoms were more likely to develop postoperative delirium (p = .048) and experience a longer duration of postoperative delirium (p = .027). Even after adjusting, for covariates associated with depression and postoperative delirium-including age, educational level, functional status, and preoperative alcohol use-patients with more than six preoperative depressive symptoms were still significantly more likely to have a longer duration of postoperative delirium than did those patients with fewer than two depressive symptoms (odds ratio = 2.69, confidence interval = 1.04-6.93). Conclusion. Preoperative screening for the presence of depressive symptoms can be performed easily in elderly patients. and yields useful prognostic information relating to postoperative delirium.","Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA; Purdue Univ, Sch Nursing, W Lafayette, IN USA; Purdue Univ, Dept Stat, W Lafayette, IN USA","University of California System; University of California San Francisco; Purdue University System; Purdue University; Purdue University West Lafayette Campus; Purdue University System; Purdue University; Purdue University West Lafayette Campus","Leung, JM (通讯作者)，Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, 521 Parnassus, San Francisco, CA 94143 USA.","jmleung@itsa.ucsf.edu","Sands, Laura P/E-8919-2015; Leung, Joyce/JCE-3061-2023","Sands, Laura P/0000-0003-2446-4486; Vaurio, Linnea/0000-0003-3993-6116","NIA NIH HHS [1K24 AG00948-04] Funding Source: Medline","NIA NIH HHS(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","","",41,88,92,0,14,"OXFORD UNIV PRESS INC","CARY","JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA","1079-5006","1758-535X","","J GERONTOL A-BIOL","J. Gerontol. Ser. A-Biol. Sci. Med. Sci.","DEC",2005,60,12,"","","","",1563,1568,"","10.1093/gerona/60.12.1563","http://dx.doi.org/10.1093/gerona/60.12.1563","","",6,"Geriatrics & Gerontology; Gerontology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Geriatrics & Gerontology","005RK",16424289,"Green Submitted, Bronze","","","2023-11-07","WOS:000234841300010","View Full Record in Web of Science"]
["J","Papaioannou, A; Fraidakis, O; Michaloudis, D; Balalis, C; Askitopoulou, H","","","","Papaioannou, A; Fraidakis, O; Michaloudis, D; Balalis, C; Askitopoulou, H","","","The impact of the type of anaesthesia on cognitive status and delirium during the first postoperative days in elderly patients","EUROPEAN JOURNAL OF ANAESTHESIOLOGY","","","English","Article","","","","","","anaesthesia, conduction, general; postoperative period, psychological tests, mini mental state examination; postoperative period, complications; cognitive disorders, delirium; aged","MINI-MENTAL-STATE; GENERAL-ANESTHESIA; DYSFUNCTION; SURGERY","Background and objectives: Postoperative confusion and delirium is a common complication in the elderly with a poorly understood pathophysiology. The aim of this study was to examine whether the type of anaesthesia (general or regional) plays a role in the development of cognitive impairment in elderly patients during the immediate postoperative period. Methods: Forty-seven patients >60 yr of age and undergoing major surgery were randomly allocated to receive either regional or general anaesthesia. The mental status of the patients was assessed preoperatively and during the first three postoperative days with the Mini Mental State Examination. The incidence of delirium was also examined during the same period with the use of DSM III criteria. Results: Overall, during the first three postoperative days, the mean Mini Mental State Examination score decreased significantly (P < 0.001). However, this decline was very significant only in patients assigned to receive general anaesthesia (P < 0.001) compared to regional anaesthesia. Nine patients developed delirium but the type of anaesthesia did not affect its incidence. The only important factor for the development of delirium was preexisting cardiovascular disease irrespective of anaesthesia type (P < 0.025). Conclusions: Elderly patients subjected to general anaesthesia displayed more frequent cognitive impairment during the immediate postoperative period in comparison to those who received a regional technique.","Univ Hosp Heraklion, Dept Anaesthesiol, Iraklion 71409, Crete, Greece; Univ Hosp Heraklion, Dept Orthopaed, Iraklion 71409, Crete, Greece","University Hospital of Heraklion; University Hospital of Heraklion","Askitopoulou, H (通讯作者)，Univ Hosp Heraklion, Dept Anaesthesiol, Livadias 11A, Iraklion 71409, Crete, Greece.","fraidako@med.uoc.gr","","Papaioannou, Alexandra/0000-0002-5710-4279","","","","",24,84,99,0,16,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0265-0215","1365-2346","","EUR J ANAESTH","Eur. J. Anaesth.","JUL",2005,22,7,"","","","",492,499,"","10.1017/S0265021505000840","http://dx.doi.org/10.1017/S0265021505000840","","",8,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Anesthesiology","948HP",16045136,"","","","2023-11-07","WOS:000230707000002","View Full Record in Web of Science"]
["J","Yildizeli, B; Özyurtkan, O; Batirel, HF; Kuscu, K; Bekiroglu, N; Yüksel, M","","","","Yildizeli, B; Özyurtkan, O; Batirel, HF; Kuscu, K; Bekiroglu, N; Yüksel, M","","","Factors associated with postoperative delirium after thoracic surgery","ANNALS OF THORACIC SURGERY","","","English","Article","","","","","","","GASTROINTESTINAL SURGERY; COGNITIVE DYSFUNCTION; VASCULAR-SURGERY; ELDERLY-PATIENTS; CARDIAC-SURGERY; RISK-FACTORS; PREVENTION; PREDICTION; DIAGNOSIS; PROGNOSIS","Background. Postoperative delirium is an acute confusional state characterized by fluctuating consciousness and is associated with increased morbidity and mortality. We analyzed the incidence and risk factors of delirium following thoracic surgery. Methods. All patients (n = 432) who underwent thoracotomy or sternotomy from 1996 to 2003 were analyzed retrospectively. The diagnosis of postoperative delirium was based on Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Results. Postoperative delirium developed in 23 patients (5.32%) between postoperative days 2 to 12 (mean, 4.4 +/- 2.6 days). There were 15 males and 8 females, with a mean age of 59.4 years (24 to 77 years). The delirium group was older (59.4 +/- 14.6 vs 51.3 +/- 15.5 years, p < 0.01) and had a longer operation time than the nondelirious group (5.34 +/- 1.58 vs 4.38 +/- 1.6 hours, p = 0.005). Morbidity and mortality rates were not significantly different between the two groups (56.5% vs 47.1%; 13.0% vs 3.66%, respectively). Univariate analysis showed that the older age, markedly abnormal postoperative levels of sodium, potassium, or glucose, sleep deprivation, operation time, and diabetes mellitus were risk factors (p < 0.05). According to multivariate analyses, four factors were selected as predictive risk factors: (1) markedly abnormal postoperative levels of sodium, potassium, or glucose (p = 0.038); (2) sleep deprivation (p = 0.05); (3) age (p = 0.033); and (4) operation time (p = 0.041). Conclusions. Postoperative delirium may cause higher morbidity and mortality rates after thoracic surgery. Close postoperative follow-up and early identification of predisposing factors such as older age, sleep deprivation, abnormal postoperative levels of sodium, potassium, or glucose, and longer operation time can prevent occurrence of postoperative delirium. (C) 2005 by The Society of Thoracic Surgeons.","Marmara Univ Hosp, Dept Thorac Surg, TR-34718 Istanbul, Turkey; Marmara Univ Hosp, Dept Thorac Surg, Istanbul, Turkey; Marmara Univ Hosp, Dept Psychiat, Istanbul, Turkey; Marmara Univ Hosp, Dept Biostat, Istanbul, Turkey","Marmara University; Marmara University; Marmara University; Marmara University","Marmara Univ Hosp, Dept Thorac Surg, PK 97, TR-34718 Istanbul, Turkey.","myuksel@marmara.edu.tr","","","","","","",28,84,92,0,20,"ELSEVIER SCIENCE INC","NEW YORK","360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA","0003-4975","1552-6259","","ANN THORAC SURG","Ann. Thorac. Surg.","MAR",2005,79,3,"","","","",1004,1009,"","10.1016/j.athoracsur.2004.06.022","http://dx.doi.org/10.1016/j.athoracsur.2004.06.022","","",6,"Cardiac & Cardiovascular Systems; Respiratory System; Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Cardiovascular System & Cardiology; Respiratory System; Surgery","903GR",15734423,"","","","2023-11-07","WOS:000227414400039","View Full Record in Web of Science"]
["J","Vaurio, LE; Sands, LP; Wang, Y; Mullen, EA; Leung, JM","","","","Vaurio, LE; Sands, LP; Wang, Y; Mullen, EA; Leung, JM","","","Postoperative delirium: The importance of pain and pain management","ANESTHESIA AND ANALGESIA","","","English","Article","","","","","","","RISK-FACTORS; GENERAL-ANESTHESIA; CONFUSION; SURGERY","Postoperative delirium is common in geriatric patients. Few studies have examined events in the postoperative period that may contribute to the occurrence of postoperative delirium. We hypothesized that postoperative delirium is related to postoperative pain and/or pain management strategy. Patients aged >= 65 years who were scheduled for major noncardiac surgery were studied. A structured interview was conducted preoperatively and for the first 3 postoperative days to determine the presence of delirium using the Confusion Assessment Method. The method of postoperative pain management, as well as pre- and postoperative medications for the first 3 days, was collected. Pre- and postoperative pain at rest and with movement was recorded using the Visual Analog Scale. Three hundred thirty-three patients, with a mean age of 74 +/- 6 years, were studied. After surgery, 46% of patients developed postoperative delirium. By multivariate logistic regression, age (odds ratio [OR], 2.5; 95% confidence interval [C9I] 1.5 to 4.2), moderate (OR, 2.2; 95% CI 1.2 to 4.0) and severe (OR, 3.7; 95% CI 1.5 to 9.0) preoperative resting pain, and increase in level of pain from baseline to postoperative day one (OR, 1.1; 95% CI 1.01 to 1.2) were independently associated with a greater risk for the development of postoperative delirium. In contrast, patients who used oral opioid analgesics as their sole means of postoperative pain control were at decreased risk of developing delirium in comparison with those who used opioid analgesics via IV patient-controlled analgesia technique (OR, 0.4; 95% CI 0.2 to 0.7). These results validate our hypothesis that pain and pain management strategies are important factors related to the development of postoperative delirium in elderly patients.","Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA; Purdue Univ, Sch Nursing, Ctr Aging, W Lafayette, IN 47907 USA; Purdue Univ, Sch Nursing, Life Course, W Lafayette, IN 47907 USA; Purdue Univ, Dept Stat, W Lafayette, IN 47907 USA","University of California System; University of California San Francisco; Purdue University System; Purdue University; Purdue University West Lafayette Campus; Purdue University System; Purdue University West Lafayette Campus; Purdue University; Purdue University System; Purdue University; Purdue University West Lafayette Campus","Leung, JM (通讯作者)，Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, 521 Parnassus, San Francisco, CA 94143 USA.","leungj@anesthesia.ucsf.edu","Sands, Laura P/E-8919-2015; Leung, Joyce/JCE-3061-2023","Sands, Laura P/0000-0003-2446-4486; Vaurio, Linnea/0000-0003-3993-6116","NIA NIH HHS [1K24-AG00948-05] Funding Source: Medline","NIA NIH HHS(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","","",29,261,286,1,17,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-2999","","","ANESTH ANALG","Anesth. Analg.","APR",2006,102,4,"","","","",1267,1273,"","10.1213/01.ane.0000199156.59226.af","http://dx.doi.org/10.1213/01.ane.0000199156.59226.af","","",7,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","026VO",16551935,"Bronze","","","2023-11-07","WOS:000236371100051","View Full Record in Web of Science"]
["J","Fong, HK; Sands, LP; Leung, JM","","","","Fong, HK; Sands, LP; Leung, JM","","","The role of postoperative analgesia in delirium and cognitive decline in elderly patients: A systematic review","ANESTHESIA AND ANALGESIA","","","English","Article","","","","","","","CONFUSION ASSESSMENT METHOD; RISK-FACTORS; REGIONAL ANESTHESIA; GENERAL-ANESTHESIA; MINOR SURGERY; OLDER-ADULTS; DYSFUNCTION; PAIN; MORPHINE; BYPASS","Postoperative delirium and cognitive decline are adverse events that occur frequently in elderly patients. Preexisting patient factors, medications, and various intraoperative and postoperative causes have been implicated in the development of postoperative delirium and cognitive decline. Despite previous studies identifying postoperative pain as a risk factor, relatively few clinical studies have compared the effect of common postoperative pain management techniques (IV and epidural) or opioid analgesics on postoperative cognitive status. A systematic search of the PubMed and CINAHL databases identified six studies comparing different opioid analgesics on postoperative delirium and cognitive decline and five studies comparing IV and epidural routes of administering analgesia. Meperidine was consistently associated with an increased risk of delirium in elderly surgical patients, but the current evidence has not shown a significant difference in postoperative delirium or cognitive decline among other more frequently used postoperative opioids such as morphine, fentanyl, or hydromorphone. The available studies also suggest that IV or epidural techniques do not influence cognitive function differently. However, future investigations of sufficient study size and more standardized methods of defining outcomes are necessary to confirm the current findings.","Univ Calif San Francisco, Sch Med, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA; Purdue Univ, W Lafayette, IN 47907 USA","University of California System; University of California San Francisco; Purdue University System; Purdue University; Purdue University West Lafayette Campus","Leung, JM (通讯作者)，Univ Calif San Francisco, Sch Med, Dept Anesthesia & Perioperat Care, 521 Parnassus, San Francisco, CA 94143 USA.","leungj@anesthesia.ucsf.edu","Sands, Laura P/E-8919-2015; Leung, Joyce/JCE-3061-2023","Sands, Laura P/0000-0003-2446-4486;","","","","",76,206,233,0,25,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-2999","","","ANESTH ANALG","Anesth. Analg.","APR",2006,102,4,"","","","",1255,1266,"","10.1213/01.ane.0000198602.29716.53","http://dx.doi.org/10.1213/01.ane.0000198602.29716.53","","",12,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Anesthesiology","026VO",16551934,"Bronze","","","2023-11-07","WOS:000236371100050","View Full Record in Web of Science"]
["J","Kalisvaart, KJ; Vreeswijk, R; de Jonghe, JFM; van der Ploeg, T; van Gool, WA; Eikelenboom, P","","","","Kalisvaart, Kees J.; Vreeswijk, Ralpb; de Jonghe, Jos F. M.; van der Ploeg, Tjeerd; van Gool, Willem A.; Eikelenboom, Piet","","","Risk factors and prediction of postoperative delirium in elderly hip-surgery patients: Implementation and validation of a medical risk factor model","JOURNAL OF THE AMERICAN GERIATRICS SOCIETY","","","English","Article; Proceedings Paper","Annual Meeting of the American-Geriatrics-Society","MAY 11-15, 2005","Orlando, FL","Amer Geriatr Soc","","delirium; risk-stratification; risk factors; validation; elderly; hip surgery","PRECIPITATING FACTORS; CONFUSION; STATE","OBJECTIVES: To evaluate risk factors for postoperative delirium in a cohort of elderly hip-surgery patients and to validate a medical risk stratification model. DESIGN: Prospective cohort study. SETTING: Medical school-affiliated general hospital in Alkmaar, the Netherlands. PARTICIPANTS: Six hundred three hip-surgery patients aged 70 and older screened for risk factors for postoperative delirium. MEASUREMENTS: Predefined risk factors for delirium were assessed on admission. One point was assigned for each of four risk factors present, resulting in three groups: low, intermediate, and high risk. Baseline screening and assessment included the Mini-Mental State Examination, the standardized Snellen test for visual impairment, chart review to determine Acute Physiological and Chronic Health Evaluation II score, and blood urea nitrogen to creatinine ratio. The primary outcome was postoperative delirium, as defined using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and Confusion Assessment Method criteria. All patients were Screened daily for delirium. RESULTS: Incidence of delirium was 3.8% in the low-risk group (P < .001), 11.1% in the intermediate-risk group (P = .27, relative risk (RR) = 3.0), and 37.1.% in the high-risk group (P < .001, RR = 9.8). Cognitive impairment at admission had the highest predictive value for postoperative delirium (coefficient of determination = 0.15). Contrary to previous findings, age was an independent predictive factor for delirium. Moreover, postoperative delirium was four times as frequent in acute patients as in elective hip-replacement patients. CONCLUSION: The medical risk factor model Is valid for elderly hip-surgery patients. Cognitive impairment, age, and type of admission are important risk factors for delirium in this surgical population.","Med Ctr Alkmaar, Dept Geriatr Med, NL-1800 AM Alkmaar, Netherlands; Med Ctr Alkmaar, Dept Clin Psychol, NL-1800 AM Alkmaar, Netherlands; Med Ctr Alkmaar, Dept Stat, NL-1800 AM Alkmaar, Netherlands; Univ Amsterdam, Acad Med Ctr, Dept Neurol, NL-1105 AZ Amsterdam, Netherlands; Univ Amsterdam, Acad Med Ctr, Dept Psychiat, NL-1105 AZ Amsterdam, Netherlands; Free Univ Amsterdam, Amsterdam, Netherlands","Medical Center Of Alkmaar; Medical Center Of Alkmaar; Medical Center Of Alkmaar; University of Amsterdam; Academic Medical Center Amsterdam; University of Amsterdam; Academic Medical Center Amsterdam; Vrije Universiteit Amsterdam","Kalisvaart, KJ (通讯作者)，Med Ctr Alkmaar, Dept Geriatr Med, POB 501, NL-1800 AM Alkmaar, Netherlands.","k.kalisvaart@mca.nl","Eikelenboom, Piet/AAF-6359-2020; Van Gool, Willem A/G-5985-2012","Vreeswijk, Ralph/0000-0001-9588-3499; Kalisvaart, Kees/0000-0002-7027-490X; van der Ploeg, Tjeerd/0000-0003-0429-6753; Van Gool, Willem/0000-0003-3174-8233","","","","",28,184,191,0,15,"WILEY","HOBOKEN","111 RIVER ST, HOBOKEN 07030-5774, NJ USA","0002-8614","1532-5415","","J AM GERIATR SOC","J. Am. Geriatr. Soc.","MAY",2006,54,5,"","","","",817,822,"","10.1111/j.1532-5415.2006.00704.x","http://dx.doi.org/10.1111/j.1532-5415.2006.00704.x","","",6,"Geriatrics & Gerontology; Gerontology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI); Conference Proceedings Citation Index - Science (CPCI-S); Conference Proceedings Citation Index - Social Science & Humanities (CPCI-SSH)","Geriatrics & Gerontology","042MJ",16696749,"","","","2023-11-07","WOS:000237531900013","View Full Record in Web of Science"]
["J","Bryson, GL; Wyand, A","","","","Bryson, GL; Wyand, A","","","Evidence-based clinical update: General anesthesia and the risk of delirium and postoperative cognitive dysfunction","CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE","","","English","Article","","","","","","","CONFUSION ASSESSMENT METHOD; ELDERLY-PATIENTS; MENTAL FUNCTION; REGIONAL ANESTHESIA; SPINAL-ANESTHESIA; HIP-ARTHROPLASTY; RANDOMIZED TRIAL; CATARACT-SURGERY; OUTCOMES; ANALGESIA","Purpose: The purpose of this structured, evidence-based, clinical update was to identify the best evidence comparing general and regional anesthesia and their influence on delirium or cognitive dysfunction (POCD) in the postoperative period. Source: In June 2005 a structured search of MEDLINE from 1966 to present using OVID software was undertaken. Medical subject headings and textwords describing both delirium and POCD were employed. OVID's Therapy (sensitivity) algorithm was used to maximize the detection of randomized trials. The bibliographies of eligible publications were hand-searched to identify trials not identified in the electronic search. Publications enrolling children were excluded. Levels of evidence and grades of recommendations were scored using Centre for Evidence Based Medicine criteria. Principal findings: A total of 18 unique randomized controlled trials were identified: two evaluating delirium; ten evaluating POCD; and six evaluating both. Outcomes for delirium were abstracted from eight trials that enrolled 765 patients (387 regional anesthesia; 378 general anesthesia). Outcomes for POCD were identified from 16 trials that enrolled 2,708 patients (1,3 13 regional anesthesia; 1,395 general anesthesia). Both delirium (11-43%) and POCD (15-25%) were relatively common in trials actively seeking these outcomes. Consistent Level 2b evidence suggests no significant increase in delirium in patients receiving general anesthesia compared with those receiving regional anesthesia. Similarly, consistent Level I evidence indicates that exposure to general anesthesia is not significantly associated with POCD. Conclusion: Available randomized controlled trials suggest that there is no significant difference in the incidence of delirium or POCD when general anesthesia and regional anesthesia are compared.","Univ Ottawa Hosp, Dept Anesthesiol, Ottawa, ON K1Y 4E9, Canada","University of Ottawa; Ottawa Hospital Research Institute","Bryson, GL (通讯作者)，Univ Ottawa Hosp, Dept Anesthesiol, Box 249C,Civic Campus 1056 Carling Ave, Ottawa, ON K1Y 4E9, Canada.","glbryson@ottawahospital.on.ca","Bryson, Gregory Lyle/AAG-5108-2019","Bryson, Gregory Lyle/0000-0003-3583-9802","","","","",47,133,162,0,20,"CANADIAN ANESTHESIOLOGISTS SOC","TORONTO","1 EGLINTON AVE EAST, SUITE 208, TORONTO, ONTARIO M4P 3A1, CANADA","0832-610X","","","CAN J ANAESTH","Can. J. Anaesth.-J. Can. Anesth.","JUL",2006,53,7,"","","","",669,677,"","10.1007/BF03021625","http://dx.doi.org/10.1007/BF03021625","","",9,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","059IZ",16803914,"Bronze","","","2023-11-07","WOS:000238727800006","View Full Record in Web of Science"]
["J","Leung, JM; Sands, LP; Rico, M; Petersen, KL; Rowbotham, MC; Dahl, JB; Ames, C; Chou, D; Weinstein, P","","","","Leung, J. M.; Sands, L. P.; Rico, M.; Petersen, K. L.; Rowbotham, M. C.; Dahl, J. B.; Ames, C.; Chou, D.; Weinstein, P.","","","Pilot clinical trial of gabapentin to decrease postoperative delirium in older patients","NEUROLOGY","","","English","Article","","","","","","","ABDOMINAL HYSTERECTOMY; MORPHINE CONSUMPTION; PAIN; PLACEBO","In this randomized pilot clinical trial, the authors tested the hypothesis that using gabapentin as an add-on agent in the treatment of postoperative pain reduces the occurrence of postoperative delirium. Postoperative delirium occurred in 5/12 patients (42%) who received placebo vs 0/9 patients who received gabapentin, p = 0.045. The reduction in delirium appears to be secondary to the opioid-sparing effect of gabapentin.","Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA; Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA; Univ Calif San Francisco, Dept Neurol Surg, San Francisco, CA 94143 USA; Purdue Univ, Sch Nursing, W Lafayette, IN 47907 USA; Glostrup Univ Hosp, Glostrup, Denmark","University of California System; University of California San Francisco; University of California System; University of California San Francisco; University of California System; University of California San Francisco; Purdue University System; Purdue University West Lafayette Campus; Purdue University; University of Copenhagen","Leung, JM (通讯作者)，Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, 521 Parnassus, San Francisco, CA 94143 USA.","leungj@anesthesia.ucsf.edu","Weinstein, Phil/C-9805-2011; Rowbotham, Michael/AAA-3606-2019; Sands, Laura P/E-8919-2015; Leung, Joyce/JCE-3061-2023","Sands, Laura P/0000-0003-2446-4486;","NIA NIH HHS [1K24 AG00948-05] Funding Source: Medline","NIA NIH HHS(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","","",10,92,96,0,7,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA","0028-3878","","","NEUROLOGY","Neurology","OCT 10",2006,67,7,"","","","",1251,1253,"","10.1212/01.wnl.0000233831.87781.a9","http://dx.doi.org/10.1212/01.wnl.0000233831.87781.a9","","",3,"Clinical Neurology","Science Citation Index Expanded (SCI-EXPANDED)","Neurosciences & Neurology","092DL",16914695,"","","","2023-11-07","WOS:000241077100026","View Full Record in Web of Science"]
["J","Lundström, M; Olofsson, B; Stenvall, M; Karlsson, S; Nyberg, L; Englund, U; Borssén, B; Svensson, O; Gustafson, Y","","","","Lundstrom, Maria; Olofsson, Birgitta; Stenvall, Michael; Karlsson, Stig; Nyberg, Lars; Englund, Undis; Borssen, Bengt; Svensson, Olle; Gustafson, Yngve","","","Postoperative delirium in old patients with femoral neck fracture:: a randomized intervention study","AGING CLINICAL AND EXPERIMENTAL RESEARCH","","","English","Article","","","","","","delirium; femoral neck fracture; geriatric team; intervention; RCT","ACUTE CONFUSIONAL STATES; ELDERLY-PATIENTS; HIP-FRACTURE; GERIATRIC INTERVENTION; NORDIC COUNTRIES; CONTROLLED-TRIAL; PROGRAM; SCALE; REHABILITATION; SURGERY","Background and aims: Delirium is a common postoperative complication in elderly patients which has a serious impact on outcome in terms of morbidity and costs. We examined whether a postoperative multi-factorial intervention program can reduce delirium and improve outcome in patients with femoral neck fractures. Methods: One hundred and ninety-nine patients, aged 70 years and over (mean age SD, 82 +/- 6, 74% women), were randomly assigned to postoperative care in a specialized geriatric word or a conventional orthopedic ward, The intervention consisted of staff education focusing on the assessment, prevention and treatment of delirium and associated complications. The staff worked as a team, applying comprehensive geriatric assessment, management and rehabilitation. Patients were assessed using the Mini Mental State Examination and the Organic Brain Syndrome Scale, and delirium was diagnosed according to DSM-IV criteria. Results: The number of days of postoperative delirium among intervention patients was fewer (5.0 +/- 7.1 days vs 10.2 +/- 13.3 days, p=0.009) compared with controls. A lower proportion of intervention patients were delirious postoperatively than controls (561102, 54.9% vs 73197, 75.3%, p=0.003). Eighteen percent in the intervention ward and 52% of controls were delirious after the seventh postoperative day (p < 0.001). Intervention patients suffered from fewer complications, such as decubitus ulcers, urinary tract infections, nutritional complications, sleeping problems and falls, than controls. Total postoperative hospitalization was shorter in the intervention ward (28.0 +/- 17.9 days vs 38.0 +/- 40.6 days, p=0.028). Conclusions: Patients with postoperative delirium can be successfully treated, resulting in fewer days of delirium, fewer other complications, and shorter length of hospitalization.","Umea Univ, Dept Community Med & Rehabil, S-90187 Umea, Sweden; Umea Univ, Dept Surg & Perioperat Sci, S-90187 Umea, Sweden; Lulea Univ Technol, Dept Hlth Sci, S-95187 Lulea, Sweden; Umea Univ Hosp, S-90185 Umea, Sweden","Umea University; Umea University; Lulea University of Technology; Umea University","Lundström, M (通讯作者)，Umea Univ, Dept Community Med & Rehabil, S-90187 Umea, Sweden.","maria.lundstrom@germed.umu.se","Olofsson, Birgitta/AAZ-1039-2021","Olofsson, Birgitta/0000-0002-3754-5026; Gustafson, Yngve/0000-0002-0999-377X","","","","",33,197,200,0,29,"SPRINGER","NEW YORK","ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES","1594-0667","1720-8319","","AGING CLIN EXP RES","Aging Clin. Exp. Res.","JUN",2007,19,3,"","","","",178,186,"","","","","",9,"Geriatrics & Gerontology","Science Citation Index Expanded (SCI-EXPANDED)","Geriatrics & Gerontology","215OY",17607084,"","","","2023-11-07","WOS:000249820100003","View Full Record in Web of Science"]
["J","Prakanrattana, U; Prapaitrakool, S","","","","Prakanrattana, U.; Prapaitrakool, S.","","","Efficacy of risperidone for prevention of postoperative delirium in cardiac surgery","ANAESTHESIA AND INTENSIVE CARE","","","English","Article","","","","","","delirium; postoperative; cardiac surgery; risperidone; antipsychotic","CONFUSION ASSESSMENT METHOD; CAM","This randomised, double-blinded, placebo-controlled study was primarily aimed to evaluate the potential of risperidone to prevent postoperative delirium following cardiac surgery with cardiopulmonary bypass and the secondary objective was to explore clinical factors associated with postoperative delirium. One-hundred-and-twenty-six adult patients undergoing elective cardiac surgery with cardiopulmonary bypass were randomly assigned to receive either 1 mg of risperidone or placebo sublingually when they regained consciousness. Delirium and other outcomes were assessed. The confusion assessment method for intensive care unit was used to assess postoperative delirium. The incidence of postoperative delirium in the risperidone group was lower than the placebo group (11.1% vs. 31.7% respectively, P=0.009, relative risk=0.35, 95% confidence interval [CI]=0.16-0.77). Other postoperative outcomes were not statistically different between the groups. In exploring the factors associated with delirium, univariate analysis showed many factors were associated with postoperative delirium. However multiple logistic regression analysis showed a lapse of 70 minutes from the time of opening eyes to following commands and postoperative respiratory failure were independent risk factors (P=0.003, odds ratio [OR]=4.57, 95% CI=1.66-12.59 and P=0.038, OR=13.78, 95% CI=1.15-165.18 respectively). A single dose of risperidone administered soon after cardiac surgery with cardiopulmonary bypass reduces the incidence of postoperative delirium. Multiple factors tended to be associated with postoperative delirium, but only the time from opening eyes to following commands and postoperative respiratory failure were independent risk factors in this study.","Thammasat Univ, Fac Med, Div Anaesthesiol, Pathum Thani 12120, Thailand; Mahidol Univ, Siriraj Hosp, Dept Anaesthesiol, Bangkok 10700, Thailand","Thammasat University; Mahidol University","Prakanrattana, U (通讯作者)，Thammasat Univ, Fac Med, Div Anaesthesiol, Rangsit Campus, Pathum Thani 12120, Thailand.","","","","","","","",17,182,190,0,12,"SAGE PUBLICATIONS LTD","LONDON","1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND","0310-057X","1448-0271","","ANAESTH INTENS CARE","Anaesth. Intensive Care","OCT",2007,35,5,"","","","",714,719,"","10.1177/0310057X0703500509","http://dx.doi.org/10.1177/0310057X0703500509","","",6,"Anesthesiology; Critical Care Medicine","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology; General & Internal Medicine","220PO",17933157,"Bronze","","","2023-11-07","WOS:000250168900009","View Full Record in Web of Science"]
["J","Rudolph, JL; Jones, RN; Rasmussen, LS; Silverstein, JH; Inouye, SK; Marcantonio, ER","","","","Rudolph, James L.; Jones, Richard N.; Rasmussen, Lars S.; Silverstein, Jeffrey H.; Inouye, Sharon K.; Marcantonio, Edward R.","","","Independent vascular and cognitive risk factors for postoperative delirium","AMERICAN JOURNAL OF MEDICINE","","","English","Article","","","","","","atherosclerosis; cognition; delirium; risk factors; surgery; tobacco; vascular surgery","BYPASS GRAFT-SURGERY; NONCARDIAC SURGERY; DYSFUNCTION; IMPAIRMENT; DEMENTIA; SYMPTOMS; DISEASE; HEALTH; CARE; AGE","BACKGROUND: Delirium is a common, morbid, and costly syndrome that occurs frequently after surgery for atherosclerosis. We hypothesized that vascular risk factors and mildly impaired cognitive performance would independently predispose nondemented patients to develop delirium after noncardiac surgery. METHODS: The International Study of Postoperative Cognitive Dysfunction recruited patients undergoing noncardiac surgery from 8 countries. Subjects provided detailed medical history and underwent preoperative testing of multiple cognitive domains with a neuropsychologic battery. Postoperatively, subjects (n = 1161) were assessed daily for delirium. RESULTS: Ninety-nine subjects (8%) developed delirium. In bivariable analysis, several vascular risk factors were significantly associated with the likelihood of delirium, including male sex, exposure to tobacco, previous myocardial infarction, and vascular surgery. After adjustment for age, tobacco exposure and vascular surgery were independent vascular risk factors for delirium (adjusted relative risk [RR] 3.2, 95% confidence interval [CI], 2.1-4.9). In addition, mildly impaired cognitive performance, defined as performance 1.5 standard deviation below the mean on either of 2 neuropsychologic tests, was independently associated with delirium (adjusted RR 2.2, 95% CI, 1.4-3.6). Subjects with both vascular risk factors and mildly impaired cognitive performance were at double the risk of delirium (RR 2.2, 95% CI, 1.2-4.2) compared with those with either of these risk factors alone. CONCLUSIONS: Vascular risk and mildly impaired cognitive performance independently predispose patients to delirium after noncardiac surgery. These factors will help to identify high-risk patients for delirium and to design and target future intervention strategies. (C) 2007 Elsevier Inc. All rights reserved.","VA Boston Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Boston, MA USA; Hebrew SenoirLife, Inst Aging Res, Boston, MA USA; Hebrew SenoirLife, Inst Aging Brain Ctr, Boston, MA USA; Univ Copenhagen Hosp, Ctr Head & Orthopaed, Dept Anesthesia, DK-2100 Copenhagen, Denmark; Mt Sinai Sch Med, Dept Anesthesiol, New York, NY USA; Mt Sinai Sch Med, Dept Surg, New York, NY USA; Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY USA; Beth Israel Deaconess Med Ctr, Div Gerontol, Boston, MA 02215 USA; Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, Boston, MA 02215 USA; Brigham & Womens Hosp, Div Aging, Boston, MA 02115 USA; Harvard Univ, Sch Med, Dept Med, Boston, MA USA; VABHS, Boston, MA 02130 USA","Geriatric Research Education & Clinical Center; US Department of Veterans Affairs; Veterans Health Administration (VHA); Harvard University; VA Boston Healthcare System; University of Copenhagen; Icahn School of Medicine at Mount Sinai; Icahn School of Medicine at Mount Sinai; Icahn School of Medicine at Mount Sinai; Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Brigham & Women's Hospital; Harvard University; Harvard Medical School; US Department of Veterans Affairs; Veterans Health Administration (VHA); Harvard University; VA Boston Healthcare System","Rudolph, JL (通讯作者)，VABHS, JP-182,150 S Huntington Ave, Boston, MA 02130 USA.","jrudolph@partners.org","Jones, Richard Norman/J-3488-2013; Inouye, Sharon/R-7216-2019; Marcantonio, Edward R/U-3929-2017","Jones, Richard Norman/0000-0002-1049-218X; Marcantonio, Edward R/0000-0002-2911-4250; Rasmussen, Lars/0000-0002-7480-3004","NIA NIH HHS [5 K12 AG00294-18, K24AG000949, 5 P60 AG08812-14, R21AG025193, R01AG018772-04] Funding Source: Medline","NIA NIH HHS(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","","",39,123,131,0,8,"ELSEVIER SCIENCE INC","NEW YORK","360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA","0002-9343","1555-7162","","AM J MED","Am. J. Med.","SEP",2007,120,9,"","","","",807,813,"","10.1016/j.amjmed.2007.02.026","http://dx.doi.org/10.1016/j.amjmed.2007.02.026","","",7,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED)","General & Internal Medicine","205ON",17765051,"","","","2023-11-07","WOS:000249123800015","View Full Record in Web of Science"]
["J","Sampson, EL; Raven, PR; Ndhlovu, PN; Vallance, A; Garlick, N; Watts, J; Blanchard, MR; Bruce, A; Blizard, R; Ritchie, CW","","","","Sampson, Elizabeth L.; Raven, Peter R.; Ndhlovu, Patricia N.; Vallance, Aaron; Garlick, Nicholas; Watts, Julie; Blanchard, Martin R.; Bruce, Angela; Blizard, Robert; Ritchie, Craig W.","","","A randomized, double-blind, placebo-controlled trial of donepezil hydrochloride (Aricept) for reducing the incidence of postoperative delirium after elective total hip replacement","INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY","","","English","Article","","","","","","delirium; donepezil hydrochloride; randomized controlled trial","SERUM ANTICHOLINERGIC ACTIVITY; SYMPTOMS; SUBTYPES; DISEASE","Objectives This was a pilot, phase 2a study to assess methodological feasibility and the safety and efficacy of donepezil in preventing postoperative delirium after elective total hip replacement surgery in older people without pre-existing dementia. The hypothesis was that donepezil would reduce the incidence of postoperative delirium. Methods A double blind, placebo controlled, parallel group randomized trial was undertaken. Patients were block randomized pre-operatively to receive placebo or donepezil 5 mg immediately following surgery and every 24 h thereafter for a further three days. The main outcome was the incidence of delirium (using the Delirium Symptom Interview). The secondary outcome was length of hospital stay. Results Thirty-three patients (mean age 67 years; 17 males, 16 females) completed the study (19 donepezil, 14 placebo). Donepezil was well tolerated with no serious adverse events. Postoperative delirium occurred in 21.2% of subjects. Donepezil did not significantly reduce the incidence of delirium. The unadjusted risk ratio (donepezil vs placebo) for delirium was 0.29 (95% CI = 0.06,1.30) (chi(2)([1]) = 3.06; p = 0.08). Mean length of hospital stay was 9.9 days for the donepezil group vs 12.1 days in the placebo group; difference in means = -2.2 days (95% CI = -0.39,4.78) (t([31]) = 1.73: p = 0.09). Conclusions The experimental paradigm was feasible and acceptable. Donepezil did not significantly reduce the incidence of delirium or length of hospital stay, however for both outcomes there was a consistent trend suggesting possible benefit. The sample size required for a definitive trial (99% power, alpha 0.05) would be 95 subjects per arm. Copyright (c) 2006 John Wiley & Sons, Ltd.","UCL Royal Free & Univ Coll, Sch Med, Metab & Clin Trials Unit, Dept Mental Hlth Sci, London NW3 2PF, England; UCL Royal Free Hosp, Dept Orthopaed, London NW3 2QG, England; UCL Royal Free Hosp, Dept Anaesthet, London, England","University of London; University College London; UCL Medical School; University of London; University College London; University of London; University College London","Sampson, EL (通讯作者)，UCL Royal Free & Univ Coll, Sch Med, Metab & Clin Trials Unit, Dept Mental Hlth Sci, Hampstead Campus,Rowland Hill St, London NW3 2PF, England.","e.sampson@medsch.ucl.ac.uk","Sampson, Elizabeth L/B-8647-2009","Sampson, Elizabeth L/0000-0001-8929-7362","","","","",23,118,124,0,8,"JOHN WILEY & SONS LTD","CHICHESTER","THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND","0885-6230","","","INT J GERIATR PSYCH","Int. J. Geriatr. Psychiatr.","APR",2007,22,4,"","","","",343,349,"","10.1002/gps.1679","http://dx.doi.org/10.1002/gps.1679","","",7,"Geriatrics & Gerontology; Gerontology; Psychiatry","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Geriatrics & Gerontology; Psychiatry","156XS",17006875,"","","","2023-11-07","WOS:000245683800010","View Full Record in Web of Science"]
["J","Leung, JM; Sands, LP; Wang, Y; Poon, A; Kwok, PY; Kane, JP; Pullinger, CR","","","","Leung, Jacqueline M.; Sands, Laura P.; Wang, Yun; Poon, Annie; Kwok, Pui-yan; Kane, John P.; Pullinger, Clive R.","","","Apolipoprotein E e4 allele increases the risk of early postoperative delirium in older patients undergoing noncardiac surgery","ANESTHESIOLOGY","","","English","Article; Proceedings Paper","Annual Meeting of the Association-of-University-Anesthesiologists","MAY 11-15, 2006","Phoenix, AZ","Assoc Univ Anesthesiol","","","COGNITIVE DECLINE; ALZHEIMERS-DISEASE; E POLYMORPHISM; E GENOTYPE; DYSFUNCTION; DEMENTIA","Background: Whether patients who subsequently develop early postoperative delirium have a genetic predisposition that renders them at risk for postoperative delirium has not been determined. Methods: The authors conducted a nested cohort study to include patients aged >= 65 yr who were scheduled to undergo major noncardiac surgery requiring anesthesia. A structured interview was conducted preoperatively and for the first 2 days postoperatively to determine the presence of delirium, defined using the Confusion Assessment Method. Blood was drawn for measurement of the apolipoprotein genotypes. Bivariate tests of association were conducted between delirium and apolipoprotein genotypes and other potentially important risk factors. Variables that had significant bivariate association with postoperative delirium were entered in a forward multivariable logistic regression model. Results: Of the 190 patients studied, 15.3% developed delirium on both days 1 and 2 after surgery. Forty-six patients (24.2%) had at least one copy of the apolipoprotein e4 allele. The presence of one copy of the e4 allele was associated with an increased risk of early postoperative delirium (28.3% vs. 11.1%; P = 0.005). Even after adjusting for covariates, patients with one copy of the e4 allele were still more likely to have an increased risk of early postoperative delirium (odds ratio, 3.64; 95% confidence interval, 1.51-8.77) compared with those without the e4 allele. Conclusions: Apolipoprotein e4 carrier status was associated with an increased risk for early postoperative delirium after controlling for known demographic and clinical risk factors. These results suggest that genetic predisposition plays a role and may interact with anesthetic/surgical factors contributing to the development of early postoperative delirium.","Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA; Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco, CA 94143 USA; Univ Calif San Francisco, Dept Biochem & Biophys, San Francisco, CA 94143 USA; Univ Calif San Francisco, Dept Physiol Nursing, San Francisco, CA 94143 USA; Univ Pittsburgh, Pittsburgh, PA USA; Purdue Univ, Sch Nursing, W Lafayette, IN 47907 USA","University of California System; University of California San Francisco; University of California System; University of California San Francisco; University of California System; University of California San Francisco; University of California System; University of California San Francisco; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; Purdue University System; Purdue University West Lafayette Campus; Purdue University","Leung, JM (通讯作者)，Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, 521 Parnassus, San Francisco, CA 94143 USA.","leungj@anesthesia.ucsf.edu","Kwok, Pui-Yan/F-7725-2014; Sands, Laura P/E-8919-2015","Kwok, Pui-Yan/0000-0002-5087-3059; Sands, Laura P/0000-0003-2446-4486","NIA NIH HHS [1K24 AG00948-05] Funding Source: Medline","NIA NIH HHS(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","","",43,87,95,1,6,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-3022","1528-1175","","ANESTHESIOLOGY","Anesthesiology","SEP",2007,107,3,"","","","",406,411,"","10.1097/01.anes.0000278905.07899.df","http://dx.doi.org/10.1097/01.anes.0000278905.07899.df","","",6,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)","Anesthesiology","208CK",17721242,"Bronze","","","2023-11-07","WOS:000249297200008","View Full Record in Web of Science"]
["J","Bickel, H; Gradinger, R; Kochs, E; Först, H","","","","Bickel, Horst; Gradinger, Reiner; Kochs, Eberhard; Foerst, Hans","","","High risk of cognitive and functional decline after postoperative delirium -: A three-year prospective study","DEMENTIA AND GERIATRIC COGNITIVE DISORDERS","","","English","Article","","","","","","delirium, prognosis; confusional state; cognitive decline, prediction; disability","OLDER MEDICAL INPATIENTS; ACUTE CONFUSIONAL STATE; HIP FRACTURE PATIENTS; FOLLOW-UP; DEMENTIA; OUTCOMES; IMPAIRMENT; DISEASE; SURGERY; EPIDEMIOLOGY","Background/Aims: The aim of the study was to investigate the association of postoperative delirium with the outcomes of cognitive impairment, functional disability and death. Methods: Hip surgery patients aged 60 years or over (n = 200) underwent preoperative and daily postoperative assessment of their cognitive status during hospital stay. Outcome variables were determined at an average of 8 and 38 months after discharge from hospital. Results: Fourty-one patients developed postoperative delirium. Delirium was a strong independent predictor of cognitive impairment and the occurrence of severe dependency in activities of daily living. The associations were more marked for the long-than for the short-term outcome. Thirty-eight months after discharge from hospital, 53.8% of the surviving patients with postoperative delirium suffered from cognitive impairment, as compared to only 4.4% of the nondelirious participants. Logistic regression analysis adjusted for age, sex, medical comorbidity and preoperative cognitive performance revealed highly significant associations between delirium and cognitive impairment (OR = 41.2; 95% CI = 4.3-396.2), subjective memory decline (OR = 6.2; 95% CI = 1.5-25.8) and incident need for long-term care (OR=5.6; 95% CI = 1.6-19.7). Conclusion: The present study confirms a poor prognosis after delirium in elderly patients. The findings suggest that delirium does not simply persist for a certain time but also predicts a future cognitive decline with an increased risk of dementia. Copyright (c) 2008 S. Karger AG, Basel.","[Bickel, Horst; Foerst, Hans] Tech Univ Munich, Klinikum Rechts Isar, Klin & Poliklin Psychiat & Psychotherapie, Dept Psychiat & Psychotherapy, DE-81675 Munich, Germany; [Gradinger, Reiner] Tech Univ Munich, Klinikum Rechts Isar, Dept Orthoped, DE-81675 Munich, Germany; [Kochs, Eberhard] Tech Univ Munich, Klinikum Rechts Isar, Dept Anesthesiol, DE-81675 Munich, Germany","University of Munich; Technical University of Munich; Technical University of Munich; Technical University of Munich","Först, H (通讯作者)，Tech Univ Munich, Klinikum Rechts Isar, Klin & Poliklin Psychiat & Psychotherapie, Dept Psychiat & Psychotherapy, Ismaninger Str 22, DE-81675 Munich, Germany.","hans.foerstl@lrz.tu-muenchen.de","förstl, hans/B-5869-2008","Forstl, Hans/0000-0002-6188-6883","","","","",39,205,213,0,32,"KARGER","BASEL","ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND","1420-8008","","","DEMENT GERIATR COGN","Dement. Geriatr. Cogn. Disord.","",2008,26,1,"","","","",26,31,"","10.1159/000140804","http://dx.doi.org/10.1159/000140804","","",6,"Geriatrics & Gerontology; Clinical Neurology; Psychiatry","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry","324JW",18577850,"","","","2023-11-07","WOS:000257515900004","View Full Record in Web of Science"]
["J","Rudolph, JL; Marcantonio, ER; Culley, DJ; Silverstein, JH; Rasmussen, LS; Crosby, GJ; Inouye, SK","","","","Rudolph, J. L.; Marcantonio, E. R.; Culley, D. J.; Silverstein, J. H.; Rasmussen, L. S.; Crosby, G. J.; Inouye, S. K.","","","Delirium is associated with early postoperative cognitive dysfunction","ANAESTHESIA","","","English","Article","","","","","","","POOR FUNCTIONAL RECOVERY; MINI-MENTAL-STATE; NONCARDIAC SURGERY; HIP FRACTURE; SYMPTOMS; OUTCOMES; PREDICTION; SCALE; RISK","The purpose of this analysis was to determine if postoperative delirium was associated with early postoperative cognitive dysfunction (at 7 days) and long-term postoperative cognitive dysfunction (at 3 months). The International Study of Postoperative Cognitive Dysfunction recruited 1218 subjects >= 60 years old undergoing elective, non-cardiac surgery. Postoperatively, subjects were evaluated for delirium using the criteria of the Diagnostic and Statistical Manual. Subjects underwent neuropsychological testing pre-operatively and postoperatively at 7 days (n = 1018) and 3 months (n = 946). Postoperative cognitive dysfunction was defined as a composite Z-score > 2 across tests or at least two individual test Z-scores > 2. Subjects with delirium were significantly less likely to participate in postoperative testing. Delirium was associated with an increased incidence of early postoperative cognitive dysfunction (adjusted risk ratio 1.6, 95% CI 1.1-2.1), but not long-term postoperative cognitive dysfunction (adjusted risk ratio 1.3, 95% CI 0.6-2.4). Delirium was associated with early postoperative cognitive dysfunction, but the relationship of delirium to long-term postoperative cognitive dysfunction remains unclear.","[Rudolph, J. L.] Harvard Univ, Sch Med, VA Boston Healthcare Syst Geriatr Educ & Clin Ct, Brigham & Womens Hosp,Div Aging, Boston, MA 02115 USA; [Marcantonio, E. R.] Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, Boston, MA 02115 USA; [Marcantonio, E. R.] Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Div Gerontol, Boston, MA 02115 USA; [Culley, D. J.] Harvard Univ, Sch Med, Brigham & Womens Hosp, Dept Anesthesiol, Boston, MA 02115 USA; [Silverstein, J. H.] Mt Sinai Sch Med, Dept Anesthesiol, New York, NY USA; [Silverstein, J. H.] Mt Sinai Sch Med, Dept Surg, New York, NY USA; [Silverstein, J. H.] Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY USA; [Rasmussen, L. S.] Copenhagen Univ Hosp, Dept Anaesthesia, Ctr Head & Orthopaed, Copenhagen, Denmark; [Inouye, S. K.] Harvard Univ, Sch Med, Hebrew Senior Life Aging Brain Ctr, Boston, MA 02115 USA; [Inouye, S. K.] Harvard Univ, Sch Med, Inst Aging Res, Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA","Harvard University; Brigham & Women's Hospital; Harvard Medical School; Harvard University; Beth Israel Deaconess Medical Center; Harvard Medical School; Harvard University; Beth Israel Deaconess Medical Center; Harvard Medical School; Harvard University; Brigham & Women's Hospital; Harvard Medical School; Icahn School of Medicine at Mount Sinai; Icahn School of Medicine at Mount Sinai; Icahn School of Medicine at Mount Sinai; University of Copenhagen; Harvard University; Hebrew SeniorLife; Harvard Medical School; Harvard University; Harvard Medical School; Beth Israel Deaconess Medical Center","Rudolph, JL (通讯作者)，Harvard Univ, Sch Med, VA Boston Healthcare Syst Geriatr Educ & Clin Ct, Brigham & Womens Hosp,Div Aging, Boston, MA 02115 USA.","jrudolph@partners.org","Marcantonio, Edward R/U-3929-2017; Inouye, Sharon/R-7216-2019; Crosby, Gregory/N-6578-2019","Marcantonio, Edward R/0000-0002-2911-4250; Rasmussen, Lars/0000-0002-7480-3004","NIA NIH HHS [R01 AG017649, R01 AG018772-04, R01 AG020253-03, R21 AG025193, K24 AG000949-08, R03 AG029861-01A1, R01 AG029656, R01 AG017649-05, R21AG025193, K24 AG000949, R01 AG018772, R21 AG025193-02, K24AG00949, R01 AG020253, R03 AG029861, R03AG029861, R01AG20253, R01AG018772-04, R01AG17649] Funding Source: Medline; NIGMS NIH HHS [K08 GM077057-03, K08 GM077057, KO8GM077057] Funding Source: Medline","NIA NIH HHS(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA)); NIGMS NIH HHS(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of General Medical Sciences (NIGMS))","","",31,119,130,1,16,"WILEY-BLACKWELL","MALDEN","COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA","0003-2409","","","ANAESTHESIA","Anaesthesia","SEP",2008,63,9,"","","","",941,947,"","10.1111/j.1365-2044.2008.05523.x","http://dx.doi.org/10.1111/j.1365-2044.2008.05523.x","","",7,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","334XP",18547292,"Green Accepted, Green Submitted, Bronze","","","2023-11-07","WOS:000258255400005","View Full Record in Web of Science"]
["J","Robinson, TN; Eiseman, B","","","","Robinson, Thomas N.; Eiseman, Ben","","","Postoperative delirium in the elderly: diagnosis and management","CLINICAL INTERVENTIONS IN AGING","","","English","Review","","","","","","postoperative; delirium; geriatric; elderly; review","MECHANICALLY VENTILATED PATIENTS; CONFUSION ASSESSMENT METHOD; INTENSIVE-CARE-UNIT; DOUBLE-BLIND TRIAL; SURGERY; HALOPERIDOL; RISK; RELIABILITY; VALIDITY; FRACTURE","Delirium is a common but often undiagnosed complication in the elderly following a major operation. Recognizing the presentation of delirium and the criteria to establish the diagnosis of delirium will improve a clinician's ability to detect this complication. Treating delirium with environmental, supportive, and pharmacologic interventions reduces the incidence and side effects of postoperative delirium. The purpose of this review is to describe the diagnosis and treatment of postoperative delirium.","[Robinson, Thomas N.; Eiseman, Ben] Univ Colorado Denver, Hlth Sci Ctr, Dept Surg, Aurora, CO USA","Children's Hospital Colorado; University of Colorado System; University of Colorado Anschutz Medical Campus","Robinson, TN (通讯作者)，12631 E 17th Ave,Mail Stop C313,POB 6511, Aurora, CO 80045 USA.","thomas.robinson@uchsc.edu","","","American Geriatrics Society; John A Hartford Foundation","American Geriatrics Society; John A Hartford Foundation","This work was supported by a Geriatrics Education for Specialty Residents (GSR) grant from the American Geriatrics Society and the John A Hartford Foundation.","",31,101,107,2,13,"DOVE MEDICAL PRESS LTD","ALBANY","PO BOX 300-008, ALBANY, AUCKLAND 0752, NEW ZEALAND","","1178-1998","","CLIN INTERV AGING","Clin. Interv. Aging","",2008,3,2,"","","","",351,355,"","10.2147/CIA.S2759","http://dx.doi.org/10.2147/CIA.S2759","","",5,"Geriatrics & Gerontology","Science Citation Index Expanded (SCI-EXPANDED)","Geriatrics & Gerontology","V23GX",18686756,"Green Published, Green Submitted, gold","","","2023-11-07","WOS:000208332400013","View Full Record in Web of Science"]
["J","Robinson, TN; Raeburn, CD; Tran, ZV; Angles, EM; Brenner, LA; Moss, M","","","","Robinson, Thomas N.; Raeburn, Christopher D.; Tran, Zung V.; Angles, Erik M.; Brenner, Lisa A.; Moss, Marc","","","Postoperative Delirium in the Elderly Risk Factors and Outcomes","ANNALS OF SURGERY","","","English","Article","","","","","","","MECHANICALLY VENTILATED PATIENTS; MINI-COG; SURGERY; RELIABILITY; POPULATION; VALIDITY; SCALE; PUMP","Objective: The purpose of this study was to describe the natural history, identify risk factors, and determine outcomes for the development of postoperative delirium in the elderly. Background: Postoperative delirium is it common and deleterious complication in geriatric patients. Methods: Subjects older than 50 years scheduled for an operation requiring a postoperative intensive care unit admission were recruited. After preoperative informed written consent, enrolled subjects had baseline cognitive and functional assessments. Postoperatively, subjects were assessed daily for delirium using the confusion assessment method-intensive care unit. Patients were also followed for outcomes. Results: During the study period, 144 patients were enrolled before major abdominal (40%), thoracic (53%), or vascular (7%) operations. The overall incidence of delirium was 44% (64/144). The average time to onset of delirium was 2.1 +/- 0.9 days and the mean duration of delirium was 4,0 +/- 5.1 days. Several preoperative variables were associated with an increased risk of delirium including older age (P < 0.001), hypoalbuminemia (P < 0.001), impaired functional Status (P < 0.001), pre-existing dementia (P < 0.001) and pre-existing comorbidities (P < 0.001). In a multivariable logistic regression model, pre-existing dementia remains the strongest risk factor for the development of postoperative delirium. Worse Outcomes, including increased length of stay (P < 0.001), postdischarge institutionalization (P < 0.001), and 6 month mortality (P = 0.001), occurred in subjects who developed delirium. Conclusions: In the current study, delirium occurred in 44%, of elderly patients after a major operation. Pre-existing cognitive dysfunction was the strongest predictor of the development of postoperative delirium. Outcomes, including an increased rate of 6 month mortality, were worse in patients who developed postoperative delirium.","[Robinson, Thomas N.; Raeburn, Christopher D.; Angles, Erik M.] Univ Colorado, Dept Surg, Denver Sch Med, Denver, CO 80202 USA; [Tran, Zung V.] Univ Colorado, Denver Sch Med, Dept Prevent Med & Biometr, Denver, CO 80202 USA; [Brenner, Lisa A.] Univ Colorado, Denver Sch Med, Dept Psychiat, Denver, CO 80202 USA; [Brenner, Lisa A.] Univ Colorado, Denver Sch Med, Dept Phys Med & Rehabil, Denver, CO 80202 USA; [Brenner, Lisa A.] Univ Colorado, Denver Sch Med, Dept Neurol, Denver, CO 80202 USA; [Moss, Marc] Univ Colorado, Denver Sch Med, Dept Pulm Sci, Denver, CO 80202 USA; [Brenner, Lisa A.] Mental Illness Res Educ & Clin Ctr, Denver, CO USA","University of Colorado System; University of Colorado Denver; University of Colorado Anschutz Medical Campus; University of Colorado System; University of Colorado Denver; University of Colorado Anschutz Medical Campus; University of Colorado System; University of Colorado Anschutz Medical Campus; University of Colorado Denver; University of Colorado System; University of Colorado Denver; University of Colorado Anschutz Medical Campus; University of Colorado System; University of Colorado Anschutz Medical Campus; University of Colorado Denver; University of Colorado System; University of Colorado Denver; University of Colorado Anschutz Medical Campus","Robinson, TN (通讯作者)，12631 E 17th Ave,MS C313,POB 6511, Aurora, CO 80045 USA.","thomas.robinson@uchsc.edu","Brenner, Lisa A./AAG-2442-2019","Tran, Zung/0000-0002-9322-9562","University of Colorado Hartford/Jahnigen Center of Excellence in Geriatric Medicine; NIH [K24-HL-089223]","University of Colorado Hartford/Jahnigen Center of Excellence in Geriatric Medicine; NIH(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA)","This work was supported by the University of Colorado Hartford/Jahnigen Center of Excellence in Geriatric Medicine (to T.N.R) and NIH K24-HL-089223 (to M.M).","",34,417,442,2,46,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-4932","1528-1140","","ANN SURG","Ann. Surg.","JAN",2009,249,1,"","","","",173,178,"","10.1097/SLA.0b013e31818e4776","http://dx.doi.org/10.1097/SLA.0b013e31818e4776","","",6,"Surgery","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Surgery","391FN",19106695,"","","","2023-11-07","WOS:000262219300029","View Full Record in Web of Science"]
["J","Maldonado, JR; Wysong, A; van der Starre, PJA; Block, T; Miller, C; Reitz, BA","","","","Maldonado, Jose R.; Wysong, Ashley; van der Starre, Pieter J. A.; Block, Thaddeus; Miller, Craig; Reitz, Bruce A.","","","Dexmedetomidine and the Reduction of Postoperative Delirium after Cardiac Surgery","PSYCHOSOMATICS","","","English","Article","","","","","","","INTENSIVE-CARE-UNIT; MECHANICALLY VENTILATED PATIENTS; CONFUSION ASSESSMENT METHOD; BYPASS GRAFT-SURGERY; AGONIST DEXMEDETOMIDINE; OFF-PUMP; PROPOFOL; STATE; ACETYLCHOLINE; DYSFUNCTION","Background: Delirium is a neurobehavioral syndrome caused by the transient disruption of normal neuronal activity secondary to systemic disturbances. Objective: The authors investigated the effects of postoperative sedation on the development of delirium in patients undergoing cardiac-valve procedures. Methods: Patients underwent elective cardiac surgery with a standardized intraoperative anesthesia protocol, followed by random assignment to one of three postoperative sedation protocols: dexmedetomidine, propofol, or midazolam. Results: The incidence of delirium for patients receiving dexmedetomidine was 3%, for those receiving propofol was 50%, and for patients receiving midazolam, 50%. Patients who developed postoperative delirium experienced significantly longer intensive-care stays and longer total hospitalization. Conclusion: The findings of this open-label, randomized clinical investigation suggest that postoperative sedation with dexmedetomidine was associated with significantly lower rates of postoperative delirium and lower care costs. (Psychosomatics 2009; 50: 206-217)","[Maldonado, Jose R.] Stanford Univ, Sch Med, Dept Psychiat & Behav Sci, Stanford, CA 94305 USA; Stanford Univ, Sch Med, Dept Anesthesiol, Stanford, CA 94305 USA; Stanford Univ, Sch Med, Dept Cardiothorac Surg, Stanford, CA 94305 USA","Stanford University; Stanford University; Stanford University","Maldonado, JR (通讯作者)，Stanford Univ, Sch Med, Dept Psychiat & Behav Sci, 401 Quarry Rd,Suite 2317, Stanford, CA 94305 USA.","jrm@stanford.edu","Maldonado, Jose R/B-5964-2011; Miller, Craig/GWQ-5012-2022","","","","","",75,284,332,1,36,"ELSEVIER SCIENCE INC","NEW YORK","STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA","0033-3182","1545-7206","","PSYCHOSOMATICS","Psychosomatics","MAY-JUN",2009,50,3,"","","","",206,217,"","10.1176/appi.psy.50.3.206","http://dx.doi.org/10.1176/appi.psy.50.3.206","","",12,"Psychiatry; Psychology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Psychiatry; Psychology","464VV",19567759,"","","","2023-11-07","WOS:000267537700004","View Full Record in Web of Science"]
["J","Juliebo, V; Bjoro, K; Krogseth, M; Skovlund, E; Ranhoff, AH; Wyller, TB","","","","Juliebo, Vibeke; Bjoro, Karen; Krogseth, Maria; Skovlund, Eva; Ranhoff, Anette H.; Wyller, Torgeir Bruun","","","Risk Factors for Preoperative and Postoperative Delirium in Elderly Patients with Hip Fracture","JOURNAL OF THE AMERICAN GERIATRICS SOCIETY","","","English","Article; Proceedings Paper","3rd Scientific Meeting of the European-Delirium-Association","OCT, 2008","Helsinki, FINLAND","European Delirium Assoc","","delirium; risk factors; BMI; hip fracture","ACUTE CONFUSIONAL STATES; INFORMANT QUESTIONNAIRE; COGNITIVE DECLINE; OLD PATIENTS; SURGERY; IQCODE; CARE; MALNUTRITION; MANAGEMENT; MORBIDITY","OBJECTIVES To evaluate risk factors for preoperative and postoperative delirium. DESIGN Prospective cohort study. SETTING Departments of orthopedic surgery in two Norwegian hospitals. PARTICIPANTS Three hundred sixty-four patients with and without cognitive impairment, aged 65 and older. MEASUREMENTS Patients were screened daily for delirium using the Confusion Assessment Method. Established risk factors and risk factors regarded as clinically important according to expert opinion were explored in univariate analyses. Variables associated with the outcomes (P <.05) were entered into multivariate logistic regression models. RESULTS Delirium was present in 50 of 237 (21.1%) assessable patients preoperatively, whereas 68 of 187 (36.4%) patients developed delirium postoperatively (incident delirium). Multivariate logistic regression identified four risk factors for preoperative delirium: cognitive impairment (adjusted odds ratio (AOR)=4.7, 95% confidence interval (CI)=1.9-11.3), indoor injury (AOR=3.6, 95% CI=1.1-12.2), fever (AOR=3.4, 95% CI=1.5-7.7), and preoperative waiting time (AOR=1.05, 95% CI=1.0-1.1 per hour). Cognitive impairment (AOR=2.9, 95% CI=1.4-6.2), indoor injury (AOR=2.9, 95% CI=1.1-6.3), and body mass index (BMI) less than 20.0 (AOR=2.9, 95% CI=1.3-6.7) were independent and statistically significant risk factors for postoperative delirium. CONCLUSION Time from admission to operation is a risk factor for preoperative delirium, whereas low BMI is an important risk factor for postoperative delirium in hip fracture patients. Cognitive impairment and indoor injury are independent risk factors for preoperative and postoperative delirium.","[Juliebo, Vibeke] Univ Oslo, Ullevaal Univ Hosp, Dept Geriatr Med, N-0407 Oslo, Norway; [Bjoro, Karen] Ullevaal Univ Hosp, Dept Res, Nursing Unit, N-0407 Oslo, Norway; [Juliebo, Vibeke; Krogseth, Maria; Wyller, Torgeir Bruun] Univ Oslo, Fac Med, N-0407 Oslo, Norway; [Skovlund, Eva] Univ Oslo, Sch Pharm, N-0407 Oslo, Norway; [Skovlund, Eva] Norwegian Med Agcy, Oslo, Norway; [Ranhoff, Anette H.] Diakonhjemmet Hosp, Dept Geriatr Med, Oslo, Norway; [Ranhoff, Anette H.] Haraldsplass Diacon Hosp, Kavli Res Ctr Ageing & Dementia, Bergen, Norway","University of Oslo; University of Oslo; University of Oslo; University of Oslo; Diakonhjemmet Hospital","Juliebo, V (通讯作者)，Univ Oslo, Ullevaal Univ Hosp, Dept Geriatr Med, N-0407 Oslo, Norway.","vibeke.juliebo@medisin.uio.no","","","","","","",38,170,178,1,13,"WILEY","HOBOKEN","111 RIVER ST, HOBOKEN 07030-5774, NJ USA","0002-8614","1532-5415","","J AM GERIATR SOC","J. Am. Geriatr. Soc.","AUG",2009,57,8,"","","","",1354,1361,"","10.1111/j.1532-5415.2009.02377.x","http://dx.doi.org/10.1111/j.1532-5415.2009.02377.x","","",8,"Geriatrics & Gerontology; Gerontology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI); Conference Proceedings Citation Index - Science (CPCI-S); Conference Proceedings Citation Index - Social Science & Humanities (CPCI-SSH)","Geriatrics & Gerontology","477QH",19573218,"","","","2023-11-07","WOS:000268533100003","View Full Record in Web of Science"]
["J","Gamberini, M; Bolliger, D; Buse, GAL; Burkhart, CS; Grapow, M; Gagneux, A; Filipovic, M; Seeberger, MD; Pargger, H; Siegemund, M; Carrel, T; Seiler, WO; Berres, M; Strebel, SP; Monsch, AU; Steiner, LA","","","","Gamberini, Melanie; Bolliger, Daniel; Buse, Giovanna A. Lurati; Burkhart, Christoph S.; Grapow, Martin; Gagneux, Alexa; Filipovic, Miodrag; Seeberger, Manfred D.; Pargger, Hans; Siegemund, Martin; Carrel, Thierry; Seiler, Walter O.; Berres, Manfred; Strebel, Stephan P.; Monsch, Andreas U.; Steiner, Luzius A.","","","Rivastigmine for the prevention of postoperative delirium in elderly patients undergoing elective cardiac surgery-A randomized controlled trial","CRITICAL CARE MEDICINE","","","English","Article","","","","","","delirium; cardiac surgical procedures; cardiopulmonary bypass; prevention; rivastigmine; randomized controlled trial","CONFUSION ASSESSMENT METHOD; INTENSIVE-CARE-UNIT; ALZHEIMERS-DISEASE; ANTICHOLINERGIC DRUGS; CAM-ICU; DONEPEZIL; PHARMACODYNAMICS; PHARMACOKINETICS; BYPASS; RISK","Objective. Cardiac surgery is frequently followed by postoperative delirium, which is associated with increased 1-year mortality, late cognitive deficits, and higher costs. Currently, there are no recommendations for pharmacologic prevention of postoperative delirium. Impaired cholinergic transmission is believed to play an important role in the development of delirium. We tested the hypothesis that prophylactic short-term administration of oral rivastigmine, a cholinesterase inhibitor, reduces the incidence of delirium in elderly patients during the first 6 days after elective cardiac surgery. Design: Double-blind, randomized, placebo-controlled trial. Setting. One Swiss University Hospital. Patients: One hundred twenty patients aged 65 or older undergoing elective cardiac surgery with cardiopulmonary bypass. Intervention: Patients were randomly assigned to receive either placebo or 3 doses of 1.5 mg of oral rivastigmine per day starting the evening before surgery and continuing until the evening of the sixth postoperative day. Measurements and Main Results. The primary predefined outcome was delirium diagnosed with the Confusion Assessment Method within 6 days postoperatively. Secondary outcome measures were the results of daily Mini-Mental State Examinations and clock drawing tests, and the use of a rescue treatment consisting of haloperidol and/or lorazepam in patients with delirium. Delirium developed in 17 of 57 (30%) and 18 of 56 (32%) patients in the placebo and rivastigmine groups, respectively (P = 0.8). There was no treatment effect on the time course of Mini-Mental State Examinations and clock drawing tests (p = 0.4 and p = 0.8, respectively). There was no significant difference in the number of patients receiving haloperidol (18 of 57 and 17 of 56, p = 0.9) or lorazepam (38 of 57 and 35 of 56, p = 0.6) in the placebo and rivastigmine groups, respectively. Conclusion: This negative or, because of methodologic issues, possibly failed trial does not support short-term prophylactic administration of oral rivastigmine to prevent postoperative delirium in elderly patients undergoing elective cardiac surgery with cardiopulmonary bypass. (Crit Care Med 2009; 37:1762-1768)","[Steiner, Luzius A.] Univ Lausanne Hosp, Dept Anesthesiol, Lausanne, Switzerland; [Gamberini, Melanie; Bolliger, Daniel; Buse, Giovanna A. Lurati; Burkhart, Christoph S.; Filipovic, Miodrag; Seeberger, Manfred D.; Pargger, Hans; Siegemund, Martin; Strebel, Stephan P.] Univ Basel Hosp, Dept Anesthesia, CH-4031 Basel, Switzerland; [Grapow, Martin; Carrel, Thierry] Univ Basel Hosp, Div Cardiac Surg, CH-4031 Basel, Switzerland; [Gagneux, Alexa; Monsch, Andreas U.] Univ Basel Hosp, Memory Clin, CH-4031 Basel, Switzerland; [Seiler, Walter O.] Univ Basel Hosp, Geriatr Unit, CH-4031 Basel, Switzerland; [Berres, Manfred] Univ Appl Sci Koblenz, Remagen, Germany","University of Lausanne; Centre Hospitalier Universitaire Vaudois (CHUV); University of Basel; University of Basel; University of Basel; University of Basel","Steiner, LA (通讯作者)，Univ Lausanne Hosp, Dept Anesthesiol, Lausanne, Switzerland.","lsteiner@uhbs.ch","Steiner, Luzius/C-9836-2011; Filipovic, Miodrag/HTL-3980-2023; Monsch, Andreas/HGU-8171-2022; Steiner, Luzius/J-1987-2019; Carrel, Thierry/AAI-5910-2021; Siegemund, Martin/AAM-8929-2020; Burkhart, Christoph/GXG-3932-2022; Buse, Giovanna Lurati/ABE-6008-2020; Monsch, Andreas U/C-8309-2019; Seeberger, Manfred D/J-2847-2019","Steiner, Luzius/0000-0002-1437-3532; Siegemund, Martin/0000-0002-2013-4140; Burkhart, Christoph/0000-0002-9288-117X; Buse, Giovanna Lurati/0000-0002-8076-5737; Monsch, Andreas U/0000-0003-1692-1560; Seeberger, Manfred/0000-0002-2358-7233; Bolliger, Daniel/0000-0003-4094-448X","Novartis Switzerland; Society for Research in Anesthesia and Critical Care Medicine of the Department of Anesthesia, University Hospital Basel, Basel, Switzerland","Novartis Switzerland; Society for Research in Anesthesia and Critical Care Medicine of the Department of Anesthesia, University Hospital Basel, Basel, Switzerland","Supported, in part, by an unrestricted research grant from Novartis Switzerland and the Society for Research in Anesthesia and Critical Care Medicine of the Department of Anesthesia, University Hospital Basel, Basel, Switzerland. This was an investigator-initiated trial. The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Dr. Steiner received honoraria and grants from Novartis. Dr. Berres has stock ownership in Novartis. The remaining authors have not disclosed any potential conflicts of interest.","",31,162,167,1,28,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0090-3493","1530-0293","","CRIT CARE MED","Crit. Care Med.","MAY",2009,37,5,"","","","",1762,1768,"","10.1097/CCM.0b013e31819da780","http://dx.doi.org/10.1097/CCM.0b013e31819da780","","",7,"Critical Care Medicine","Science Citation Index Expanded (SCI-EXPANDED)","General & Internal Medicine","435UN",19325490,"","","","2023-11-07","WOS:000265368900031","View Full Record in Web of Science"]
["J","Koster, S; Hensens, AG; van der Palen, J","","","","Koster, Sandra; Hensens, Ab G.; van der Palen, Job","","","The Long-Term Cognitive and Functional Outcomes of Postoperative Delirium After Cardiac Surgery","ANNALS OF THORACIC SURGERY","","","English","Article","","","","","","","OLDER; RISK; DEPRESSION; PREDICTORS; ANXIETY","Background. Delirium or acute confusion is a temporary mental disorder, which occurs frequently among hospitalized elderly patients. Patients who undergo cardiac surgery have an increased risk of developing delirium. This is associated with many negative consequences such as prolonged hospital stay, nursing home placement, and reduced cognitive and functional recovery. Methods. In this prospective follow-up study, a questionnaire was used 1 to 1.5 years after cardiac surgery in our earlier cohort of 112 patients who underwent elective cardiac surgery, of which 24 patients (21%) developed postoperative delirium as diagnosed by a single psychiatrist. Results. Postoperative delirium after cardiac surgery may be associated with increased mortality (12.5% in patients with delirium versus 4.5% in patients without delirium; p = 0.16), more readmissions to the hospital (47.6% vs 32.6%; p = 0.19), dysfunction in memory (31.6% vs 22.6%; p = 0.39), and concentration problems (36.8% vs 20.2%; p = 0.13); and is associated with sleep disturbance (47.4% vs 23.8%; p = 0.03). Conclusions. Postoperative delirium after cardiac surgery may be associated with increased mortality and readmissions to the hospital, as well as poorer cognitive and functional outcomes. Therefore, prevention and (or) early recognition of delirium must be improved. In addition, patients and caregivers (family and general practitioner) must be better informed about the long-term consequences of delirium and what they can do about it.","Med Spectrum Twente, Dept Thorac Surg, Enschede, Netherlands; Med Spectrum Twente, Dept Epidemiol, Enschede, Netherlands","Medical Spectrum Twente; Medical Spectrum Twente","Koster, S (通讯作者)，Haaksbergerstr 55, NL-7500 KA Enschede, Netherlands.","s.koster@ziekenhuis-mst.nl","","van der Palen, Job/0000-0003-1071-6769","","","","",20,121,126,0,18,"ELSEVIER SCIENCE INC","NEW YORK","STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA","0003-4975","1552-6259","","ANN THORAC SURG","Ann. Thorac. Surg.","MAY",2009,87,5,"","","","",1469,1474,"","10.1016/j.athoracsur.2009.02.080","http://dx.doi.org/10.1016/j.athoracsur.2009.02.080","","",6,"Cardiac & Cardiovascular Systems; Respiratory System; Surgery","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Cardiovascular System & Cardiology; Respiratory System; Surgery","434UH",19379886,"","","","2023-11-07","WOS:000265299100023","View Full Record in Web of Science"]
["J","Sieber, FE; Zakriya, KJ; Gottschalk, A; Blute, MR; Lee, HB; Rosenberg, PB; Mears, SC","","","","Sieber, Frederick E.; Zakriya, Khwaji J.; Gottschalk, Allan; Blute, Mary-Rita; Lee, Hochang B.; Rosenberg, Paul B.; Mears, Simon C.","","","Sedation Depth During Spinal Anesthesia and the Development of Postoperative Delirium in Elderly Patients Undergoing Hip Fracture Repair","MAYO CLINIC PROCEEDINGS","","","English","Article","","","","","","","ACUTE COGNITIVE DYSFUNCTION; CONFUSION ASSESSMENT METHOD; INTENSIVE-CARE-UNIT; BISPECTRAL INDEX; GENERAL-ANESTHESIA; INSTRUMENTAL ACTIVITIES; PSYCHIATRIC-ILLNESS; RISK-FACTORS; PROPOFOL; RECOVERY","OBJECTIVE: To determine whether limiting Intraoperative sedation depth during spinal anesthesia for hip fracture repair In elderly patients can decrease the prevalence of postoperative delirium. PATIENTS AND METHODS: We performed a double-blind, randomized controlled trial at an academic medical center of elderly patients (>= 65 years) without preoperative delirium or severe dementia who underwent hip fracture repair under spinal anesthesia with propofol sedation. Sedation depth was titrated using processed electroencephalography with the bispectral Index (BIS), and patients were randomized to receive either deep (BIS, approximately 50) or light (BIS, >= 80) sedation. Postoperative delirium was assessed as defined by Diagnostic and Statistical Manual of Mental Disorders (Third Edition Revised) criteria using the Confusion Assessment Method beginning at any time from the second day after surgery. RESULTS: From April 2, 2005, through October 30, 2008, a total of 114 patients were randomized. The prevalence of postoperative delirium was significantly lower In the light sedation group (11/57 [19%] vs 23/57 [40%] in the deep sedation group; P = .02), Indicating that I incident of delirium will be prevented for every 4.7 patients treated with light sedation. The mean +/- SD number of days of delirium during hospitalization was lower In the light sedation group than In the deep sedation group (0.5 +/- 1.5 days vs, 1.4 +/- 4.0 days; P = .01). CONCLUSION: The use of light propofol sedation decreased the prevalence of postoperative delirium by 50% compared with deep sedation. Limiting depth of sedation during spinal anesthesia Is a simple, safe, and cost-effective Intervention for preventing postoperative delirium in elderly patients that could be widely and readily adopted.","[Sieber, Frederick E.] Johns Hopkins Med Inst, Johns Hopkins Bayview Med Ctr, Dept Anesthesiol & Crit Care Med, Baltimore, MD 21224 USA; [Lee, Hochang B.; Rosenberg, Paul B.] Johns Hopkins Med Inst, Dept Psychiat & Behav Sci, Div Geriatr Psychiat & Neuropsychiat, Baltimore, MD 21224 USA","Johns Hopkins University; Johns Hopkins Medicine; Johns Hopkins University; Johns Hopkins Medicine","Sieber, FE (通讯作者)，Johns Hopkins Med Inst, Johns Hopkins Bayview Med Ctr, Dept Anesthesiol & Crit Care Med, 4940 Eastern Ave, Baltimore, MD 21224 USA.","fsieber1@jhmi.edu","","Lee, Hochang/0000-0001-8379-4018","NIA NIH HHS [K08 AG029157] Funding Source: Medline","NIA NIH HHS(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","","",61,249,263,0,19,"ELSEVIER SCIENCE INC","NEW YORK","STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA","0025-6196","1942-5546","","MAYO CLIN PROC","Mayo Clin. Proc.","JAN",2010,85,1,"","","","",18,26,"","10.4065/mcp.2009.0469","http://dx.doi.org/10.4065/mcp.2009.0469","","",9,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","General & Internal Medicine","537ZV",20042557,"Green Published","","","2023-11-07","WOS:000273154300004","View Full Record in Web of Science"]
["J","Ansaloni, L; Catena, F; Chattat, R; Fortuna, D; Franceschi, C; Mascitti, P; Melotti, RM","","","","Ansaloni, L.; Catena, F.; Chattat, R.; Fortuna, D.; Franceschi, C.; Mascitti, P.; Melotti, R. M.","","","Risk factors and incidence of postoperative delirium in elderly patients after elective and emergency surgery","BRITISH JOURNAL OF SURGERY","","","English","Article","","","","","","","MENTAL STATUS QUESTIONNAIRE","Background: This study evaluated the incidence of postoperative delirium (POD) in elderly patients undergoing general surgery, the risk factors associated with POD, and its impact on hospital stay and mortality. Methods: Patients aged over 65 years who had emergency or elective operations were eligible for this case-control study. Risk factors significantly associated with POD using univariable analysis were entered into multivariable analysis, to establish those independently associated with POD. Results: A total of 351 patients (357 admissions) were enrolled in the study. The incidence of POD was 13.2 percent (17.9 percent for emergency operations). Independent variables associated with POD were: age above 75 years, co-morbidity, preoperative cognitive impairment, psychopathological symptoms and abnormal glycaemic control. Median length of hospital stay was 21 (range 1-75) days for patients with POD versus 8 (range 1-79) days for control patients (P < 0.001). The hospital mortality rate was 19 and 8.4 per cent respectively (P = 0.021). Conclusion: The incidence of POD is high in elderly patients for both emergency and elective surgery, leading to an increase in hospital stay and perioperative mortality. To minimize POD, associated risk factors of co-morbidity, cognitive impairment, psychopathology and abnormal glycaemic control must be identified and treated.","[Ansaloni, L.; Catena, F.] St Orsola Malpighi Univ Hosp, Unit Gen Emergency & Transplant Surg, I-40138 Bologna, Italy; [Mascitti, P.; Melotti, R. M.] St Orsola Malpighi Univ Hosp, Unit Anaesthesiol, I-40138 Bologna, Italy; [Chattat, R.; Melotti, R. M.] Univ Bologna, Dept Psychol, Bologna, Italy; [Franceschi, C.] Univ Bologna, Dept Expt Pathol, I-40126 Bologna, Italy; [Fortuna, D.] Agcy Hlth & Social Care Emilia Romagna, Bologna, Italy","IRCCS Azienda Ospedaliero-Universitaria di Bologna; IRCCS Azienda Ospedaliero-Universitaria di Bologna; University of Bologna; University of Bologna","Ansaloni, L (通讯作者)，St Orsola Malpighi Univ Hosp, Unit Gen Emergency & Transplant Surg, Via Massarenti 9, I-40138 Bologna, Italy.","luca.ansaloni@aosp.bo.it","Franceschi, Claudio/L-4484-2017; Ansaloni, Luca/AAP-9134-2020; Fortuna, Daniela/HOC-6976-2023; Melotti, Rita MGiuditta19aria/AAC-5989-2021","Franceschi, Claudio/0000-0001-9841-6386; Ansaloni, Luca/0000-0001-6427-0307; Melotti, Rita MGiuditta19aria/0000-0001-6258-6607; fortuna, daniela/0000-0003-0927-7199; Chattat, Rabih/0000-0002-3889-2839","Department of Surgery, St Orsola-Malpighi University Hospital of Bologna","Department of Surgery, St Orsola-Malpighi University Hospital of Bologna","This study was funded entirely by the Department of Surgery, St Orsola-Malpighi University Hospital of Bologna. The authors declare no conflict of interest.","",32,201,216,0,24,"WILEY","HOBOKEN","111 RIVER ST, HOBOKEN 07030-5774, NJ USA","0007-1323","1365-2168","","BRIT J SURG","Br. J. Surg.","FEB",2010,97,2,"","","","",273,280,"","10.1002/bjs.6843","http://dx.doi.org/10.1002/bjs.6843","","",8,"Surgery","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Surgery","550AN",20069607,"Bronze","","","2023-11-07","WOS:000274098100021","View Full Record in Web of Science"]
["J","Larsen, KA; Kelly, SE; Stern, TA; Bode, RH; Price, LL; Hunter, DJ; Gulczynski, D; Bierbaum, BE; Sweeney, GA; Hoikala, KA; Cotter, JJ; Potter, AW","","","","Larsen, Kenneth A.; Kelly, Susan E.; Stern, Theodore A.; Bode, Robert H., Jr.; Price, Lori Lyn; Hunter, David J.; Gulczynski, Diane; Bierbaum, Benjamin E.; Sweeney, Gerard A.; Hoikala, Karen A.; Cotter, James J.; Potter, Adam W.","","","Administration of Olanzapine to Prevent Postoperative Delirium in Elderly Joint-Replacement Patients: A Randomized, Controlled Trial","PSYCHOSOMATICS","","","English","Article","","","","","","","CONFUSION ASSESSMENT METHOD; RISK-FACTORS; HALOPERIDOL PROPHYLAXIS; HIP FRACTURE; SURGERY; CARE; POPULATION; DONEPEZIL; COSTS","Background: Delirium is a serious postoperative condition for which few pharmacologic prevention trials have been conducted. Objective: The authors tested the efficacy of perioperative olanzapine administration to prevent postoperative delirium in elderly patients after joint-replacement surgery. Method: The authors conducted a randomized, double-blind, placebo-controlled, prophylaxis trial at an orthopedic teaching hospital, enrolling 495 elderly patients age >= 65 years, who were undergoing elective knee-or hip-replacement surgery; 400 patients received either 5 mg of orally-disintegrating olanzapine or placebo just before and after surgery. The primary efficacy outcome was the incidence of (DSM-III-R) delirium. Results: The incidence of delirium was significantly lower in the olanzapine group than in the placebo group; this held true for both knee-and hip-replacement surgery. However, delirium lasted longer and was more severe in the olanzapine group. Advanced age, a high level of medical comorbidity, an abnormal albumin level, and having knee-replacement surgery were independent risk factors for postoperative delirium (Clinicaltrials.gov Identifier: NCT000699946). Conclusion: Administration of 10 mg of oral olanzapine perioperatively, versus placebo, was associated with a significantly lower incidence of delirium. These findings suggest that olanzapine prophylaxis of postoperative delirium may be an effective strategy. (Psychosomatics 2010; 51: 409-418)","New England Baptist Hosp, Dept Med, Boston, MA USA; New England Baptist Hosp, Dept Anesthesiol, Boston, MA USA; New England Baptist Hosp, Dept Res, Boston, MA USA; New England Baptist Hosp, Dept Orthoped, Boston, MA USA; New England Baptist Hosp, Dept Nursing, Boston, MA USA; New England Baptist Hosp, Dept Pharm, Boston, MA USA; New England Baptist Hosp, Dept Adm, Boston, MA USA; [Kelly, Susan E.] Beth Israel Deaconess Med Ctr, Dept Gastroenterol, Boston, MA 02215 USA; Tufts Med Ctr, Dept Med, Boston, MA USA; Massachusetts Gen Hosp, Dept Stat Anal, Boston, MA 02114 USA; Massachusetts Gen Hosp, Dept Psychiat, Boston, MA 02114 USA","New England Baptist Hospital; New England Baptist Hospital; New England Baptist Hospital; New England Baptist Hospital; New England Baptist Hospital; New England Baptist Hospital; New England Baptist Hospital; Harvard University; Beth Israel Deaconess Medical Center; Tufts Medical Center; Harvard University; Massachusetts General Hospital; Harvard University; Massachusetts General Hospital","Kelly, SE (通讯作者)，Beth Israel Deaconess Med Ctr, Dept Gastroenterol, 110 Francis St,8th Floor, Boston, MA 02215 USA.","skelly@bidmc.harvard.edu","Hunter, David J/A-4622-2010; Stern, Theodore/JEZ-4584-2023; Larsen, Kenneth/HDO-5510-2022; Potter, Adam W/D-9893-2014","Hunter, David J/0000-0003-3197-752X; Stern, Theodore/0000-0001-7866-0752; Price, Lori Lyn/0000-0003-0664-8978; Potter, Adam/0000-0003-4980-8353","New England Baptist Hospital Research Department","New England Baptist Hospital Research Department","This study was made possible by a grant from the New England Baptist Hospital Research Department. The sponsor supplied the olanzapine and retained the study data; however, it had no other role in the study design; in the collection, analysis, and interpretation of the study; in the writing of the report; or in the decision to submit the paper for publication.","",40,150,159,0,10,"ELSEVIER SCIENCE INC","NEW YORK","360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA","0033-3182","","","PSYCHOSOMATICS","Psychosomatics","SEP-OCT",2010,51,5,"","","","",409,418,"","","","","",10,"Psychiatry; Psychology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Psychiatry; Psychology","649AF",20833940,"","","","2023-11-07","WOS:000281736600007","View Full Record in Web of Science"]
["J","Brouquet, A; Cudennec, T; Benoist, S; Moulias, S; Beauchet, A; Penna, C; Teillet, L; Nordlinger, B","","","","Brouquet, Antoine; Cudennec, Tristan; Benoist, Stephane; Moulias, Sophie; Beauchet, Alain; Penna, Christophe; Teillet, Laurent; Nordlinger, Bernard","","","Impaired Mobility, ASA Status and Administration of Tramadol are Risk Factors for Postoperative Delirium in Patients Aged 75 Years or More After Major Abdominal Surgery","ANNALS OF SURGERY","","","English","Article","","","","","","","COGNITIVE DYSFUNCTION; ELDERLY-PATIENTS; CARCINOMA; VALIDATION; CANCER","Objective: The aim of this prospective study was to determine incidence, duration, and risk factors for postoperative delirium (PD) in elderly patients undergoing major abdominal surgery. Summary Background Data: The incidence and risk factors of PD after major abdominal surgery in elderly patients are not well documented. Methods: From May 2006 to May 2008, 118 patients aged 75 years or more without severe preoperative cognitive dysfunction (mini mental state examination score >10/30) and undergoing major elective abdominal surgery were included. The preoperative geriatric assessment battery consisted of 4 tests evaluating physical (instrumental activities of daily living and timed get up and go test score) and cognitive function (mini mental state examination score), and detecting the presence of an underlying depression (Short-GDS). After the operation, geriatric patients were assessed for PD by the Confusion Assessment Method. Univariate and multivariate analyses were used to determine risk factors for PD. Results: Overall, PD occurred in 28 patients (24%). Multivariate analysis showed that an American Society of Anesthesiologists status of 3-4 (P = 0.02), impaired mobility (timed get up and go test score >20 seconds) (P = 0.009) and postoperative tramadol administration (P = 0.0009) were risk factors for PD. The mortality rate was 14% in 28 patients with PD and 3.3% in 90 patients without PD (P = 0.051). The morbidity rate was 35.5% in 28 patients with PD and 32% in 90 patients without PD (NS). The mean hospital stay was 19 +/- 11 days for patients with PD and 14 +/- 8 for patients without PD (P = 0.01). Fifteen of 24 (62.5%) surviving patients with PD and 28 of 87 (32%) surviving patients without PD were discharged to geriatric rehabilitation unit (P = 0.007). Conclusions: PD is a frequent and severe postoperative event in elderly patients after major abdominal surgery. A perioperative geriatric assessment should be recommended to patients with an American Society of Anesthesiologists status of 3-4 and preoperative impaired mobility to facilitate the management of PD. In these patients, the postoperative administration of tramadol should be avoided.","[Nordlinger, Bernard] Hop Ambroise Pare, Serv Chirurg Gen & Digest, AP HP, Dept Surg, F-92104 Boulogne, France; [Brouquet, Antoine; Cudennec, Tristan; Benoist, Stephane; Moulias, Sophie; Beauchet, Alain; Penna, Christophe; Teillet, Laurent; Nordlinger, Bernard] Univ Versailles St Quentin Yvelines, Versailles, France; [Cudennec, Tristan; Moulias, Sophie; Teillet, Laurent] Hop Ambroise Pare, AP HP, Dept Gerontol, F-92104 Boulogne, France; [Beauchet, Alain] Hop Ambroise Pare, AP HP, Dept Biostat, F-92104 Boulogne, France","Assistance Publique Hopitaux Paris (APHP); Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Ambroise-Pare - APHP; Universite Paris Cite; Hopital Universitaire Hotel-Dieu - APHP; Universite Paris Saclay; Assistance Publique Hopitaux Paris (APHP); Universite Paris Cite; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Paul-Brousse - APHP; Hopital Universitaire Ambroise-Pare - APHP; Assistance Publique Hopitaux Paris (APHP); Universite Paris Cite; Hopital Universitaire Hotel-Dieu - APHP; Hopital Universitaire Ambroise-Pare - APHP; Hopital Universitaire Paul-Brousse - APHP","Nordlinger, B (通讯作者)，Hop Ambroise Pare, Serv Chirurg Gen & Digest, AP HP, Dept Surg, 9 Ave Charles de Gaulle, F-92104 Boulogne, France.","bernard.nordlinger@apr.aphp.fr","Brouquet, Antoine/Q-3813-2018","Brouquet, Antoine/0000-0003-0536-3030","AROLD association","AROLD association","Supported by grants from the AROLD association.","",40,141,151,0,12,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-4932","1528-1140","","ANN SURG","Ann. Surg.","APR",2010,251,4,"","","","",759,765,"","10.1097/SLA.0b013e3181c1cfc9","http://dx.doi.org/10.1097/SLA.0b013e3181c1cfc9","","",7,"Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Surgery","580QS",20224380,"","","","2023-11-07","WOS:000276464900028","View Full Record in Web of Science"]
["J","Plaschke, K; Fichtenkamm, P; Schramm, C; Hauth, S; Martin, E; Verch, M; Karck, M; Kopitz, J","","","","Plaschke, Konstanze; Fichtenkamm, Philipp; Schramm, Christoph; Hauth, Steffen; Martin, Eike; Verch, Markus; Karck, Matthias; Kopitz, Juergen","","","Early postoperative delirium after open-heart cardiac surgery is associated with decreased bispectral EEG and increased cortisol and interleukin-6","INTENSIVE CARE MEDICINE","","","English","Article","","","","","","Delirium; Open-heart cardiac surgery; Cortisol; Interleukin-6; Bispectral (BIS) EEG","INTENSIVE-CARE-UNIT; SEDATION; DYSFUNCTION; BIOMARKERS","It is difficult to substantiate the clinical diagnosis of postoperative delirium with objective parameters in intensive care units (ICU). The purpose of this study was to analyze (1) whether the bilateral bispectral (BIS) index, (2) cortisol as a stress marker, and (3) interleukin-6 as a marker of inflammation were different in delirious patients as compared to nondelirious ones after cardiac surgery. On the first postoperative day, delirium was analyzed in 114 patients by using the confusion assessment method for ICU (CAM-ICU). Bilateral BIS data were determined; immediately thereafter plasma samples were drawn to analyze patients' blood characteristics. The current ICU medication, hemodynamic characteristics, SOFA and APACHE II scores, and artificial ventilation were noted. Delirium was detected at 19.1 +/- A 4.8 h after the end of surgery in 32 of 114 patients (28%). Delirious patients were significantly older than nondelirious ones and were artificially ventilated 4.7-fold more often during the testing. In delirious patients, plasma cortisol and interleukin-6 levels were higher (p = 0.01). The mean BIS index was significantly lower in delirious patients (72.6 (69.6-89.1); median [interquartile range (IQR), 25th-75th percentiles] than in nondelirious patients, 84.8 (76.8-89.9). BIS EEG raw data analysis detected significant lower relative alpha and higher theta power. A significant correlation was found between plasma cortisol levels and BIS index. Early postoperative delirium after cardiac surgery was characterized by increased stress levels and inflammatory reaction. BIS index measurements showed lower cortical activity in delirious patients with a low sensitivity (27%) and high specificity (96%).","[Plaschke, Konstanze; Fichtenkamm, Philipp; Schramm, Christoph; Hauth, Steffen; Martin, Eike] Heidelberg Univ, Dept Anesthesiol, D-69120 Heidelberg, Germany; [Kopitz, Juergen] Heidelberg Univ, Dept Pathol, D-69120 Heidelberg, Germany; [Verch, Markus; Karck, Matthias] Heidelberg Univ, Dept Cardiac Surg, D-69120 Heidelberg, Germany","Ruprecht Karls University Heidelberg; Ruprecht Karls University Heidelberg; Ruprecht Karls University Heidelberg","Plaschke, K (通讯作者)，Heidelberg Univ, Dept Anesthesiol, Neuenheimer Feld 110, D-69120 Heidelberg, Germany.","konstanze.plaschke@med.uni-heidelberg.de","Schramm, Christoph/X-6915-2019","Schramm, Christoph/0000-0003-1081-5556","","","","",39,130,142,0,15,"SPRINGER","NEW YORK","233 SPRING ST, NEW YORK, NY 10013 USA","0342-4642","1432-1238","","INTENS CARE MED","Intensive Care Med.","DEC",2010,36,12,"","","","",2081,2089,"","10.1007/s00134-010-2004-4","http://dx.doi.org/10.1007/s00134-010-2004-4","","",9,"Critical Care Medicine","Science Citation Index Expanded (SCI-EXPANDED)","General & Internal Medicine","680ZK",20689917,"","","","2023-11-07","WOS:000284275800014","View Full Record in Web of Science"]
["J","Burkhart, CS; Dell-Kuster, S; Gamberini, M; Moeckli, A; Grapow, M; Filipovic, M; Seeberger, MD; Monsch, AU; Strebel, SP; Steiner, LA","","","","Burkhart, Christoph S.; Dell-Kuster, Salome; Gamberini, Melanie; Moeckli, Ariane; Grapow, Martin; Filipovic, Miodrag; Seeberger, Manfred D.; Monsch, Andreas U.; Strebel, Stephan P.; Steiner, Luzius A.","","","Modifiable and Nonmodifiable Risk Factors for Postoperative Delirium After Cardiac Surgery With Cardiopulmonary Bypass","JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA","","","English","Article","","","","","","delirium; cardiac surgical procedures; risk factors; fentanyl; mechanical ventilation","CONFUSION ASSESSMENT METHOD; INTENSIVE-CARE UNIT; GRAFT-SURGERY; PREDICTORS; COMPLICATIONS; INFLAMMATION; MEDICATIONS; EXTUBATION; SYSTEM","Objectives: Postoperative delirium after cardiac surgery is associated with increased morbidity and mortality as well as prolonged stay in both the intensive care unit and the hospital. The authors sought to identify modifiable risk factors associated with the development of postoperative delirium in elderly patients after elective cardiac surgery in order to be able to design follow-up studies aimed at the prevention of delirium by optimizing perioperative management. Design: A post hoc analysis of data from patients enrolled in a randomized controlled trial was performed. Setting: A single university hospital. Participants: One hundred thirteen patients aged 65 or older undergoing elective cardiac surgery with cardiopulmonary bypass. Interventions: None. Measurements and Mains Results: Screening for delirium was performed using the Confusion Assessment Method (CAM) on the first 6 postoperative days. A multivariable logistic regression model was developed to identify significant risk factors and to control for confounders. Delirium developed in 35 of 113 patients (30%). The multivariable model showed the maximum value of C-reactive protein measured postoperatively, the dose of fentanyl per kilogram of body weight administered intraoperatively, and the duration of mechanical ventilation to be independently associated with delirium. Conclusions: In this post hoc analysis, larger doses of fentanyl administered intraoperatively and longer duration of mechanical ventilation were associated with postoperative delirium in the elderly after cardiac surgery. Prospective randomized trials should be performed to test the hypotheses that a reduced dose of fentanyl administered intraoperatively, the use of a different opioid, or weaning protocols aimed at early extubation prevent delirium in these patients. (C) 2010 Elsevier Inc. All rights reserved.","[Burkhart, Christoph S.; Dell-Kuster, Salome; Gamberini, Melanie; Moeckli, Ariane; Filipovic, Miodrag; Seeberger, Manfred D.; Strebel, Stephan P.; Steiner, Luzius A.] Univ Basel Hosp, Dept Anesthesia & Intens Care Med, CH-4031 Basel, Switzerland; [Grapow, Martin] Univ Basel Hosp, Div Cardiac Surg, CH-4031 Basel, Switzerland; [Steiner, Luzius A.] Univ Hosp Ctr, Dept Anaesthesia, Lausanne, Switzerland; [Steiner, Luzius A.] Univ Lausanne, Lausanne, Switzerland","University of Basel; University of Basel; University of Lausanne","Burkhart, CS (通讯作者)，Univ Basel Hosp, Dept Anesthesia & Intens Care Med, CH-4031 Basel, Switzerland.","cburkhart@uhbs.ch","Monsch, Andreas U/C-8309-2019; Filipovic, Miodrag/HTL-3980-2023; Steiner, Luzius/J-1987-2019; Burkhart, Christoph/GXG-3932-2022; Dell-Kuster, Salome/H-4259-2017; Monsch, Andreas/HGU-8171-2022; Dell-Kuster, Salome/P-2653-2019; Seeberger, Manfred D/J-2847-2019; Steiner, Luzius/C-9836-2011","Monsch, Andreas U/0000-0003-1692-1560; Steiner, Luzius/0000-0002-1437-3532; Burkhart, Christoph/0000-0002-9288-117X; Dell-Kuster, Salome/0000-0001-7219-7138; Dell-Kuster, Salome/0000-0001-7219-7138; Seeberger, Manfred/0000-0002-2358-7233","Novartis Switzerland; Society for Research in Anesthesia and Critical Care Medicine of the Department of Anesthesia and Intensive Care Medicine, University Hospital Basel, Basel, Switzerland","Novartis Switzerland; Society for Research in Anesthesia and Critical Care Medicine of the Department of Anesthesia and Intensive Care Medicine, University Hospital Basel, Basel, Switzerland","Supported in part by an unrestricted research grant from Novartis Switzerland and the Society for Research in Anesthesia and Critical Care Medicine of the Department of Anesthesia and Intensive Care Medicine, University Hospital Basel, Basel, Switzerland.","",35,98,103,0,13,"W B SAUNDERS CO-ELSEVIER INC","PHILADELPHIA","1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA","1053-0770","1532-8422","","J CARDIOTHOR VASC AN","J. Cardiothorac. Vasc. Anesth.","AUG",2010,24,4,"","","","",555,559,"","10.1053/j.jvca.2010.01.003","http://dx.doi.org/10.1053/j.jvca.2010.01.003","","",5,"Anesthesiology; Cardiac & Cardiovascular Systems; Respiratory System; Peripheral Vascular Disease","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology; Cardiovascular System & Cardiology; Respiratory System","636IS",20227891,"","","","2023-11-07","WOS:000280726000004","View Full Record in Web of Science"]
["J","Radtke, FM; Franck, M; MacGuill, M; Seeling, M; Lütz, A; Westhoff, S; Neumann, U; Wernecke, KD; Spies, CD","","","","Radtke, Finn M.; Franck, Martin; MacGuill, Martin; Seeling, Matthes; Luetz, Alawi; Westhoff, Sarah; Neumann, Ulf; Wernecke, Klaus D.; Spies, Claudia D.","","","Duration of fluid fasting and choice of analgesic are modifiable factors for early postoperative delirium","EUROPEAN JOURNAL OF ANAESTHESIOLOGY","","","English","Article","","","","","","analgesia; delirium; fasting","COGNITIVE DYSFUNCTION; INTERVENTION PROGRAM; ELDERLY-PATIENTS; RECOVERY ROOM; RISK; GUIDELINES; SURGERY","Background and objective Most therapeutic options for postoperative delirium are only symptom oriented; therefore, the best approach remains prevention. The aim of this study was to identify predisposing and precipitating factors for early postoperative delirium. Methods A total of 1002 patients were screened for delirium in an observational, cohort study. Nine hundred and ten patients were observed in the recovery room and 862 patients on the first postoperative day in the ward at the Charite - Universitaetsmedizin, Berlin. Delirium was measured with the nursing delirium screening scale. Risk factors were analysed in a multivariate analysis. Results Delirium was seen in 11.0% of the patients in the recovery room and in 4.2% of the patients on the ward. Delirium in the recovery room was associated with delirium on the ward (McNemar's test P = <0.001). Apart from age and site of surgery, we found the duration of preoperative fluid fasting to be a modifiable precipitating factor for delirium in the recovery room (odds ratio 2.69, 95% confidence interval 1.4-5.2) and on the ward (odds ratio 10.57, 95% confidence interval 1.4-78.6) and the choice of intraoperative opioid for delirium on the ward (odds ratio 2.27, 95% confidence interval 1.0-5.1). Conclusion Duration of preoperative fluid fasting and the choice of intraoperative analgesic are risk factors for postoperative delirium, and their modification provides a promising approach to reduce the incidence of postoperative delirium. Eur J Anaesthesiol 2010;27:411-416","[Radtke, Finn M.; Franck, Martin; MacGuill, Martin; Seeling, Matthes; Luetz, Alawi; Westhoff, Sarah; Spies, Claudia D.] Charite, Dept Anesthesiol & Surg Intens Care Med, D-10117 Berlin, Germany; [Wernecke, Klaus D.] Sostana GmbH, Berlin, Germany; [Neumann, Ulf] Charite, Dept Gen Abdominal & Transplant Surg, D-10117 Berlin, Germany","Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Sostana GmbH; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin","Spies, CD (通讯作者)，Charite, Dept Anesthesiol & Surg Intens Care Med, Charitepl 1, D-10117 Berlin, Germany.","claudia.spies@charite.de","","Spies, Claudia/0000-0002-1062-0495; Radtke, Finn M./0000-0001-5260-5384; Luetz, Alawi/0000-0001-8814-1809","Charite - Universitaetsmedizin Berlin, Berlin","Charite - Universitaetsmedizin Berlin, Berlin","The study was supported by a grant from Charite - Universitaetsmedizin Berlin, Berlin.","",20,95,102,0,17,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0265-0215","1365-2346","","EUR J ANAESTH","Eur. J. Anaesth.","MAY",2010,27,5,"","","","",411,416,"","10.1097/EJA.0b013e3283335cee","http://dx.doi.org/10.1097/EJA.0b013e3283335cee","","",6,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Anesthesiology","581VL",19887950,"Bronze","","","2023-11-07","WOS:000276552900003","View Full Record in Web of Science"]
["J","Rudolph, JL; Marcantonio, ER","","","","Rudolph, James L.; Marcantonio, Edward R.","","","Postoperative Delirium: Acute Change with Long-Term Implications","ANESTHESIA AND ANALGESIA","","","English","Article","","","","","","","CONFUSION ASSESSMENT METHOD; INTENSIVE-CARE-UNIT; MECHANICALLY VENTILATED PATIENTS; PATIENT-CONTROLLED ANALGESIA; CRITICALLY-ILL PATIENTS; RISK-FACTORS; ELDERLY-PATIENTS; CARDIAC-SURGERY; COGNITIVE DYSFUNCTION; PRECIPITATING FACTORS","Delirium is an acute change in cognition and attention, which may include alterations in consciousness and disorganized thinking. Although delirium may affect any age group, it is most common in older patients, especially those with preexisting cognitive impairment. Patients with delirium after surgery recover more slowly than those without delirium and, as a result, have increased length of stay and hospital costs. The measured incidence of postoperative delirium varies with the type of surgery, the urgency of surgery, and the type and sensitivity of the delirium assessment. Although generally considered a short-term condition, delirium can persist for months and is associated with poor cognitive and functional outcomes beyond the immediate postoperative period. In this article, we provide a guide to assess delirium risk preoperatively and to prevent, diagnose, and treat this common and morbid condition. Care improvements such as identifying delirium risk preoperatively; training surgeons, anesthesiologists, and nurses to screen for delirium; implementing delirium prevention programs; and developing standardized delirium treatment protocols may reduce the risk of delirium and its associated morbidity. (Anesth Analg 2011; 112: 1202-11)","[Rudolph, James L.] VA Boston Healthcare Syst, GRECC, Boston, MA 02130 USA; [Rudolph, James L.] Brigham & Womens Hosp, Div Aging, Boston, MA 02115 USA; [Marcantonio, Edward R.] Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care & Gerontol, Boston, MA 02215 USA; [Rudolph, James L.; Marcantonio, Edward R.] Harvard Univ, Sch Med, Boston, MA USA","Geriatric Research Education & Clinical Center; US Department of Veterans Affairs; Veterans Health Administration (VHA); Harvard University; VA Boston Healthcare System; Harvard University; Brigham & Women's Hospital; Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Harvard Medical School","Rudolph, JL (通讯作者)，VA Boston Healthcare Syst, GRECC, 150 S Huntington Ave, Boston, MA 02130 USA.","jrudolph@partners.org","Marcantonio, Edward R/U-3929-2017","Marcantonio, Edward R/0000-0002-2911-4250","National Institute on Aging [K24 AG035075]","National Institute on Aging(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","Dr. Rudolph is the recipient of a VA Rehabilitation Research Career Development Award and Dr. Marcantonio is a recipient of a Mid-Career Investigator Award in patient-oriented research from the National Institute on Aging (K24 AG035075).","",105,337,374,0,32,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-2999","","","ANESTH ANALG","Anesth. Analg.","MAY",2011,112,5,"","","","",1202,1211,"","10.1213/ANE.0b013e3182147f6d","http://dx.doi.org/10.1213/ANE.0b013e3182147f6d","","",10,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Anesthesiology","753NI",21474660,"Green Accepted, Bronze","","","2023-11-07","WOS:000289785100031","View Full Record in Web of Science"]
["J","Robinson, TN; Raeburn, CD; Tran, ZV; Brenner, LA; Moss, M","","","","Robinson, Thomas N.; Raeburn, Christopher D.; Tran, Zung V.; Brenner, Lisa A.; Moss, Marc","","","Motor Subtypes of Postoperative Delirium in Older Adults","ARCHIVES OF SURGERY","","","English","Article","","","","","","","RISK-FACTORS; RELIABILITY; DISABILITY; VALIDITY; FRAILTY","Hypothesis: Increased knowledge about motor subtypes of delirium may aid clinicians in the management of postoperative geriatric patients. Design: Prospective cohort study defining preoperative risk factors, outcomes, and adverse events related to motor subtypes of postoperative delirium. Setting: Referral medical center. Patients: Persons 50 years and older with planned postoperative intensive care unit (ICU) admission following an elective operation were recruited. Main Outcome Measures: Before surgery, a standardized frailty assessment was performed. After surgery, delirium and its motor subtypes were measured using the validated tools of the Confusion Assessment Method-ICU and the Richmond Agitation-Sedation Scale. Statistical analysis included the univariate t and chi(2) tests and analysis of variance with post hoc analysis. Results: Delirium occurred in 43.0% (74 of 172) of patients, representing 67.6% (50 of 74) hypoactive, 31.1% (23 of 74) mixed, and 1.4% (1 of 74) hyperactive motor subtypes. Compared with those having mixed delirium, patients having hypoactive delirium were older (mean [SD] age, 71 [9] vs 65 [9] years) and more anemic (mean [SD] hematocrit, 36% [8%] vs 41% [6%]) (P=.002 for both). Patients with hypoactive delirium had higher 6-month mortality (32.0% [16 of 50] vs 8.7% [2 of 23], P=.04). Delirium-related adverse events occurred in 24.3% (18 of 74) of patients with delirium; inadvertent tube or line removals occurred more frequently in the mixed group (P=. 006), and sacral skin breakdown was more common in the hypoactive group (P=. 002). Conclusions: Motor subtypes of delirium alert clinicians to differing prognosis and adverse event profiles in postoperative geriatric patients. Hypoactive delirium is the most common motor subtype and is associated with worse prognosis (6-month mortality, 1 in 3 patients). Knowledge of differing adverse event profiles can modify clinicians' management of older patients with postoperative delirium.","[Robinson, Thomas N.; Raeburn, Christopher D.] Univ Colorado Denver, Sch Med, Dept Surg, Aurora, CO 80045 USA; [Tran, Zung V.] Univ Colorado Denver, Sch Med, Dept Prevent Med & Biometr, Aurora, CO 80045 USA; [Brenner, Lisa A.] Univ Colorado Denver, Sch Med, Dept Psychiat, Aurora, CO 80045 USA; [Brenner, Lisa A.] Univ Colorado Denver, Sch Med, Dept Phys Med & Rehabil, Aurora, CO 80045 USA; [Brenner, Lisa A.] Univ Colorado Denver, Sch Med, Dept Neurol, Aurora, CO 80045 USA; [Moss, Marc] Univ Colorado Denver, Sch Med, Dept Pulm Sci, Aurora, CO 80045 USA; [Robinson, Thomas N.; Raeburn, Christopher D.] Denver Vet Affairs VA Med Ctr, VA Rocky Mt Network, Dept Surg, Denver, CO USA; [Brenner, Lisa A.] Denver Vet Affairs VA Med Ctr, VA Rocky Mt Network, Mental Illness Res Educ & Clin Ctr, Denver, CO USA","University of Colorado System; University of Colorado Anschutz Medical Campus; Children's Hospital Colorado; University of Colorado System; University of Colorado Anschutz Medical Campus; Children's Hospital Colorado; University of Colorado System; University of Colorado Anschutz Medical Campus; Children's Hospital Colorado; Children's Hospital Colorado; University of Colorado System; University of Colorado Anschutz Medical Campus; Children's Hospital Colorado; University of Colorado System; University of Colorado Anschutz Medical Campus; Children's Hospital Colorado; University of Colorado System; University of Colorado Anschutz Medical Campus","Robinson, TN (通讯作者)，Univ Colorado Denver, Sch Med, Dept Surg, Mail Stop C313,12631 E 17th Ave, Aurora, CO 80045 USA.","thomas.robinson@ucdenver.edu","Brenner, Lisa A./AAG-2442-2019","Tran, Zung/0000-0002-9322-9562","American Geriatric Society; National Institutes of Health [K24-HL-089223]","American Geriatric Society; National Institutes of Health(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA)","Funding/Support: This work was supported by the Jahnigen Scholars Award from the American Geriatric Society (Dr Robinson) and by grant K24-HL-089223 from the National Institutes of Health (Dr Moss).","",26,143,154,2,11,"AMER MEDICAL ASSOC","CHICAGO","330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA","0004-0010","1538-3644","","ARCH SURG-CHICAGO","Arch. Surg.","MAR",2011,146,3,"","","","",295,300,"","10.1001/archsurg.2011.14","http://dx.doi.org/10.1001/archsurg.2011.14","","",6,"Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Surgery","738AI",21422360,"Green Accepted","","","2023-11-07","WOS:000288611300011","View Full Record in Web of Science"]
["J","Schoen, J; Meyerrose, J; Paarmann, H; Heringlake, M; Hueppe, M; Berger, KU","","","","Schoen, Julika; Meyerrose, Joscha; Paarmann, Hauke; Heringlake, Matthias; Hueppe, Michael; Berger, Klaus-Ulrich","","","Preoperative regional cerebral oxygen saturation is a predictor of postoperative delirium in on-pump cardiac surgery patients: a prospective observational trial","CRITICAL CARE","","","English","Article","","","","","","","INTENSIVE-CARE-UNIT; CONFUSION ASSESSMENT METHOD; MECHANICALLY VENTILATED PATIENTS; CRITICALLY-ILL PATIENTS; PRECIPITATING FACTORS; COGNITIVE FUNCTION; MOTORIC SUBTYPES; CAM-ICU; LEVOSIMENDAN; DYSFUNCTION","Introduction: Postoperative delirium is an important problem in patients undergoing major surgery. Cerebral oximetry is a non-invasive method to detect imbalances in the cerebral oxygen supply/demand-ratio. Low preoperative cerebral oxygen saturation (ScO2) levels have been associated with postoperative delirium in non-cardiac surgery patients. The present prospective observational study determines the relationship between pre- and intra-operative ScO2 levels and postoperative delirium in patients undergoing on-pump cardiac surgery. Methods: After approval of the local ethical committee and written informed consent, N = 231 patients scheduled for elective/urgent cardiac surgery were enrolled. Delirium was assessed by the confusion-assessment-method for the intensive care unit (CAM-ICU) on the first three days after surgery. ScO2 was obtained on the day before surgery, immediately before surgery and throughout the surgical procedure. Preoperative cognitive function, demographic, surgery related, and intra-and post-operative physiological data were registered. Results: Patients with delirium had lower pre- and intra-operative ScO2 readings, were older, had lower mini-mental-status-examination(MMSE) scores, higher additive EuroScore and lower preoperative haemoglobin-levels. The binary logistic regression identified older age, lower MMSE, neurological or psychiatric disease and lower preoperative ScO2 as independent predictors of postoperative delirium. Conclusions: The presented study shows that a low preoperative ScO2 is associated with postoperative delirium after on-pump cardiac surgery.","[Schoen, Julika; Meyerrose, Joscha; Paarmann, Hauke; Heringlake, Matthias; Hueppe, Michael; Berger, Klaus-Ulrich] Univ Lubeck, Dept Anaesthesiol, D-23538 Lubeck, Germany","University of Lubeck","Heringlake, M (通讯作者)，Univ Lubeck, Dept Anaesthesiol, Ratzeburger Allee 160, D-23538 Lubeck, Germany.","heringlake@t-online.de","Heringlake, Matthias/AAJ-8249-2020","","","","","",43,141,156,3,30,"BIOMED CENTRAL LTD","LONDON","236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND","1466-609X","","","CRIT CARE","Crit. Care","",2011,15,5,"","","","","","","R218","10.1186/cc10454","http://dx.doi.org/10.1186/cc10454","","",10,"Critical Care Medicine","Science Citation Index Expanded (SCI-EXPANDED)","General & Internal Medicine","929GB",21929765,"gold, Green Published","","","2023-11-07","WOS:000303048200014","View Full Record in Web of Science"]
["J","Whitlock, EL; Vannucci, A; Avidan, MS","","","","Whitlock, E. L.; Vannucci, A.; Avidan, M. S.","","","Postoperative delirium","MINERVA ANESTESIOLOGICA","","","English","Article","","","","","","Delirium; Postoperative complications; Intensive care units; Aging; Dementia","CONFUSION ASSESSMENT METHOD; ELDERLY-PATIENTS; RISK-FACTORS; DOUBLE-BLIND; ACUTE-CARE; ANESTHESIA; IMPACT; PREVENTION; MORTALITY; EFFICACY","Delirium is a common complication during the postoperative period. Because of its significant associations with physical and cognitive morbidity, clinicians should be aware of the evidence-based practices relating to its diagnosis, treatment, and prevention. Here, we review select recent literature pertaining to the epidemiology and impact of postoperative delirium, the perioperative risk factors for its development and/or exacerbation, and the strategies for its management, with additional attention paid to the population of patients in intensive care units. (Minerva Anestesiol 2011;77:448-56)","[Whitlock, E. L.; Vannucci, A.; Avidan, M. S.] Washington Univ, Sch Med, Dept Anesthesiol, St Louis, MO 63110 USA; [Whitlock, E. L.; Avidan, M. S.] Washington Univ, Sch Med, Div Cardiothorac Anesthesiol, St Louis, MO 63110 USA","Washington University (WUSTL); Washington University (WUSTL)","Avidan, MS (通讯作者)，Washington Univ, Sch Med, Dept Anesthesiol, Campus Box 8054,660 S Euclid Ave, St Louis, MO 63110 USA.","avidanm@anest.wustl.edu","Whitlock, Elizabeth/N-1860-2014","Whitlock, Elizabeth/0000-0002-6868-4301; Avidan, Michael/0000-0001-6248-044X; Vannucci, Andrea/0000-0002-7115-677X","National Center for Research Resources (NCRR), National Institutes of Health (NIH) [UL1 RR024992, TL1 RR024995]; NIH","National Center for Research Resources (NCRR), National Institutes of Health (NIH)(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Center for Research Resources (NCRR)); NIH(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA)","This publication was made possible by grant number UL1 RR024992 and sub-award number TL1 RR024995 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and the NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.","",59,138,151,2,12,"EDIZIONI MINERVA MEDICA","TURIN","CORSO BRAMANTE 83-85 INT JOURNALS DEPT., 10126 TURIN, ITALY","0375-9393","1827-1596","","MINERVA ANESTESIOL","Minerva Anestesiol.","APR",2011,77,4,"","","","",448,456,"","","","","",9,"Anesthesiology; Critical Care Medicine","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology; General & Internal Medicine","757XC",21483389,"","","","2023-11-07","WOS:000290120900009","View Full Record in Web of Science"]
["J","Siepe, M; Pfeiffer, T; Gieringer, A; Zemann, S; Benk, C; Schlensak, C; Beyersdorf, F","","","","Siepe, Matthias; Pfeiffer, Thomas; Gieringer, Andreas; Zemann, Silke; Benk, Christoph; Schlensak, Christian; Beyersdorf, Friedhelm","","","Increased systemic perfusion pressure during cardiopulmonary bypass is associated with less early postoperative cognitive dysfunction and delirium","EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY","","","English","Article; Proceedings Paper","24th Annual Meeting of the European-Association-for-Cardio-Thoracic-Surgery (EACTS)","SEP 11-15, 2010","Geneva, SWITZERLAND","European Assoc Cardio Thorac Surg (EACTS)","","Coronary artery bypass grafting; Cardiopulmonary bypass; Perfusion pressure; Postoperative cognitive dysfunction","OFF-PUMP; ON-PUMP; CEREBRAL MICROEMBOLI; RISK-FACTORS; CORONARY; SURGERY; HYPERLACTATEMIA; OUTCOMES","Objective: Patients undergoing cardiac surgery procedures are thought to be at risk of early neuropsychological deficits and delirium. Regional cerebral hypoperfusion may play a role in the etiology of this complication. We hypothesized that low systemic perfusion pressure during cardiopulmonary bypass (CPB) would correlate with early postoperative cognitive dysfunction in on-pump patients. Methods: In this prospective, randomized, single-center trial, we assigned 92 patients scheduled for elective or urgent coronary artery bypass grafting (CABG) to high-pressure (HP: 80-90 mmHg, n = 44) or low-pressure (LP: 60-70 mmHg, n = 48) perfusion groups during CPB. Patients with prior cerebrovascular or psychiatric disorders were excluded. Primary end point was the cognitive outcome as measured by Mini-Mental-Status examination before and 48 h after surgery. Results: Patients' pre- and intra-operative characteristics did not differ between groups. Significantly more patients in the LP group developed postoperative delirium than in the HP group (LP 13%. vs HP 0%, p = 0.017). The postoperative drop in Mini-Mental-Status scores was significantly greater in the LP group (LP 3.9 +/- 6.5 vs HP 1.1 +/- 1.9; p = 0.012). No group differences were detected in cerebral oxygenation measured by near-infrared spectroscopy during CPB. The LP group's postoperative arterial lactate concentration in the intensive care unit was significantly higher as compared with the HP group (LP 2.0 +/- 1.1 mmol l(-1) vs HP 1.4 +/- 0.6 mmol l(-1); p < 0.001). We observed no differences between the groups in any other postoperative clinical, functional, or laboratory parameters. Conclusion: Maintaining perfusion pressure at physiologic levels during normothermic CPB (80-90 mmHg) is associated with less early postoperative cognitive dysfunction and delirium. This perfusion strategy neither increases morbidity, nor does it impair organ function. (C) 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.","[Siepe, Matthias; Pfeiffer, Thomas; Gieringer, Andreas; Zemann, Silke; Benk, Christoph; Schlensak, Christian; Beyersdorf, Friedhelm] Univ Med Ctr Freiburg, Dept Cardiovasc Surg, D-79106 Freiburg, Germany","University of Freiburg","Siepe, M (通讯作者)，Univ Med Ctr Freiburg, Dept Cardiovasc Surg, Hugstetterstr 55, D-79106 Freiburg, Germany.","matthias.siepe@web.de","Beyersdorf, Friedhelm/AAK-3718-2020; Siepe, Matthias/AAF-9846-2019","Beyersdorf, Friedhelm/0000-0003-2975-2751; Siepe, Matthias/0000-0003-3305-9343","","","","",25,136,153,0,17,"OXFORD UNIV PRESS INC","CARY","JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA","1010-7940","1873-734X","","EUR J CARDIO-THORAC","Eur. J. Cardio-Thorac. Surg.","JUL",2011,40,1,"","","","",200,207,"","10.1016/j.ejcts.2010.11.024","http://dx.doi.org/10.1016/j.ejcts.2010.11.024","","",8,"Cardiac & Cardiovascular Systems; Respiratory System; Surgery","Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)","Cardiovascular System & Cardiology; Respiratory System; Surgery","775SG",21168339,"Bronze","","","2023-11-07","WOS:000291483100048","View Full Record in Web of Science"]
["J","Steiner, LA","","","","Steiner, Luzius A.","","","Postoperative delirium. Part 1: pathophysiology and risk factors","EUROPEAN JOURNAL OF ANAESTHESIOLOGY","","","English","Review","","","","","","acetylcholine; age; alcohol-withdrawal delirium; delirium; postoperative complications","ELDERLY-PATIENTS; COGNITIVE DECLINE; PREDICTIVE MODEL; CARDIAC-SURGERY; SPINAL-ANESTHESIA; HIP-SURGERY; BRAIN; IMPAIRMENT; CYTOKINES; SEPSIS","Delirium presents clinically with differing subtypes ranging from hyperactive to hypoactive. The clinical presentation is not clearly linked to specific pathophysiological mechanisms. Nevertheless, there seem to be different mechanisms that lead to delirium; for example the mechanisms leading to alcohol-withdrawal delirium are different from those responsible for postoperative delirium. In many forms of delirium, the brain's reaction to a peripheral inflammatory process is considered to be a pathophysiological key element and the aged brain seems to react more markedly to a peripheral inflammatory stimulus than a younger brain. The effects of inflammatory mediators on the brain include changes in neurotransmission and apoptosis. On a neurotransmitter level, impaired cholinergic transmission and disturbances of the intricate interactions between dopamine, serotonin and acetylcholine seem to play an important role in the development of delirium. The risk factors for delirium are categorised as predisposing or precipitating factors. In the presence of many predisposing factors, even trivial precipitating factors may trigger delirium, whereas in patients without or with only a few predisposing factors, a major precipitating insult is necessary to trigger delirium. Well documented predisposing factors are age, medical comorbidities, cognitive, functional, visual and hearing impairment and institutional residence. Important precipitating factors apart from surgery are admission to an ICU, anticholinergic drugs, alcohol or drug withdrawal, infections, iatrogenic complications, metabolic derangements and pain. Scores to predict the risk of delirium based on four or five risk factors have been validated in surgical patients. Eur J Anaesthesiol 2011; 28: 628-636 Published online 3 August 2011","[Steiner, Luzius A.] CHU Vaudois, Anesthesiol Serv, CH-1011 Lausanne, Switzerland; [Steiner, Luzius A.] Univ Lausanne, Lausanne, Switzerland","University of Lausanne; Centre Hospitalier Universitaire Vaudois (CHUV); University of Lausanne","Steiner, LA (通讯作者)，CHU Vaudois, Serv Anesthesiol BH10, Rue Bugnon 46, CH-1011 Lausanne, Switzerland.","luzius.steiner@chuv.ch","Steiner, Luzius/C-9836-2011; Steiner, Luzius/J-1987-2019","Steiner, Luzius/0000-0002-1437-3532","Swiss National Science Foundation [32003B_121956]; Swiss National Science Foundation (SNF) [32003B_121956] Funding Source: Swiss National Science Foundation (SNF)","Swiss National Science Foundation(Swiss National Science Foundation (SNSF)); Swiss National Science Foundation (SNF)(Swiss National Science Foundation (SNSF))","L.A.S. is supported by a grant from the Swiss National Science Foundation (grant number: 32003B_121956). No conflicts of interest declared.","",90,133,139,3,47,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0265-0215","1365-2346","","EUR J ANAESTH","Eur. J. Anaesth.","SEP",2011,28,9,"","","","",628,636,"","10.1097/EJA.0b013e328349b7f5","http://dx.doi.org/10.1097/EJA.0b013e328349b7f5","","",9,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","803PQ",21785356,"Bronze","","","2023-11-07","WOS:000293593600006","View Full Record in Web of Science"]
["J","Lee, HB; Mears, SC; Rosenberg, PB; Leoutsakos, JMS; Gottschalk, A; Sieber, FE","","","","Lee, Hochang B.; Mears, Simon C.; Rosenberg, Paul B.; Leoutsakos, Jeannie-Marie S.; Gottschalk, Allan; Sieber, Frederick E.","","","Predisposing Factors for Postoperative Delirium After Hip Fracture Repair in Individuals with and without Dementia","JOURNAL OF THE AMERICAN GERIATRICS SOCIETY","","","English","Article","","","","","","dementia; delirium; hip fracture; surgery; risk factor","ELDERLY-PATIENTS; PRECIPITATING FACTORS; GENERAL-ANESTHESIA; RISK-FACTORS; SURGERY; INTERRELATIONSHIP; PREDICTION; CONFUSION; SEDATION; MODEL","OBJECTIVES: Based on a multifactorial model of delirium, to compare the types and magnitude of pre-and intraoperative predisposing factors for incident delirium in a stratified sample of individuals with and without preoperative dementia undergoing acute hip fracture repair. DESIGN: Prospective cohort study. SETTING: Academic medical center. PARTICIPANTS: Four hundred twenty-five individuals with acute hip fracture and without delirium (mean age 80.2 +/- 6.8, 73.2% female, 33.1% with probable dementia) admitted to a multidisciplinary hip fracture repair service. MEASUREMENTS: A research nurse assessed each participant for delirium based on the Confusion Assessment Method (CAM) before study enrollment and from the second postoperative day until hospital discharge. RESULTS: The incidence of delirium was higher in the group with probable dementia (56%) than in the group without dementia (26%) (P <.001). In the group without dementia (n = 284), age (odds ratio (OR) = 1.07, 95% CI = 1.02-1.13), male sex (OR = 2.81, 95% CI = 1.40-5.64), body mass index (OR = 0.92, 95% CI = 0.860.99), number of medical comorbidities (OR = 1.15, 95% CI = 1.01-1.32), and duration of surgery longer than 2 hours (OR = 2.53, 95% CI = 1.20-4.88) were independently associated with postoperative delirium. In the group with probable dementia, only the lag time from the emergency department to operating room was significantly associated (OR = 2.83, 95% CI = 1.24-2.25) with delirium. CONCLUSION: Preoperative determination of dementia status is important for risk stratification for incident delirium after acute hip fracture repair surgery because types and magnitude of predisposing risk factors for postopera-tive delirium substantially differ based on preoperative dementia status. J Am Geriatr Soc 59: 2306-2313, 2011.","[Lee, Hochang B.; Rosenberg, Paul B.; Leoutsakos, Jeannie-Marie S.] Johns Hopkins Univ, Sch Med, Dept Psychiat, Baltimore, MD 21224 USA; [Mears, Simon C.] Johns Hopkins Univ, Sch Med, Dept Orthoped Surg, Baltimore, MD 21224 USA; [Gottschalk, Allan; Sieber, Frederick E.] Johns Hopkins Univ, Sch Med, Dept Anesthesiol, Baltimore, MD 21224 USA","Johns Hopkins University; Johns Hopkins University; Johns Hopkins University","Lee, HB (通讯作者)，Johns Hopkins Univ, Sch Med, Dept Psychiat, 5300 Alpha Commons Dr,4th Floor, Baltimore, MD 21224 USA.","Hochang@jhmi.edu","","Lee, Hochang/0000-0001-8379-4018; Leoutsakos, Jeannie-Marie/0000-0002-1010-1046","National Institute of Aging [R01 AG033615]","National Institute of Aging(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","This research was supported by National Institute of Aging Grant R01 AG033615.","",38,103,117,0,17,"WILEY","HOBOKEN","111 RIVER ST, HOBOKEN 07030-5774, NJ USA","0002-8614","1532-5415","","J AM GERIATR SOC","J. Am. Geriatr. Soc.","DEC",2011,59,12,"","","","",2306,2313,"","10.1111/j.1532-5415.2011.03725.x","http://dx.doi.org/10.1111/j.1532-5415.2011.03725.x","","",8,"Geriatrics & Gerontology; Gerontology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Geriatrics & Gerontology","869LU",22188077,"Green Accepted","","","2023-11-07","WOS:000298600300015","View Full Record in Web of Science"]
["J","Jankowski, CJ; Trenerry, MR; Cook, DJ; Buenvenida, SL; Stevens, SR; Schroeder, DR; Warner, DO","","","","Jankowski, Christopher J.; Trenerry, Max R.; Cook, David J.; Buenvenida, Shonie L.; Stevens, Susanna R.; Schroeder, Darrell R.; Warner, David O.","","","Cognitive and Functional Predictors and Sequelae of Postoperative Delirium in Elderly Patients Undergoing Elective Joint Arthroplasty","ANESTHESIA AND ANALGESIA","","","English","Article","","","","","","","IQ-ADJUSTED NORMS; EXECUTIVE FUNCTION; NONCARDIAC SURGERY; HIP FRACTURE; RISK-FACTORS; DYSFUNCTION; DEPRESSION; MODEL; PAIN; VALIDATION","BACKGROUND: Postoperative delirium (POD) is common in the elderly and associated with adverse outcomes. The cognitive and functional sequelae of POD in elective surgical patients are not known. We sought to determine whether (1) lower scores on sensitive neurocognitive tests are an independent risk factor for POD in elderly surgical patients, and (2) POD predicts cognitive and functional decline 3 months postoperatively. METHODS: We conducted a prospective, cohort study on patients >= 65 years old undergoing total hip or knee arthroplasty. Participants underwent preoperative neurocognitive and functional testing. POD was diagnosed using the Confusion Assessment Method. Patients who developed POD and matched controls underwent repeat neurocognitive and functional testing 3 months after surgery. RESULTS: Four hundred eighteen patients met entry criteria, and 42 (10%) developed POD. There were no differences in baseline Mini-Mental State Examination scores, alcohol abuse, depression, and verbal intelligence between groups. Independent predictors of POD included age, history of psychiatric illness, decreased functional status, and decreased verbal memory. For all tests, changes from before to 3 months after surgery were similar between those patients with POD and matched controls. CONCLUSIONS: Subtly reduced preoperative neurocognitive and functional status predict POD. However, in the small group that developed POD, there was no evidence of cognitive and functional decline 3 months after surgery. POD is associated with decreased preoperative cognitive reserve but, in elderly elective surgical patients, may be without adverse cognitive or functional sequelae 3 months postoperatively. (Anesth Analg 2011; 112: 1186-93)","[Jankowski, Christopher J.; Buenvenida, Shonie L.] Mayo Clin, Dept Anesthesiol, Anesthesiol Clin Res Unit, Rochester, MN 55905 USA; [Trenerry, Max R.] Mayo Clin, Dept Psychol, Rochester, MN 55905 USA; [Stevens, Susanna R.; Schroeder, Darrell R.] Mayo Clin, Dept Biostat, Rochester, MN 55905 USA","Mayo Clinic; Mayo Clinic; Mayo Clinic","Jankowski, CJ (通讯作者)，Mayo Clin, Dept Anesthesiol, Anesthesiol Clin Res Unit, Charlton 1-145,200 1st St SW, Rochester, MN 55905 USA.","jankowski.christopher@mayo.edu","","Cook, David/0000-0003-1158-8893","Foundation for Anesthesia Education and Research, Rochester, MN; Mayo Foundation, Rochester, MN","Foundation for Anesthesia Education and Research, Rochester, MN; Mayo Foundation, Rochester, MN","Supported by a grant from the Foundation for Anesthesia Education and Research, Rochester, MN, and the Mayo Foundation, Rochester, MN.","",47,96,101,0,19,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-2999","","","ANESTH ANALG","Anesth. Analg.","MAY",2011,112,5,"","","","",1186,1193,"","10.1213/ANE.0b013e318211501b","http://dx.doi.org/10.1213/ANE.0b013e318211501b","","",8,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Anesthesiology","753NI",21415433,"","","","2023-11-07","WOS:000289785100028","View Full Record in Web of Science"]
["J","Sanders, RD; Pandharipande, PP; Davidson, AJ; Ma, DQ; Maze, M","","","","Sanders, Robert D.; Pandharipande, Pratik P.; Davidson, Andrew J.; Ma, Daqing; Maze, Mervyn","","","Anticipating and managing postoperative delirium and cognitive decline in adults","BMJ-BRITISH MEDICAL JOURNAL","","","English","Review","","","","","","","CRITICALLY-ILL PATIENTS; CARDIAC-SURGERY; HIP FRACTURE; RISK-FACTORS; RANDOMIZED-TRIAL; ELDERLY-PATIENTS; CARE-UNIT; DEXMEDETOMIDINE; DYSFUNCTION; EMERGENCE","","[Sanders, Robert D.; Ma, Daqing] Univ London Imperial Coll Sci Technol & Med, Chelsea & Westminster Hosp, Magill Dept Anaesthet Intens Care & Pain Med, London SW10 9NH, England; [Sanders, Robert D.] Univ London Imperial Coll Sci Technol & Med, Dept Leucocyte Biol, London SW10 9NH, England; [Pandharipande, Pratik P.] VA TN Valley Hlth Care Syst, Anesthesiol Serv, Nashville, TN USA; [Pandharipande, Pratik P.] Vanderbilt Univ, Sch Med, Dept Anesthesiol, Div Crit Care, Nashville, TN 37212 USA; [Davidson, Andrew J.] Royal Childrens Hosp, Dept Anaesthesia, Melbourne, Vic, Australia; [Davidson, Andrew J.] Murdoch Childrens Res Inst, Anaesthesia Res Grp, Melbourne, Vic, Australia; [Maze, Mervyn] Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA","Imperial College London; Imperial College London; US Department of Veterans Affairs; Veterans Health Administration (VHA); VA Tennessee Valley Healthcare System; Vanderbilt University; Royal Children's Hospital Melbourne; Murdoch Children's Research Institute; University of California System; University of California San Francisco","Sanders, RD (通讯作者)，Univ London Imperial Coll Sci Technol & Med, Chelsea & Westminster Hosp, Magill Dept Anaesthet Intens Care & Pain Med, London SW10 9NH, England.","robert.sanders@imperial.ac.uk","Sanders, Robert D/A-7844-2012","Pandharipande, Pratik/0000-0002-1389-8580; Sanders, Robert/0000-0003-0113-0328","Hospira, USA; Air Liquide, France; Air Products, USA; Medical Research Council [G0802353] Funding Source: researchfish; MRC [G0802353] Funding Source: UKRI","Hospira, USA; Air Liquide, France; Air Products, USA; Medical Research Council(UK Research & Innovation (UKRI)Medical Research Council UK (MRC)); MRC(UK Research & Innovation (UKRI)Medical Research Council UK (MRC))","All authors have completed the ICMJE disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; RDS has worked as a consultant for Air Liquide, France, and is a member of the Steering Committee of an Air Liquide sponsored clinical trial exploring the utility of xenon anaesthesia to prevent postoperative delirium. PPP has received funding from Hospira, USA, for clinical trials relating to the use of dexmedetomidine as a critical care sedative and honorariums from Hospira, USA, Orion Pharma, Finland, and Glaxo Smith Klein, United Kingdom. MM has received consultancy fees from Air Liquide, France, and Air Products, USA, regarding the clinical development of xenon and from Hospira and Orion regarding the clinical development of dexmedetomidine; no other relationships or activities that could appear to have influenced the","",34,91,94,2,32,"BMJ PUBLISHING GROUP","LONDON","BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND","1756-1833","","","BMJ-BRIT MED J","BMJ-British Medical Journal","JUL 20",2011,343,"","","","","","","","d4331","10.1136/bmj.d4331","http://dx.doi.org/10.1136/bmj.d4331","","",6,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED)","General & Internal Medicine","797ZH",21775401,"","","","2023-11-07","WOS:000293168700005","View Full Record in Web of Science"]
["J","Pol, RA; van Leeuwen, BL; Visser, L; Izaks, GJ; van den Dungen, JJAM; Tielliu, IFJ; Zeebregts, CJ","","","","Pol, R. A.; van Leeuwen, B. L.; Visser, L.; Izaks, G. J.; van den Dungen, J. J. A. M.; Tielliu, I. F. J.; Zeebregts, C. J.","","","Standardised Frailty Indicator as Predictor for Postoperative Delirium after Vascular Surgery: A Prospective Cohort Study","EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY","","","English","Article","","","","","","Postoperative delirium; Vascular surgery; Risk factor; Frailty; Groningen Frailty Indicator","RISK-FACTORS; SURGICAL COMPLICATIONS; OUTCOMES; CLASSIFICATION","Objectives: To determine whether the Groningen Frailty Indicator (GFI) has a positive predictive value for postoperative delirium (POD) after vascular surgery. Methods: Between March and August 2010, 142 consecutive vascular surgery patients were prospectively evaluated. Preoperatively, the GFI was obtained and postoperatively patients were screened with the Delirium Observation Scale (DOS). Patients with a DOS-score >= 3 points were assessed by a geriatrician. Delirium was defined by the DSM-IV-TR criteria. Primary outcome variable was the incidence of POD. Secondary outcome variables were any surgical complication and hospital length of stay (HLOS) (>7 days). Results: Ten patients (7%) developed POD. The highest incidence of POD was found after aortic surgery (17%) and amputation procedures (40%). Increased comorbidities (p = 0.006), GFI score (p = 0.03), renal insufficiency (p = 0.04), elevated C-reactive protein (p = 0.008), high American Society of Anaesthesiologists score (p = 0.05), a DOS-score of >= 3 points (p = 0.001), post-operative intensive care unit admittance (p = 0.01) and HLOS >= 7 days (p = 0.005) were risk factors for POD. The GFI score was not associated with a prolonged HLOS. A mean number of 2 +/- 1 (range 0-5) complications were registered. The receiver operator characteristics (ROC) area under the curve for the GFI was 0.70. Conclusions: The GFI can be helpful in the early identification of POD after vascular surgery in a select group of high-risk patients. (C) 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.","[Zeebregts, C. J.] Univ Groningen, Univ Med Ctr Groningen, Dept Surg, Div Vasc Surg, NL-9700 RB Groningen, Netherlands; [Izaks, G. J.] Univ Groningen, Univ Med Ctr Groningen, Univ Ctr Geriatr Med, NL-9700 RB Groningen, Netherlands","University of Groningen; University of Groningen","Zeebregts, CJ (通讯作者)，Univ Groningen, Univ Med Ctr Groningen, Dept Surg, Div Vasc Surg, POB 30001, NL-9700 RB Groningen, Netherlands.","czeebregts@hotmail.com","Izaks, Gerbrand J/F-5089-2014","Izaks, Gerbrand J/0000-0003-3213-7637","","","","",32,89,94,1,16,"W B SAUNDERS CO LTD","LONDON","32 JAMESTOWN RD, LONDON NW1 7BY, ENGLAND","1078-5884","","","EUR J VASC ENDOVASC","Eur. J. Vasc. Endovasc. Surg.","DEC",2011,42,6,"","","","",824,830,"","10.1016/j.ejvs.2011.07.006","http://dx.doi.org/10.1016/j.ejvs.2011.07.006","","",7,"Surgery; Peripheral Vascular Disease","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Surgery; Cardiovascular System & Cardiology","868IR",21810543,"Green Published, hybrid","","","2023-11-07","WOS:000298517500015","View Full Record in Web of Science"]
["J","Leung, JM; Tsai, TL; Sands, LP","","","","Leung, Jacqueline M.; Tsai, Tiffany L.; Sands, Laura P.","","","Preoperative Frailty in Older Surgical Patients Is Associated with Early Postoperative Delirium","ANESTHESIA AND ANALGESIA","","","English","Article","","","","","","","ALZHEIMERS-DISEASE; COGNITIVE DECLINE; RISK; PREDICTORS; DEMENTIA; ADULTS","We investigated whether preoperative frailty among older noncardiac surgical patients provides information about the development of postoperative delirium that is in addition to traditional geriatric risk factors. One-third of patients had a frailty score >= 3, which is considered frail in others' research. Twenty-five percent of patients developed postoperative delirium, which was measured using the confusion assessment method. Multivariable logistic regression showed that age, activities of daily living dependence, instrumental activities of daily living dependence, and cognitive functioning did not contribute significantly to the prediction of postoperative delirium. Only preoperative symptoms of depression (odds ratio = 1.42; 95% confidence interval = 1.06-1.91; P = 0.018) and the frailty score (odds ratio = 1.84; 95% confidence interval = 1.07-3.1; P = 0.028) were independently associated with the development of postoperative delirium. (Anesth Analg 2011; 112: 1199-201)","[Leung, Jacqueline M.; Tsai, Tiffany L.] Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA; [Sands, Laura P.] Purdue Univ, Dept Stat, Sch Nursing, W Lafayette, IN 47907 USA","University of California System; University of California San Francisco; Purdue University System; Purdue University West Lafayette Campus; Purdue University","Leung, JM (通讯作者)，Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA.","leungj@anesthesia.ucsf.edu","","","Anesthesia Patient Safety Foundation (Indianapolis, IN); National Institutes of Health [1RO1AG031795-02]","Anesthesia Patient Safety Foundation (Indianapolis, IN); National Institutes of Health(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA)","Supported by the Anesthesia Patient Safety Foundation (Indianapolis, IN) and National Institutes of Health grant 1RO1AG031795-02.","",19,84,87,0,17,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA","0003-2999","","","ANESTH ANALG","Anesth. Analg.","MAY",2011,112,5,"","","","",1199,1201,"","10.1213/ANE.0b013e31820c7c06","http://dx.doi.org/10.1213/ANE.0b013e31820c7c06","","",3,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Anesthesiology","753NI",21372278,"Bronze, Green Accepted","","","2023-11-07","WOS:000289785100030","View Full Record in Web of Science"]
["J","Saczynski, JS; Marcantonio, ER; Quach, L; Fong, TG; Gross, A; Inouye, SK; Jones, RN","","","","Saczynski, Jane S.; Marcantonio, Edward R.; Quach, Lien; Fong, Tamara G.; Gross, Alden; Inouye, Sharon K.; Jones, Richard N.","","","Cognitive Trajectories after Postoperative Delirium","NEW ENGLAND JOURNAL OF MEDICINE","","","English","Article","","","","","","","CORONARY-ARTERY-BYPASS; CONFUSION ASSESSMENT METHOD; MINI-MENTAL STATE; PREDICTION RULE; CARDIAC-SURGERY; HIP FRACTURE; DECLINE; OUTCOMES; DYSFUNCTION; IMPAIRMENT","BACKGROUND Delirium is common after cardiac surgery and may be associated with long-term changes in cognitive function. We examined postoperative delirium and the cognitive trajectory during the first year after cardiac surgery. METHODS We enrolled 225 patients 60 years of age or older who were planning to undergo coronary-artery bypass grafting or valve replacement. Patients were assessed preoperatively, daily during hospitalization beginning on postoperative day 2, and at 1, 6, and 12 months after surgery. Cognitive function was assessed with the use of the Mini-Mental State Examination (MMSE; score range, 0 to 30, with lower scores indicating poorer performance). Delirium was diagnosed with the use of the Confusion Assessment Method. We examined performance on the MMSE in the first year after surgery, controlling for demographic characteristics, coexisting conditions, hospital, and surgery type. RESULTS The 103 participants (46%) in whom delirium developed postoperatively had lower preoperative mean MMSE scores than those in whom delirium did not develop (25.8 vs. 26.9, P<0.001). In adjusted models, those with delirium had a larger drop in cognitive function (as measured by the MMSE score) 2 days after surgery than did those without delirium (7.7 points vs. 2.1, P<0.001) and had significantly lower postoperative cognitive function than those without delirium, both at 1 month (mean MMSE score, 24.1 vs. 27.4; P<0.001) and at 1 year (25.2 vs. 27.2, P<0.001) after surgery. With adjustment for baseline differences, the between-group difference in mean MMSE scores was significant 30 days after surgery (P<0.001) but not at 6 or 12 months (P=0.056 for both). A higher percentage of patients with delirium than those without delirium had not returned to their preoperative baseline level at 6 months (40% vs. 24%, P=0.01), but the difference was not significant at 12 months (31% vs. 20%, P=0.055). CONCLUSIONS Delirium is associated with a significant decline in cognitive ability during the first year after cardiac surgery, with a trajectory characterized by an initial decline and prolonged impairment. (Funded by the Harvard Older Americans Independence Center and others.)","[Saczynski, Jane S.] Univ Massachusetts, Sch Med, Dept Med, Div Geriatr Med, Worcester, MA 01605 USA; [Saczynski, Jane S.] Univ Massachusetts, Sch Med, Meyers Primary Care Inst, Worcester, MA 01605 USA; [Marcantonio, Edward R.; Quach, Lien; Fong, Tamara G.; Gross, Alden; Inouye, Sharon K.; Jones, Richard N.] Hebrew SeniorLife, Aging Brain Ctr, Inst Aging Res, Boston, MA USA; [Marcantonio, Edward R.] Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, Boston, MA 02215 USA; [Marcantonio, Edward R.; Gross, Alden; Inouye, Sharon K.; Jones, Richard N.] Beth Israel Deaconess Med Ctr, Div Gerontol, Boston, MA 02215 USA; [Fong, Tamara G.] Beth Israel Deaconess Med Ctr, Dept Neurol, Boston, MA 02215 USA; [Marcantonio, Edward R.; Fong, Tamara G.; Inouye, Sharon K.; Jones, Richard N.] Harvard Univ, Sch Med, Boston, MA USA","University of Massachusetts System; University of Massachusetts Worcester; University of Massachusetts System; University of Massachusetts Worcester; Harvard University; Hebrew SeniorLife; Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Harvard Medical School","Saczynski, JS (通讯作者)，Univ Massachusetts, Sch Med, Dept Med, Div Geriatr Med, 377 Plantat St,Suite 315, Worcester, MA 01605 USA.","jane.saczynski@umassmed.edu","Inouye, Sharon/R-7216-2019; Khadka, Jyoti/P-3935-2018; Marcantonio, Edward R/U-3929-2017; Pesudovs, Konrad/T-9403-2019; Jones, Richard Norman/J-3488-2013","Khadka, Jyoti/0000-0003-1012-2119; Marcantonio, Edward R/0000-0002-2911-4250; Pesudovs, Konrad/0000-0002-6322-9369; Jones, Richard Norman/0000-0002-1049-218X","Harvard Older Americans Independence Center [P60AG008812]; National Institute on Aging [K01AG33643, R01AG030618, P01AG031720]; National Heart, Lung, and Blood Institute [U01HL105268]; National Institutes of Health (NIH) Mid-Career Investigator Award [K24AG035075]; NIH [T32 AG023480]","Harvard Older Americans Independence Center; National Institute on Aging(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA)); National Heart, Lung, and Blood Institute(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Heart Lung & Blood Institute (NHLBI)); National Institutes of Health (NIH) Mid-Career Investigator Award(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USAOffice of the Administrator (NIH)); NIH(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA)","Supported by grants from the Harvard Older Americans Independence Center (P60AG008812), the National Institute on Aging (K01AG33643, to Dr. Saczynski), the National Heart, Lung, and Blood Institute (U01HL105268, to Dr. Saczynski), and the National Institute on Aging (R01AG030618, to Dr. Marcantonio, and P01AG031720, to Dr. Inouye), and by a National Institutes of Health (NIH) Mid-Career Investigator Award (K24AG035075, to Dr. Marcantonio) and an NIH Translational Research in Aging fellowship (T32 AG023480, to Dr. Gross). No potential conflict of interest relevant to this article was reported.","",52,718,748,0,90,"MASSACHUSETTS MEDICAL SOC","WALTHAM","WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA","0028-4793","1533-4406","","NEW ENGL J MED","N. Engl. J. Med.","JUL 5",2012,367,1,"","","","",30,39,"","10.1056/NEJMoa1112923","http://dx.doi.org/10.1056/NEJMoa1112923","","",10,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED)","General & Internal Medicine","968KJ",22762316,"Bronze, Green Published, Green Accepted","","","2023-11-07","WOS:000305979400003","View Full Record in Web of Science"]
["J","Marcantonio, ER","","","","Marcantonio, Edward R.","","","Postoperative Delirium A 76-Year-Old Woman With Delirium Following Surgery","JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION","","","English","Article","","","","","","","INTENSIVE-CARE-UNIT; MECHANICALLY VENTILATED PATIENTS; CONFUSION ASSESSMENT METHOD; PATIENT-CONTROLLED ANALGESIA; TERM COGNITIVE IMPAIRMENT; CRITICALLY-ILL PATIENTS; ELDERLY-PATIENTS; HIP-FRACTURE; RISK-FACTORS; ABDOMINAL-SURGERY","Delirium (acute confusion) complicates 15% to 50% of major operations in older adults and is associated with other major postoperative complications, prolonged length of stay, poor functional recovery, institutionalization, dementia, and death. Importantly, delirium may be predictable and preventable through proactive intervention. Yet clinicians fail to recognize and address postoperative delirium in up to 80% of cases. Using the case of Ms R, a 76-year-old woman who developed delirium first after colectomy with complications and again after routine surgery, the diagnosis, prevention, and treatment of delirium in the postoperative setting is reviewed. The risk of postoperative delirium can be quantified by the sum of predisposing and precipitating factors. Successful strategies for prevention and treatment of delirium include proactive multifactorial intervention targeted to reversible risk factors, limiting use of sedating medications (especially benzodiazepines), effective management of postoperative pain, and, perhaps, judicious use of antipsychotics. JAMA. 2012;308(1):73-81","[Marcantonio, Edward R.] Beth Israel Deaconess Med Ctr, Dept Med, Div Gen Med & Primary Care, Boston, MA 02215 USA; [Marcantonio, Edward R.] Harvard Univ, Sch Med, Boston, MA USA","Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Harvard Medical School","Marcantonio, ER (通讯作者)，Beth Israel Deaconess Med Ctr, Dept Med, Div Gen Med & Primary Care, CO 216,330 Brookline Ave, Boston, MA 02215 USA.","emarcant@bidmc.harvard.edu","Marcantonio, Edward R/U-3929-2017; Marcantonio Junior, Elcio/AAA-9388-2022; Marcantonio, Elcio/A-4784-2008","Marcantonio, Edward R/0000-0002-2911-4250; Marcantonio Junior, Elcio/0000-0003-1294-2305; Marcantonio, Elcio/0000-0003-1294-2305","National Institute on Aging [R01AG030618, P01AG031720, K24 AG035075]","National Institute on Aging(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","Dr Marcantonio receives support from grants R01AG030618, P01AG031720, and Mid-Career Investigator Award K24 AG035075, all from the National Institute on Aging.","",102,185,198,0,36,"AMER MEDICAL ASSOC","CHICAGO","330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA","0098-7484","1538-3598","","JAMA-J AM MED ASSOC","JAMA-J. Am. Med. Assoc.","JUL 4",2012,308,1,"","","","",73,81,"","10.1001/jama.2012.6857","http://dx.doi.org/10.1001/jama.2012.6857","","",9,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED)","General & Internal Medicine","971DD",22669559,"Green Accepted","","","2023-11-07","WOS:000306183000026","View Full Record in Web of Science"]
["J","Flink, BJ; Rivelli, SK; Cox, EA; White, WD; Falcone, G; Vail, TP; Young, CC; Bolognesi, MP; Krystal, AD; Trzepacz, PT; Moon, RE; Kwatra, MM","","","","Flink, Benjamin J.; Rivelli, Sarah K.; Cox, Elizabeth A.; White, William D.; Falcone, Grace; Vail, Thomas P.; Young, Christopher C.; Bolognesi, Michael P.; Krystal, Andrew D.; Trzepacz, Paula T.; Moon, Richard E.; Kwatra, Madan M.","","","Obstructive Sleep Apnea and Incidence of Postoperative Delirium after Elective Knee Replacement in the Nondemented Elderly","ANESTHESIOLOGY","","","English","Article","","","","","","","MINI-MENTAL-STATE; QUALITY-OF-LIFE; NONCARDIAC SURGERY; DAYTIME SLEEPINESS; JOINT REPLACEMENT; PREDICTION RULE; RISK-FACTORS; TOTAL HIP; CYTOKINES; PATHOPHYSIOLOGY","Background: Postoperative delirium, a common complication in the elderly, can occur following any type of surgery and is associated with increased morbidity and mortality; it may also be associated with subsequent cognitive problems. Effective therapy for postoperative delirium remains elusive because the causative factors of delirium are likely multiple and varied. Methods: Patients 65 yr or older undergoing elective knee arthroplasty were prospectively evaluated for postoperative Diagnostic and Statistical Manual of Mental Disorders-IV delirium. Exclusion criteria included dementia, mini-mental state exam score less than 24, delirium, clinically significant central nervous system/neurologic disorder, current alcoholism, or any serious psychiatric disorder. Delirium was assessed on postoperative days 2 and 3 using standardized scales. Patients' preexisting medical conditions were obtained from medical charts. The occurrence of obstructive sleep apnea was confirmed by contacting patients to check their polysomnography records. Data were analyzed using Pearson chi-square or Wilcoxon rank sum tests and multiple logistic regressions adjusted for effects of covariates. Results: Of 106 enrolled patients, 27 (25%) developed postoperative delirium. Of the 15 patients with obstructive sleep apnea, eight (53%) experienced postoperative delirium, compared with 19 (20%) of the patients without obstructive sleep apnea (P = 0.0123, odds ratio: 4.3). Obstructive sleep apnea was the only statistically significant predictor of postoperative delirium in multivariate analyses. Conclusions: This is the first prospective study employing validated measures of delirium to identify an association between preexisting obstructive sleep apnea and postoperative delirium.","[Cox, Elizabeth A.; White, William D.; Young, Christopher C.; Moon, Richard E.; Kwatra, Madan M.] Duke Univ, Med Ctr, Dept Anesthesiol, Durham, NC 27710 USA; [Flink, Benjamin J.] Duke Univ, Med Ctr, Sch Med, Durham, NC 27710 USA; [Rivelli, Sarah K.; Falcone, Grace; Krystal, Andrew D.] Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC 27710 USA; [Rivelli, Sarah K.; Moon, Richard E.] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA; [Bolognesi, Michael P.] Duke Univ, Med Ctr, Dept Surg, Durham, NC 27710 USA; [Vail, Thomas P.] Univ Calif San Francisco, Dept Orthopaed Surg, San Francisco, CA USA; [Trzepacz, Paula T.] Eli Lilly & Co, Lilly Corp Ctr, Lilly Res Labs, Indianapolis, IN 46285 USA","Duke University; Duke University; Duke University; Duke University; Duke University; University of California System; University of California San Francisco; Eli Lilly","Kwatra, MM (通讯作者)，Duke Univ, Med Ctr, Dept Anesthesiol, POB 3094, Durham, NC 27710 USA.","kwatr001@mc.duke.edu","Krystal, Andrew D/J-7109-2013; Vail, Thomas/S-6892-2019; Moon, Richard/AAF-2170-2019; Kwatra, Madan/ABD-2008-2020; Trzepacz, Paula/AAQ-3330-2021","Krystal, Andrew D/0000-0002-6702-781X; Moon, Richard/0000-0003-4432-0332;","National Institutes of Health, Bethesda, Maryland [R01-AG019766]; Department of Anesthesia, Duke University Medical Center","National Institutes of Health, Bethesda, Maryland(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA); Department of Anesthesia, Duke University Medical Center","Received from the Department of Anesthesia, Duke University Medical Center, Durham, North Carolina. Submitted for publication June 17, 2011. Accepted for publication January 6, 2012. Supported by grant no. R01-AG019766 from the National Institutes of Health, Bethesda, Maryland, and funds from the Department of Anesthesia, Duke University Medical Center. Presented at the annual meeting of the American Society of Anesthesiologists, October 19, 2009, New Orleans, Louisiana.","",83,133,137,1,17,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-3022","1528-1175","","ANESTHESIOLOGY","Anesthesiology","APR",2012,116,4,"","","","",788,796,"","10.1097/ALN.0b013e31824b94fc","http://dx.doi.org/10.1097/ALN.0b013e31824b94fc","","",9,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","915BM",22337162,"Green Accepted, Bronze","","","2023-11-07","WOS:000301997900008","View Full Record in Web of Science"]
["J","Chan, MTV; Cheng, BCP; Lee, TMC; Gin, T","","","","Chan, Matthew T. V.; Cheng, Benny C. P.; Lee, Tatia M. C.; Gin, Tony","","CODA Trial Grp","BIS-guided Anesthesia Decreases Postoperative Delirium and Cognitive Decline","JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY","","","English","Article","","","","","","postoperative cognitive dysfunction; depth of anesthesia; bispectral index; anesthetic toxicity; delirium; postoperative complications","RANDOMIZED CONTROLLED-TRIAL; LOW BISPECTRAL INDEX; BETA-PROTEIN-LEVELS; AMYLOID-BETA; ISOFLURANE ANESTHESIA; ALZHEIMERS-DISEASE; NONCARDIAC SURGERY; CARDIAC-SURGERY; RECOVERY SCORE; RISK-FACTORS","Background: Previous clinical trials and animal experiments have suggested that long-lasting neurotoxicity of general anesthetics may lead to postoperative cognitive dysfunction (POCD). Brain function monitoring such as the bispectral index (BIS) facilitates anesthetic titration and has been shown to reduce anesthetic exposure. In a randomized controlled trial, we tested the effect of BIS monitoring on POCD in 921 elderly patients undergoing major noncardiac surgery. Methods: Patients were randomly assigned to receive either BIS-guided anesthesia or routine care. The BIS group had anesthesia adjusted to maintain a BIS value between 40 and 60 during maintenance of anesthesia. Routine care group had BIS measured but not revealed to attending anesthesiologists. Anesthesia was adjusted according to traditional clinical signs and hemodynamic parameters. A neuropsychology battery of tests was administered before and at 1 week and 3 months after surgery. Results were compared with matched control patients who did not have surgery during the same period. Delirium was measured using the confusion assessment method criteria. Results: The median (interquartile range) BIS values during the maintenance period of anesthesia were significantly lower in the control group, 36 (31 to 49), compared with the BIS-guided group, 53 (48 to 57), P < 0.001. BIS-guided anesthesia reduced propofol delivery by 21% and that for volatile anesthetics by 30%. There were fewer patients with delirium in the BIS group compared with routine care (15.6% vs. 24.1%, P = 0.01). Although cognitive performance was similar between groups at 1 week after surgery, patients in the BIS group had a lower rate of POCD at 3 months compared with routine care (10.2% vs. 14.7%; adjusted odds ratio 0.67; 95% confidence interval, 0.32-0.98; P = 0.025). Conclusions: BIS-guided anesthesia reduced anesthetic exposure and decreased the risk of POCD at 3 months after surgery. For every 1000 elderly patients undergoing major surgery, anesthetic delivery titrated to a range of BIS between 40 and 60 would prevent 23 patients from POCD and 83 patients from delirium.","[Chan, Matthew T. V.; Gin, Tony] Chinese Univ Hong Kong, Prince Wales Hosp, Dept Anaesthesia & Intens Care, Shatin, Hong Kong, Peoples R China; [Cheng, Benny C. P.] Tuen Mun Hosp, Dept Anaesthesia & Intens Care, Tuen Mun, Hong Kong, Peoples R China; [Lee, Tatia M. C.] Univ Hong Kong, Inst Clin Neuropsychol, Neuropsychol Lab, Pokfulam, Hong Kong, Peoples R China","Chinese University of Hong Kong; Prince of Wales Hospital; Tuen Mun Hospital; University of Hong Kong","Chan, MTV (通讯作者)，Chinese Univ Hong Kong, Prince Wales Hosp, Dept Anaesthesia & Intens Care, Shatin, Hong Kong, Peoples R China.","mtvchan@cuhk.edu.hk","Chan, Matthew/J-2884-2013; GIN, Tony/J-2521-2013","Chan, Matthew/0000-0002-3574-7855; GIN, Tony/0000-0001-7283-6761","Competitive Earmarked Research Grant [CUHK4400/06M]; Research Grants Council of Hong Kong; Health and Health Services Research Fund [04060271]","Competitive Earmarked Research Grant(Hong Kong Research Grants Council); Research Grants Council of Hong Kong(Hong Kong Research Grants Council); Health and Health Services Research Fund","Supported by Competitive Earmarked Research Grant (CUHK4400/06M), Research Grants Council of Hong Kong, and Health and Health Services Research Fund (04060271).","",55,436,469,5,137,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0898-4921","1537-1921","","J NEUROSURG ANESTH","J. Neurosurg. Anesthesiol.","JAN",2013,25,1,"","","","",33,42,"","10.1097/ANA.0b013e3182712fba","http://dx.doi.org/10.1097/ANA.0b013e3182712fba","","",10,"Anesthesiology; Clinical Neurology; Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology; Neurosciences & Neurology; Surgery","057KJ",23027226,"Bronze","","","2023-11-07","WOS:000312561800005","View Full Record in Web of Science"]
["J","Radtke, FM; Franck, M; Lendner, J; Krüger, S; Wernecke, KD; Spies, CD","","","","Radtke, F. M.; Franck, M.; Lendner, J.; Krueger, S.; Wernecke, K. D.; Spies, C. D.","","","Monitoring depth of anaesthesia in a randomized trial decreases the rate of postoperative delirium but not postoperative cognitive dysfunction","BRITISH JOURNAL OF ANAESTHESIA","","","English","Article","","","","","","consciousness monitors; delirium; mild cognitive impairment","BISPECTRAL INDEX; NONCARDIAC SURGERY; CLINICAL-PRACTICE; EMERGENCE; RECOVERY","Postoperative delirium in elderly patients is a frequent complication and associated with poor outcome. The aim of this parallel group study was to determine whether monitoring depth of anaesthesia influences the incidence of postoperative delirium. Patients who were planned for surgery in general anaesthesia expected to last at least 60 min and who were older than 60 yr were included between March 2009 and May 2010. A total of 1277 patients of a consecutive sample were randomized (n638 open, n639 blinded) and the data of 1155 patients were analysed (n575 open, n580 blinded). In one group, the anaesthesiologists were allowed to use the bispectral index (BIS) data to guide anaesthesia, while in the other group, BIS monitoring was blinded. Cognitive function was evaluated at baseline, 1 week, and 3 months after operation. Delirium incidence was lower in patients guided with BIS. Postoperative delirium was detected in 95 patients (16.7) in the intervention group compared with 124 patients (21.4) in the control group (P0.036). In a multivariate analysis, the percentage of episodes of deep anaesthesia (BIS values 20) were independently predictive for postoperative delirium (P0.006; odds ratio 1.027). BIS monitoring did not alter the incidence of postoperative cognitive dysfunction (7th day P0.062; 90th day P0.372). Intraoperative neuromonitoring is associated with a lower incidence of delirium, possibly by reducing extreme low BIS values. Therefore, in high-risk surgical patients, this may give the anaesthesiologist a possibility to influence one precipitating factor in the complex genesis of delirium. ISRCTN Register: 36437985. .","[Radtke, F. M.; Franck, M.; Lendner, J.; Krueger, S.; Spies, C. D.] Charite, Dept Anaesthesiol & Surg Intens Care Med, Campus Charite Mitte, D-10117 Berlin, Germany; [Radtke, F. M.; Franck, M.; Lendner, J.; Krueger, S.; Spies, C. D.] Charite, Campus Virchow Klinikum, D-10117 Berlin, Germany; [Wernecke, K. D.] Charite, D-10318 Berlin, Germany; [Wernecke, K. D.] SoStAna GmbH, D-10318 Berlin, Germany","Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Sostana GmbH","Spies, CD (通讯作者)，Charite, Dept Anaesthesiol & Surg Intens Care Med, Campus Charite Mitte, Charitepl 1, D-10117 Berlin, Germany.","claudia.spies@charite.de","Lendner, Janna D/AGU-7619-2022","Lendner, Janna D/0000-0002-1967-6110; Radtke, Finn M./0000-0001-5260-5384","Charite-Universitatsmedizin Berlin; Covidien","Charite-Universitatsmedizin Berlin; Covidien","This work was supported by Charite-Universitatsmedizin Berlin with additional funding provided by Aspect Medical Systems, now Covidien.","",29,333,358,3,68,"ELSEVIER SCI LTD","OXFORD","THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND","0007-0912","1471-6771","","BRIT J ANAESTH","Br. J. Anaesth.","JUN",2013,110,"","",1,"SI","",98,105,"","10.1093/bja/aet055","http://dx.doi.org/10.1093/bja/aet055","","",8,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","156JK",23539235,"hybrid","","","2023-11-07","WOS:000319817700012","View Full Record in Web of Science"]
["J","Abelha, FJ; Luís, C; Veiga, D; Parente, D; Fernandes, V; Santos, P; Botelho, M; Santos, A; Santos, C","","","","Abelha, Fernando J.; Luis, Clara; Veiga, Dalila; Parente, Daniela; Fernandes, Vera; Santos, Patricia; Botelho, Miguela; Santos, Alice; Santos, Cristina","","","Outcome and quality of life in patients with postoperative delirium during an ICU stay following major surgery","CRITICAL CARE","","","English","Article","","","","","","","ELDERLY-PATIENTS; HIP-SURGERY; RISK; PREDICTOR; MORTALITY","Introduction: Delirium is an acute disturbance of consciousness and cognition that has been shown to be associated with poor outcomes, including increased mortality. We aimed to evaluate outcome after postoperative delirium in a cohort of surgical intensive care unit (SICU) patients. Methods: This prospective study was conducted over a 10-month period in a SICU. Postoperative delirium was diagnosed in accordance with the Intensive Care Delirium Screening Checklist (ICDSC). The primary outcome was mortality at 6-month follow-up. Hospital mortality and becoming dependent were considered as secondary outcomes, on the basis of the evaluation of the patient's ability to undertake both personal and instrumental activities of daily living (ADL) before surgery and 6 months after discharge from the SICU. For each dichotomous outcome - hospital mortality, mortality at 6-month follow-up, and becoming dependent - a separate multiple logistic regression analysis was performed, which included delirium as an independent variable. Another outcome analyzed was changes in health-related quality of life, as determined using short-form 36 (SF-36), which was administered before and 6 months after discharge from the SICU. Additionally, for each SF-36 domain, a separate multiple linear regression model was used for each SF-36 domain, with changes in the SF-36 domain as a dependent variable and delirium as an independent variable. Results: Of 775 SICU-admitted adults, 562 were enrolled in the study, of which 89 (16%) experienced postoperative delirium. Delirium was an independent risk factor for mortality at the 6-month follow-up (OR = 2.562, P < 0.001) and also for hospital mortality (OR = 2.673, P < 0.001). Delirium was also an independent risk factor for becoming dependent for personal ADL (P-ADL) after SICU discharge (OR = 2.188, P < 0.046). Moreover, patients who experienced postoperative delirium showed a greater decline in SF-36 domains after discharge, particularly in physical function, vitality, and social function, as compared to patients without postoperative delirium. Conclusions: Postoperative delirium was an independent risk factor for 6-month follow-up mortality, hospital mortality, and becoming independent in P-ADL after SICU discharge. It was also significantly associated with a worsening in the quality of life after surgery.","[Abelha, Fernando J.; Luis, Clara; Veiga, Dalila; Parente, Daniela; Fernandes, Vera; Santos, Patricia; Botelho, Miguela; Santos, Alice] Univ Porto, Fac Med, Dept Anesthesiol, Ctr Hosp Sao Joao, P-4202451 Oporto, Portugal; [Santos, Cristina] Univ Porto, Fac Med, Hlth Informat & Decis Sci Dept, P-4202451 Oporto, Portugal; [Abelha, Fernando J.] Univ Porto, Fac Med, Dept Surg, Anesthesiol & Perioperat Care Unit, P-4202451 Oporto, Portugal","Universidade do Porto; Sao Joao Hospital; Universidade do Porto; Universidade do Porto","Abelha, FJ (通讯作者)，Univ Porto, Fac Med, Dept Anesthesiol, Ctr Hosp Sao Joao, Alameda Prof Hernani Monteiro, P-4202451 Oporto, Portugal.","fernando.abelha@gmail.com","Costa-Santos, Cristina/J-3255-2013; , Cristina/S-7443-2019; Abelha, Fernando J/K-5973-2013","Costa-Santos, Cristina/0000-0002-7109-1101; , Cristina/0000-0002-7109-1101; Abelha, Fernando J/0000-0002-2805-2908","","","","",41,136,147,2,17,"BMC","LONDON","CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND","1466-609X","1364-8535","","CRIT CARE","Crit. Care","",2013,17,5,"","","","","","","R257","10.1186/cc13084","http://dx.doi.org/10.1186/cc13084","","",10,"Critical Care Medicine","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","General & Internal Medicine","AB1HA",24168808,"Green Published, gold","","","2023-11-07","WOS:000331540900073","View Full Record in Web of Science"]
["J","Zhang, H; Lu, Y; Liu, M; Zou, Z; Wang, L; Xu, FY; Shi, XY","","","","Zhang, Hao; Lu, Yan; Liu, Meng; Zou, Zui; Wang, Long; Xu, Feng-Ying; Shi, Xue-Yin","","","Strategies for prevention of postoperative delirium: a systematic review and meta-analysis of randomized trials","CRITICAL CARE","","","English","Review","","","","","","","CRITICALLY-ILL PATIENTS; INTENSIVE-CARE-UNIT; DOUBLE-BLIND TRIAL; ELDERLY-PATIENTS; CARDIAC-SURGERY; HIP FRACTURE; OLDER-ADULTS; HALOPERIDOL PROPHYLAXIS; COLORECTAL SURGERY; COGNITIVE FUNCTION","Introduction: The ideal measures to prevent postoperative delirium remain unestablished. We conducted this systematic review and meta-analysis to clarify the significance of potential interventions. Methods: The PRISMA statement guidelines were followed. Two researchers searched MEDLINE, EMBASE, CINAHL and the Cochrane Library for articles published in English before August 2012. Additional sources included reference lists from reviews and related articles from 'Google Scholar'. Randomized clinical trials (RCTs) on interventions seeking to prevent postoperative delirium in adult patients were included. Data extraction and methodological quality assessment were performed using predefined data fields and scoring system. Meta-analysis was accomplished for studies that used similar strategies. The primary outcome measure was the incidence of postoperative delirium. We further tested whether interventions effective in preventing postoperative delirium shortened the length of hospital stay. Results: We identified 38 RCTs with interventions ranging from perioperative managements to pharmacological, psychological or multicomponent interventions. Meta-analysis showed dexmedetomidine sedation was associated with less delirium compared to sedation produced by other drugs (two RCTs with 415 patients, pooled risk ratio (RR) = 0.39; 95% confidence interval (CI) = 0.16 to 0.95). Both typical (three RCTs with 965 patients, RR = 0.71; 95% CI = 0.54 to 0.93) and atypical antipsychotics (three RCTs with 627 patients, RR = 0.36; 95% CI = 0.26 to 0.50) decreased delirium occurrence when compared to placebos. Multicomponent interventions (two RCTs with 325 patients, RR = 0.71; 95% CI = 0.58 to 0.86) were effective in preventing delirium. No difference in the incidences of delirium was found between: neuraxial and general anesthesia (four RCTs with 511 patients, RR = 0.99; 95% CI = 0.65 to 1.50); epidural and intravenous analgesia (three RCTs with 167 patients, RR = 0.93; 95% CI = 0.61 to 1.43) or acetylcholinesterase inhibitors and placebo (four RCTs with 242 patients, RR = 0.95; 95% CI = 0.63 to 1.44). Effective prevention of postoperative delirium did not shorten the length of hospital stay (10 RCTs with 1,636 patients, pooled SMD (standard mean difference) = -0.06; 95% CI = -0.16 to 0.04). Conclusions: The included studies showed great inconsistencies in definition, incidence, severity and duration of postoperative delirium. Meta-analysis supported dexmedetomidine sedation, multicomponent interventions and antipsychotics were useful in preventing postoperative delirium.","[Zhang, Hao; Liu, Meng; Zou, Zui; Xu, Feng-Ying; Shi, Xue-Yin] Second Mil Med Univ, Changzheng Hosp, Dept Anesthesiol, Shanghai 200003, Peoples R China; [Zhang, Hao; Liu, Meng; Zou, Zui; Xu, Feng-Ying; Shi, Xue-Yin] Second Mil Med Univ, Changzheng Hosp, Neurosci Res Ctr, Shanghai 200003, Peoples R China; [Lu, Yan] Second Mil Med Univ, Inst Neurosci, Shanghai 200433, Peoples R China; [Lu, Yan] Second Mil Med Univ, MOE Key Lab Mol Neurobiol, Shanghai 200433, Peoples R China; [Wang, Long] Eastern Hepatobiliary Hosp, Dept Anesthesiol, Shanghai 200438, Peoples R China","Naval Medical University; Naval Medical University; Naval Medical University; Naval Medical University; Naval Medical University","Shi, XY (通讯作者)，Second Mil Med Univ, Changzheng Hosp, Dept Anesthesiol, 415 Fengyang Rd, Shanghai 200003, Peoples R China.","shixueyin1128@yahoo.com.cn","","Zou, Zui/0000-0002-8433-8388","National Natural Science Foundation of China [81070880]; 12th Five-Year Key Project of PLA [BWS12J027]; Science and Technology Commission of Shanghai Municipality, China [12JC1410902]","National Natural Science Foundation of China(National Natural Science Foundation of China (NSFC)); 12th Five-Year Key Project of PLA; Science and Technology Commission of Shanghai Municipality, China(Science & Technology Commission of Shanghai Municipality (STCSM))","Dr. Xue-Yin Shi receives grants from the National Natural Science Foundation of China (No. 81070880), the 12th Five-Year Key Project of PLA (No. BWS12J027) and Key Basic Research Projects of the Science and Technology Commission of Shanghai Municipality, China (No. 12JC1410902). The three grants financed this article. Hao Zhang, Yan Lu, Meng Liu, Zui Zou, Long Wang and Feng-Ying Xu declared no competing interests.","",85,134,149,1,35,"BMC","LONDON","CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND","1364-8535","1466-609X","","CRIT CARE","Crit. Care","",2013,17,2,"","","","","","","R47","10.1186/cc12566","http://dx.doi.org/10.1186/cc12566","","",21,"Critical Care Medicine","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","General & Internal Medicine","264OG",23506796,"gold, Green Published","","","2023-11-07","WOS:000327887300012","View Full Record in Web of Science"]
["J","Bilotta, F; Lauretta, MP; Borozdina, A; Mizikov, VM; Rosa, G","","","","Bilotta, F.; Lauretta, M. P.; Borozdina, A.; Mizikov, V. M.; Rosa, G.","","","Postoperative delirium: risk factors, diagnosis and perioperative care","MINERVA ANESTESIOLOGICA","","","English","Review","","","","","","Delirium; Aged; Perioperative care; Education","CONFUSION ASSESSMENT METHOD; RANDOMIZED CONTROLLED-TRIAL; SCREENING CHECKLIST; COGNITIVE RECOVERY; REDUCING DELIRIUM; PREVENT DELIRIUM; ELDERLY-PATIENTS; HIP FRACTURE; ANESTHESIA; INTERVENTION","Postoperative delirium (PD) relates to increased morbidity associated with prolonged hospital stay, institutionalization and persistent functional and cognitive decline- poor long term outcome and higher perioperative mortality. Aim of this literature review is to identify established risk factors for PD and to categorize them according timing of occurrence (pre, intra and post operative), and clinical impact (Odds ratio [OR], % increase in incidence of PD). Source of information: medical literature databases (medline and embase) were searched for published manuscripts on postoperative delirium. Predictors and preoperative risk factors for PD were categorized into 4 groups: demographics; co morbidities; surgery and anesthesia-related (age; education, laboratory anomalies, smoking habits, benzodiazepines premedication, cardiac and thoracic surgery, etc). Intra operative risk factors for PD were categorized into 2 groups: surgery and anesthesia-related (anemia, duration and type of surgery, selected opioid, intraoperative hypotension, etc). Post operative risk factors and precipitating factors include various pathophysiological and environmental conditions, (i.e., ICU admission, low cardiac output requiring inotropes infusion; new onset atrial fibrillation; persistent hypoxia or hypercarbia; use of narcotic analgesics, delayed ambulation, inadequate nutritional status; sensory deprivation, etc). In conclusion, the effective identification, prevention and treatment of pre, intra and postoperative risk factors are the cornerstones for the prevention of PD. A dedicated perioperative care path that encompasses a tailored selection of drugs used perioperatively, the appropriate anesthesia strategy, qualified nursing surveillance, systematic use of diagnostic tools and accurate staff communication reduces the incidence and clinical impact of PD.","[Bilotta, F.; Lauretta, M. P.; Rosa, G.] Univ Roma La Sapienza, Dept Anesthesiol Crit Care & Pain Med, I-00185 Rome, Italy; [Borozdina, A.; Mizikov, V. M.] Petrovsky Natl Res Ctr Surg, Moscow, Russia","Sapienza University Rome; Petrovsky National Research Centre of Surgery","Bilotta, F (通讯作者)，Via Acherusio 16, I-00199 Rome, Italy.","bilotta@tiscali.it","","LAURETTA, MARIA PAOLA/0000-0001-7466-7826","","","","",65,120,127,2,47,"EDIZIONI MINERVA MEDICA","TURIN","CORSO BRAMANTE 83-85 INT JOURNALS DEPT., 10126 TURIN, ITALY","0375-9393","1827-1596","","MINERVA ANESTESIOL","Minerva Anestesiol.","SEP",2013,79,9,"","","","",1066,1076,"","","","","",11,"Anesthesiology; Critical Care Medicine","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology; General & Internal Medicine","256BH",23511351,"","","","2023-11-07","WOS:000327284200015","View Full Record in Web of Science"]
["J","Fineberg, SJ; Nandyala, SV; Marquez-Lara, A; Oglesby, M; Patel, AA; Singh, K","","","","Fineberg, Steven J.; Nandyala, Sreeharsha V.; Marquez-Lara, Alejandro; Oglesby, Matthew; Patel, Alpesh A.; Singh, Kern","","","Incidence and Risk Factors for Postoperative Delirium After Lumbar Spine Surgery","SPINE","","","English","Article","","","","","","delirium; postoperative delirium; lumbar spine; surgery; lumbar fusion; lumbar decompression; complications; risk; factors; surgery in the elderly; Nationwide Inpatient Sample.","PSYCHIATRIC-ILLNESS; HIP FRACTURE; CARE; COMORBIDITY; ASSOCIATION; MORBIDITY; MORTALITY; OUTCOMES","Study Design. Retrospective database analysis. Objective. A population-based database was analyzed to characterize the incidence, hospital costs, mortality, and risk factors associated with postoperative delirium after lumbar decompression (LD) and lumbar fusion (LF) surgical procedures. Summary of Background Data. Postoperative delirium is a common complication after surgery in the elderly that leads to increased hospitalization, cost, and other adverse outcomes. The incidence of delirium after lumbar spine surgery has not been discussed in this literature. Methods. Data from the Nationwide Inpatient Sample were obtained from 2002-2009. Patients undergoing LD or LF for degenerative pathologies were identified. Patient demographics, comorbidities, length of stay, discharge disposition, costs, and mortality were assessed. SPSS version 20 was used for statistical analysis using independent T tests for discrete variables and. 2 tests for categorical data. Logistic regression was performed to identify independent predictors of delirium. A P value of less than 0.001 was used to denote significance. Results. A total of 578,457 LDs and LFs were identified in the United States from 2002-2009. Of these, 292,177 were LDs and 286,280 were LFs. The overall incidence of delirium was 8.4 events per 1000 cases. Patients undergoing LF had a statistically greater incidence of delirium than patients undergoing LD (11.8 vs. 5.0 per 1000; P < 0.001). Patients experiencing delirium were significantly older and more likely to be female than nonaffected patients (P < 0.001). Patients with delirium in both cohorts demonstrated significantly greater comorbidities, length of stay, greater costs, and more frequent discharge to skilled nursing facilities (P < 0.001). The presence of delirium in LD-treated patients was associated with an increased mortality rate (6.1 vs. 0.8 per 1000; P < 0.001). Logistic regression demonstrated that independent predictors of delirium included older age (= 65 yr), alcohol/drug abuse, depression, psychotic disorders, neurological disorders, deficiency anemia, fluid/electrolyte disorders, and weight loss. Conclusion. The results of our study demonstrated an overall incidence of 8.4 events per 1000 lumbar spine surgical procedures. Overall analysis demonstrated an increased incidence of delirium in older females with greater comorbid conditions. Delirium was found to be associated with increased length of stay, costs, and mortality in all patients undergoing lumbar spine surgery. We recommend that physicians put greater effort into recognizing risk factors of delirium and diagnosing it in a timely manner to mitigate its effects.","[Fineberg, Steven J.; Nandyala, Sreeharsha V.; Marquez-Lara, Alejandro; Oglesby, Matthew; Singh, Kern] Rush Univ, Med Ctr, Dept Orthopaed Surg, Chicago, IL 60612 USA; [Patel, Alpesh A.] Northwestern Univ, Feinberg Sch Med, Dept Orthopaed Surg, Chicago, IL 60611 USA","Rush University; Northwestern University; Feinberg School of Medicine","Singh, K (通讯作者)，Rush Univ, Med Ctr, Dept Orthopaed Surg, 1611 W Harrison St, Chicago, IL 60612 USA.","Kern.singh@rushortho.com","","Nandyala, Sreeharsha/0000-0002-0977-1755","","","","",29,108,117,2,20,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0362-2436","1528-1159","","SPINE","SPINE","SEP 15",2013,38,20,"","","","",1790,1796,"","10.1097/BRS.0b013e3182a0d507","http://dx.doi.org/10.1097/BRS.0b013e3182a0d507","","",7,"Clinical Neurology; Orthopedics","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Neurosciences & Neurology; Orthopedics","299BM",23797502,"","","","2023-11-07","WOS:000330369600022","View Full Record in Web of Science"]
["J","Leung, JM; Sands, LP; Lim, E; Tsai, TL; Kinjo, S","","","","Leung, Jacqueline M.; Sands, Laura P.; Lim, Eunjung; Tsai, Tiffany L.; Kinjo, Sakura","","","Does Preoperative Risk for Delirium Moderate the Effects of Postoperative Pain and Opiate Use on Postoperative Delirium?","AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY","","","English","Article","","","","","","Delirium; postoperative; surgery; pain; opioids; aging; preoperative risk stratification","PATIENT-CONTROLLED ANALGESIA; HIP; PSYCHOMOTOR; MORPHINE; SURGERY; MODEL; PREDICTION; PROGRAM; DECLINE","Objectives: To investigate whether preoperative risk for delirium moderates the effect of postoperative pain and opioids on the development of postoperative delirium. Design: Prospective cohort study. Setting: University medical center. Participants: Patients 65 years of age or older scheduled for major noncardiac surgery. Measurements: A structured interview was conducted preoperatively and postoperatively to determine the presence of delirium, defined using the Confusion Assessment Method. We first developed a prediction model to determine which patients were at high versus low risk for the development of delirium based on preoperative patient data. We then computed a logistic regression model to determine whether preoperative risk for delirium moderates the effect of postoperative pain and opioids on incident delirium. Results: Of 581 patients, 40% developed delirium on days 1 or 2 after surgery. Independent preoperative predictors of postoperative delirium included lower cognitive status, a history of central nervous system disease, high surgical risk, and major spine and joint arthroplasty surgery. Compared with the patients at low preoperative risk for developing delirium, the relative risk for postoperative delirium for those in the high preoperative risk group was 2.38 (95% confidence interval: 1.67-3.40). A significant three-way interaction indicates that preoperative risk for delirium significantly moderated the effect of postoperative pain and opioid use on the development of delirium. Among patients at high preoperative risk for development of delirium who also had high postoperative pain and received high opioid doses, the incidence of delirium was 72%, compared with 20% among patients with low preoperative risk, low postoperative pain, and those who received low opioid doses. Conclusions: High levels of postoperative pain and using high opioid doses increased risk for postoperative delirium for all patients. The highest incidence of delirium was among patients who had high preoperative risk for delirium and also had high postoperative pain and used high opioid doses.","[Leung, Jacqueline M.; Tsai, Tiffany L.; Kinjo, Sakura] Univ Calif San Francisco, San Francisco, CA 94143 USA; [Sands, Laura P.; Lim, Eunjung] Purdue Univ, Lafayette, IN USA","University of California System; University of California San Francisco; Purdue University System; Purdue University","Leung, JM (通讯作者)，Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, 521 Parnassus,C-455, San Francisco, CA 94143 USA.","leungj@anesthesia.ucsf.edu","Sands, Laura P/E-8919-2015; Lim, Eunjung/G-9969-2016","Sands, Laura P/0000-0003-2446-4486;","National Institute of Aging, National Institutes of Health, Bethesda, MD [NIH 1RO1AG031795-04]","National Institute of Aging, National Institutes of Health, Bethesda, MD(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","This project was supported in part by the National Institute of Aging, National Institutes of Health, Bethesda, MD, grant NIH 1RO1AG031795-04 (Leung).","",36,83,89,0,23,"ELSEVIER SCIENCE INC","NEW YORK","STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA","1064-7481","1545-7214","","AM J GERIAT PSYCHIAT","Am. J. Geriatr. Psychiatr.","OCT",2013,21,10,"","","","",946,956,"","10.1016/j.jagp.2013.01.069","http://dx.doi.org/10.1016/j.jagp.2013.01.069","","",11,"Geriatrics & Gerontology; Gerontology; Psychiatry","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Geriatrics & Gerontology; Psychiatry","298YZ",23659900,"Green Accepted, Green Published","","","2023-11-07","WOS:000330362300004","View Full Record in Web of Science"]
["J","Whitlock, EL; Torres, BA; Lin, N; Helsten, DL; Nadelson, MR; Mashour, GA; Avidan, MS","","","","Whitlock, Elizabeth L.; Torres, Brian A.; Lin, Nan; Helsten, Daniel L.; Nadelson, Molly R.; Mashour, George A.; Avidan, Michael S.","","","Postoperative Delirium in a Substudy of Cardiothoracic Surgical Patients in the BAG- RECALL Clinical Trial","ANESTHESIA AND ANALGESIA","","","English","Article","","","","","","","INTENSIVE-CARE-UNIT; CONFUSION ASSESSMENT METHOD; CARDIAC-SURGERY; RISK-FACTORS; COGNITIVE DYSFUNCTION; VARIABLE SELECTION; BISPECTRAL INDEX; ROUTINE USE; CAM-ICU; ANESTHESIA","BACKGROUND: Postoperative delirium in the intensive care unit (ICU) is a frequent complication after cardiac or thoracic surgery and is associated with increased morbidity and mortality. METHODS: In this single-center substudy of the BAG-RECALL trial (NCT00682825), we screened patients after cardiac or thoracic surgery in the ICU twice daily for delirium using the Confusion Assessment Method for the ICU. The primary outcome was the incidence of delirium in patients who had been randomized to intraoperative Bispectral Index (BIS)-guided and end-tidal anesthetic concentration-guided depth of anesthesia protocols. As a secondary analysis, a Bayesian stochastic search variable selection strategy was used to rank a field of candidate risk factors for delirium, followed by binary logistic regression. RESULTS: Of 310 patients assessed, 28 of 149 (18.8%) in the BIS group and 45 of 161 (28.0%) in the end-tidal anesthetic concentration group developed postoperative delirium in the ICU (odds ratio 0.60, 95% confidence interval, 0.35-1.02, P= 0.058). Low average volatile anesthetic dose, intraoperative transfusion, ASA physical status, and European System for Cardiac Operative Risk Evaluation were identified as independent predictors of delirium. CONCLUSIONS: A larger randomized study should determine whether brain monitoring with BIS or an alternative method decreases delirium after cardiac or thoracic surgery. The association between low anesthetic concentration and delirium is a surprising finding and could reflect that patients with poor health are both more sensitive to the effects of volatile anesthetic drugs and are also more likely to develop postoperative delirium. Investigation of candidate methods to prevent delirium should be prioritized in view of the established association between postoperative delirium and adverse patient outcomes.","[Whitlock, Elizabeth L.; Torres, Brian A.; Helsten, Daniel L.; Nadelson, Molly R.; Avidan, Michael S.] Washington Univ, Sch Med, Dept Anesthesiol, St Louis, MO 63110 USA; [Lin, Nan] Washington Univ, Dept Math, St Louis, MO 63130 USA; [Mashour, George A.] Univ Michigan, Dept Anesthesiol, Sch Med, Ann Arbor, MI 48109 USA","Washington University (WUSTL); Washington University (WUSTL); University of Michigan System; University of Michigan","Whitlock, EL (通讯作者)，Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, 513 Parnassus Ave,Room S436, San Francisco, CA 94143 USA.","whitlocke@anesthesia.ucsf.edu","Whitlock, Elizabeth L./N-1860-2014","Whitlock, Elizabeth L./0000-0002-6868-4301; Avidan, Michael/0000-0001-6248-044X; Helsten, Dan/0000-0001-6613-507X","Foundation for Anesthesia Education and Research; American Society of Anesthesiologists [CFM-08/15/2007]; National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) [UL1 RR024992, TL1 RR024995]","Foundation for Anesthesia Education and Research; American Society of Anesthesiologists; National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH)(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Center for Research Resources (NCRR))","The BAG-RECALL trial was supported by grants from the Foundation for Anesthesia Education and Research and the American Society of Anesthesiologists (CFM-08/15/2007 to M. Avidan). The funding agencies had no role in the design, conduct, or reporting of the study. E. Whitlock was a predoctoral research trainee under grant number UL1 RR024992 and subaward number TL1 RR024995 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and the NIH Roadmap for Medical Research. The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.","",37,127,134,1,18,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-2999","","","ANESTH ANALG","Anesth. Analg.","APR",2014,118,4,"","","","",809,817,"","10.1213/ANE.0000000000000028","http://dx.doi.org/10.1213/ANE.0000000000000028","","",9,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","AG4NJ",24413548,"Green Accepted, Green Submitted, Bronze","","","2023-11-07","WOS:000335396500018","View Full Record in Web of Science"]
["J","Bellelli, G; Mazzola, P; Morandi, A; Bruni, A; Carnevali, L; Corsi, M; Zatti, G; Zambon, A; Corrao, G; Olofsson, B; Gustafson, Y; Annoni, G","","","","Bellelli, Giuseppe; Mazzola, Paolo; Morandi, Alessandro; Bruni, Adriana; Carnevali, Lucio; Corsi, Maurizio; Zatti, Giovanni; Zambon, Antonella; Corrao, Giovanni; Olofsson, Birgitta; Gustafson, Yngve; Annoni, Giorgio","","","Duration of Postoperative Delirium Is an Independent Predictor of 6-Month Mortality in Older Adults After Hip Fracture","JOURNAL OF THE AMERICAN GERIATRICS SOCIETY","","","English","Article","","","","","","delirium duration; delirium; orthogeriatric; hip fracture; elderly; mortality","CARE-UNIT SURVIVORS; PERSISTENT DELIRIUM; REHABILITATION; CONFUSION","OBJECTIVES: To evaluate the association between number of days with delirium and 6-month mortality in elderly adults after hip fracture surgery. DESIGN: Prospective cohort study with 6-month follow-up. SETTING: Orthogeriatric Unit (OGU). PARTICIPANTS: Individuals (mean age = 84.3 +/- 6.4) admitted to the OGU between October 2011 and April 2013 with hip fracture (N = 199). MEASUREMENTS: Postoperative delirium (POD) was assessed daily using the Confusion Assessment Method algorithm and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria. Multivariable Cox regression models were used to evaluate the association between POD of and 6-month mortality after surgery, after adjustment for covariates including age, prefracture residence, Katz activity of daily living score, New Mobility score, diagnosis of prefracture dementia, American Society of Anesthesiologists score, albumin serum levels, Charlson Comorbidity Index, and length of OGU stay. RESULTS: Fifty-seven participants (28.6%) developed POD. In the 6-month period after surgery, 35 (17.6%) participants died: 16 of 57 (28.1%) with POD and 19 / of 142 (13.4%) with no POD. The average duration of POD was 2.0 +/- 3.2 days for participants who died and 0.7 +/- 1.8 days for those who survived (P < .001). After adjusting for covariates, each day of POD in the OGU increased the hazard of dying at 6 months by 17% (hazard ratio = 1.17, 95% confidence interval = 1.07-1.28). CONCLUSION: In older adults undergoing hip fracture surgery, duration of POD is an important prognostic factor for 6-month mortality. Efforts to reduce duration of POD are therefore crucial for these individuals.","[Bellelli, Giuseppe; Mazzola, Paolo; Carnevali, Lucio; Annoni, Giorgio] Univ Milano Bicocca, Dept Hlth Sci, Milan, Italy; [Bellelli, Giuseppe; Bruni, Adriana; Corsi, Maurizio] S Gerardo Hosp, Geriatr Unit, Monza, Italy; [Bellelli, Giuseppe; Morandi, Alessandro] Geriatr Res Grp, Brescia, Italy; [Morandi, Alessandro] Ancelle Hosp, Dept Rehabil & Aged Care, Cremona, Italy; [Zatti, Giovanni] Univ Milano Bicocca, Dept Surg, Milan, Italy; [Zatti, Giovanni] S Gerardo Hosp, Orthopaed Unit, Monza, Italy; [Zambon, Antonella; Corrao, Giovanni] Univ Milano Bicocca, Dept Stat & Quantitat Methods, Unit Biostat Epidemiol & Publ Hlth, Milan, Italy; [Olofsson, Birgitta] Umea Univ, Dept Nursing, Umea, Sweden; [Gustafson, Yngve] Umea Univ, Dept Community Med & Rehabil, Div Geriatr Med, Umea, Sweden","University of Milano-Bicocca; Fondazione IRCCS San Gerardo dei Tintori; University of Milano-Bicocca; Fondazione IRCCS San Gerardo dei Tintori; University of Milano-Bicocca; Umea University; Umea University","Bellelli, G (通讯作者)，Univ Milano Bicocca, Via Cadore 48, I-20900 Monza, Italy.","giuseppe.bellelli@unimib.it","Bellelli, Giuseppe/H-6443-2019; Olofsson, Birgitta/AAZ-1039-2021; Mazzola, Paolo/AAC-2448-2019","Bellelli, Giuseppe/0000-0001-5430-0947; Olofsson, Birgitta/0000-0002-3754-5026; Mazzola, Paolo/0000-0002-0484-1136; Zambon, Antonella/0000-0001-6443-3858; Gustafson, Yngve/0000-0002-0999-377X","Strategic Research Programme in Care Sciences, Sweden","Strategic Research Programme in Care Sciences, Sweden","Dr. Bellelli has received honoraria from Novartis, Nutricia, and Lundbeck. Dr. Olofsson is supported by the Strategic Research Programme in Care Sciences, Sweden. Prof. Annoni has received honoraria from Abbott and Bayer.","",30,126,132,0,29,"WILEY","HOBOKEN","111 RIVER ST, HOBOKEN 07030-5774, NJ USA","0002-8614","1532-5415","","J AM GERIATR SOC","J. Am. Geriatr. Soc.","JUL",2014,62,7,"","","","",1335,1340,"","10.1111/jgs.12885","http://dx.doi.org/10.1111/jgs.12885","","",6,"Geriatrics & Gerontology; Gerontology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Geriatrics & Gerontology","AN3IX",24890941,"","","","2023-11-07","WOS:000340482000017","View Full Record in Web of Science"]
["J","Hori, D; Brown, C; Ono, M; Rappold, T; Sieber, F; Gottschalk, A; Neufeld, KJ; Gottesman, R; Adachi, H; Hogue, CW","","","","Hori, D.; Brown, C.; Ono, M.; Rappold, T.; Sieber, F.; Gottschalk, A.; Neufeld, K. J.; Gottesman, R.; Adachi, H.; Hogue, C. W.","","","Arterial pressure above the upper cerebral autoregulation limit during cardiopulmonary bypass is associated with postoperative delirium","BRITISH JOURNAL OF ANAESTHESIA","","","English","Article","","","","","","cardiac surgery; cardiopulmonary bypass; cerebral autoregulation; delirium","NEAR-INFRARED SPECTROSCOPY; BLOOD-FLOW; RANDOMIZED-TRIAL; SERUM CREATININE; CARDIAC-SURGERY; BRAIN; OUTCOMES; OXYGENATION; ANESTHESIA; THRESHOLD","Background. Mean arterial pressure (MAP) below the lower limit of cerebral autoregulation during cardiopulmonary bypass (CPB) is associated with complications after cardiac surgery. However, simply raising empiric MAP targets during CPB might result in MAP above the upper limit of autoregulation (ULA), causing cerebral hyperperfusion in some patients and predisposing them to cerebral dysfunction after surgery. We hypothesized that MAP above an ULA during CPB is associated with postoperative delirium. Methods. Autoregulation during CPB was monitored continuously in 491 patients with the cerebral oximetry index (COx) in this prospective observational study. COx represents Pearson's correlation coefficient between low-frequency changes in regional cerebral oxygen saturation (measured with near-infrared spectroscopy) and MAP. Delirium was defined throughout the postoperative hospitalization based on clinical detection with prospectively defined methods. Results. Delirium was observed in 45 (9.2%) patients. Mechanical ventilation for >48 h [odds ratio (OR), 3.94; 95% confidence interval (CI), 1.72-9.031 preoperative antidepressant use (OR, 3.0; 95% CI, 1.29-6.96), prior stroke (OR, 2.79; 95% CI, 1.12-6.96), congestive heart failure (OR, 2.68; 95% CI, 1.28-5.62), the product of the magnitude and duration of MAP above an ULA (mm Hg h; OR, 1.09; 95% CI, 1.03-1.15), and age (per year of age; OR, 1.01; 95% CI, 1.01-1.07) were independently associated with postoperative delirium. Conclusions. Excursions of MAP above the upper limit of cerebral autoregulation during CPB are associated with risk for delirium. Optimizing MAP during CPB to remain within the cerebral autoregulation range might reduce risk of delirium.","[Hori, D.; Ono, M.] Johns Hopkins Univ, Sch Med, Johns Hopkins Hosp, Div Cardiac Surg,Dept Surg, Baltimore, MD 21287 USA; [Brown, C.; Rappold, T.; Sieber, F.; Gottschalk, A.; Hogue, C. W.] Johns Hopkins Univ, Sch Med, Johns Hopkins Hosp, Dept Anesthesiol & Crit Care Med, Baltimore, MD 21287 USA; [Neufeld, K. J.] Johns Hopkins Univ, Sch Med, Johns Hopkins Hosp, Dept Psychiat, Baltimore, MD 21287 USA; [Gottesman, R.] Johns Hopkins Univ, Sch Med, Johns Hopkins Hosp, Dept Neurol, Baltimore, MD 21287 USA; [Adachi, H.] Jichi Med Univ, Saitama Med Ctr, Dept Cardiovasc Surg, Saitama, Japan","Johns Hopkins University; Johns Hopkins Medicine; Johns Hopkins University; Johns Hopkins Medicine; Johns Hopkins University; Johns Hopkins Medicine; Johns Hopkins University; Johns Hopkins Medicine; Jichi Medical University","Hogue, CW (通讯作者)，Johns Hopkins Univ, Sch Med, Johns Hopkins Hosp, Dept Anesthesiol & Crit Care Med, 1800 Orleans Ave,Zayed 6208B, Baltimore, MD 21287 USA.","chogue2@jhmi.edu","Gottesman, Rebecca/ABA-8468-2020; Hori, Daijiro/ABC-6562-2020; Ono, Masahiro/AAE-3939-2019","Neufeld, Karin/0000-0002-2395-1883","Mid-Atlantic Affiliate of the American Heart Association [103363]; National Institutes of Health [R01HL092259, R01AG033615, R01AG029656-01A1]; Mentored Career Development Award from the National Institutes of Health [5KL2RR025006, R03 AG042331]; Jahnigen Career Development Award","Mid-Atlantic Affiliate of the American Heart Association(American Heart Association); National Institutes of Health(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA); Mentored Career Development Award from the National Institutes of Health; Jahnigen Career Development Award","Funded in part by grant-in-aid number 103363 from the Mid-Atlantic Affiliate of the American Heart Association (C.W.H.); grants R01HL092259 (C.W.H.), R01AG033615 (F.S.), and R01AG029656-01A1 (F.S.) from the National Institutes of Health; Mentored Career Development Award 5KL2RR025006 and R03 AG042331 from the National Institutes of Health (C.B.); and the Jahnigen Career Development Award (C.B.).","",36,122,138,0,23,"OXFORD UNIV PRESS","OXFORD","GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND","0007-0912","1471-6771","","BRIT J ANAESTH","Br. J. Anaesth.","DEC",2014,113,6,"","","","",1009,1017,"","10.1093/bja/aeu319","http://dx.doi.org/10.1093/bja/aeu319","","",9,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","AU8BP",25256545,"hybrid, Green Published","","","2023-11-07","WOS:000345822000017","View Full Record in Web of Science"]
["J","[Anonymous]","","","","[Anonymous]","","","Postoperative Delirium in Older Adults: Best Practice Statement from the American Geriatrics Society","JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS","","","English","Article","","","","","","","ELDER LIFE PROGRAM; CRITICALLY-ILL PATIENTS; CONFUSION ASSESSMENT METHOD; HIP-FRACTURE; HALOPERIDOL PROPHYLAXIS; QUALITY IMPROVEMENT; FUNCTIONAL DECLINE; CARDIAC-SURGERY; DOUBLE-BLIND; HIGH-RISK","","","","","","","Kennedy, Maura/0000-0002-8755-7324; Fick, Donna/0000-0002-6777-1913; Richter, Holly E/0000-0001-7741-5771","","","","",101,262,271,2,43,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","1072-7515","1879-1190","","J AM COLL SURGEONS","J. Am. Coll. Surg.","FEB",2015,220,2,"","","","",136,"+","","10.1016/j.jamcollsurg.2014.10.019","http://dx.doi.org/10.1016/j.jamcollsurg.2014.10.019","","",14,"Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Surgery","AY9XX",25535170,"hybrid","","","2023-11-07","WOS:000347902000004","View Full Record in Web of Science"]
["J","Inouye, SK; Robinson, T; Blaum, C; Busby-Whitehead, J; Boustani, M; Chalian, A; Deiner, S; Fick, D; Hutchison, L; Johanning, J; Katlic, M; Kempton, J; Kennedy, M; Kimchi, E; Ko, C; Leung, J; Mattison, M; Mohanty, S; Nana, A; Needham, D; Neufeld, K; Richter, H; Radcliff, S; Weston, C; Patil, S; Rocco, G; Yue, JR; Aiello, SE; Drootin, M; Ickowicz, E; Samuel, MJ","","","","Inouye, Sharon K.; Robinson, Tom; Blaum, Caroline; Busby-Whitehead, Jan; Boustani, Malaz; Chalian, Ara; Deiner, Stacie; Fick, Donna; Hutchison, Lisa; Johanning, Jason; Katlic, Mark; Kempton, James; Kennedy, Maura; Kimchi, Eyal; Ko, Cliff; Leung, Jacqueline; Mattison, Melissa; Mohanty, Sanjay; Nana, Arvind; Needham, Dale; Neufeld, Karin; Richter, Holly; Radcliff, Sue; Weston, Christine; Patil, Sneeha; Rocco, Gina; Yue, Jirong; Aiello, Susan E.; Drootin, Marianna; Ickowicz, Elvy; Samuel, Mary Jordan","","Amer Geriatrics Soc Expert Panel","American Geriatrics Society Abstracted Clinical Practice Guideline for Postoperative Delirium in Older Adults","JOURNAL OF THE AMERICAN GERIATRICS SOCIETY","","","English","Article","","","","","","delirium; clinical practice guidelines; post-operative delirium; delirium prevention","ELDER LIFE PROGRAM; PREVENT DELIRIUM; HIP-FRACTURE; MULTICOMPONENT INTERVENTION; TARGETED INTERVENTION; QUALITY IMPROVEMENT; REDUCING DELIRIUM; CARE; MELATONIN","The abstracted set of recommendations presented here provides essential guidance both on the prevention of postoperative delirium in older patients at risk of delirium and on the treatment of older surgical patients with delirium, and is based on the 2014 American Geriatrics Society (AGS) Guideline. The full version of the guideline, American Geriatrics Society Clinical Practice Guideline for Postoperative Delirium in Older Adults is available at the website of the AGS. The overall aims of the study were twofold: first, to present nonpharmacologic and pharmacologic interventions that should be implemented perioperatively for the prevention of postoperative delirium in older adults; and second, to present nonpharmacologic and pharmacologic interventions that should be implemented perioperatively for the treatment of postoperative delirium in older adults. Prevention recommendations focused on primary prevention (i.e., preventing delirium before it occurs) in patients who are at risk for postoperative delirium (e.g., those identified as moderate-to-high risk based on previous risk stratification models such as the National Institute for Health and Care Excellence (NICE) guidelines, Delirium: Diagnosis, Prevention and Management. Clinical Guideline 103; London (UK): 2010 July 29). For management of delirium, the goals of this guideline are to decrease delirium severity and duration, ensure patient safety and improve outcomes.","[Amer Geriatrics Soc Expert Panel] Amer Geriatr Soc, New York, NY 10024 USA; [Inouye, Sharon K.] Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Boston, MA USA; [Inouye, Sharon K.] Aging Brain Ctr, Inst Aging Res, Boston, MA USA; [Robinson, Tom] Univ Colorado, Sch Med, Aurora, CO USA; [Blaum, Caroline] NYU, Sch Med, New York, NY USA; [Busby-Whitehead, Jan] Univ N Carolina, Sch Med, Ctr Aging & Hlth, Chapel Hill, NC USA; [Boustani, Malaz] Indiana Univ Sch Med, Indianapolis, IN 46202 USA; [Chalian, Ara] Hosp Univ Penn, Philadelphia, PA 19104 USA; [Deiner, Stacie] Mt Sinai Hosp, New York, NY 10029 USA; [Fick, Donna] Penn State Univ, Coll Nursing & Med, University Pk, PA 16802 USA; [Hutchison, Lisa] Univ Arkansas Med Sci, Little Rock, AR 72205 USA; [Johanning, Jason] Univ Nebraska Med Ctr, Omaha, NE USA; [Katlic, Mark] Sinai Hosp, Baltimore, MD 21215 USA; [Kempton, James] Yale Univ, New Haven, CT 06520 USA; [Kennedy, Maura] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA; [Kimchi, Eyal] Massachusetts Gen Hosp, Boston, MA 02114 USA; [Ko, Cliff] Univ Calif Los Angeles, Los Angeles, CA USA; [Leung, Jacqueline] Univ Calif San Francisco, San Francisco, CA 94143 USA; [Mattison, Melissa] Harvard Univ, Boston, MA 02115 USA; [Mattison, Melissa] Beth Israel Deaconess Med Sch, Boston, MA USA; [Mohanty, Sanjay] Amer Coll Surg, Chicago, IL USA; [Nana, Arvind] JPS Hlth, Ft Worth, TX USA; [Needham, Dale] Johns Hopkins Univ, Baltimore, MD USA; [Neufeld, Karin] Johns Hopkins Univ Hosp, Baltimore, MD 21287 USA; [Richter, Holly] Univ Alabama Birmingham, Birmingham, AL USA","Harvard University; Beth Israel Deaconess Medical Center; Harvard Medical School; University of Colorado System; University of Colorado Anschutz Medical Campus; New York University; University of North Carolina School of Medicine; University of North Carolina; University of North Carolina Chapel Hill; Indiana University System; Indiana University Bloomington; University of Pennsylvania; Pennsylvania Medicine; Icahn School of Medicine at Mount Sinai; Pennsylvania Commonwealth System of Higher Education (PCSHE); Pennsylvania State University; Pennsylvania State University - University Park; University of Arkansas System; University of Arkansas Medical Sciences; University of Nebraska System; University of Nebraska Medical Center; Sinai Hospital of Baltimore; Yale University; Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Massachusetts General Hospital; University of California System; University of California Los Angeles; University of California System; University of California San Francisco; Harvard University; Harvard University; Beth Israel Deaconess Medical Center; American College of Surgeons; Johns Hopkins University; Johns Hopkins University; Johns Hopkins Medicine; University of Alabama System; University of Alabama Birmingham","Samuel, MJ (通讯作者)，Amer Geriatr Soc, 40 Fulton St,18th Floor, New York, NY 10024 USA.","mjsamuel@americangeriatrics.org","Nana, Arvind D./HKE-8178-2023; Kennedy, Maura/ITT-7157-2023; Boustani, Malaz/Q-3850-2019; , 月月/AAS-9999-2021; Inouye, Sharon/R-7216-2019; , 月月/ABF-7551-2020; Kennedy, Maura/AAQ-4986-2021","Nana, Arvind D./0000-0002-9702-6383; Kennedy, Maura/0000-0002-8755-7324; Boustani, Malaz/0000-0003-0330-677X; , 月月/0000-0002-3730-779X; Neufeld, Karin/0000-0002-2395-1883; Fick, Donna/0000-0002-6777-1913","American Geriatrics Society Geriatrics-for-Specialists Initiative (AGS-GSI) through John A. Hartford Foundation; NIH; ADRC; AGS Foundation for Anesthesia Education and Research; Brookdale; SLACK Inc.; National Institute of Nursing Research; MedEd Portal/Josiah Macy Foundation IPE Award; Practical Reviews in Hospital Medicine; ORNIM medical manufacturing; Pelvalon; Medtronics, Inc.; Karl Storz Endoscopy America; Covidien","American Geriatrics Society Geriatrics-for-Specialists Initiative (AGS-GSI) through John A. Hartford Foundation; NIH(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA); ADRC; AGS Foundation for Anesthesia Education and Research; Brookdale; SLACK Inc.; National Institute of Nursing Research(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of Nursing Research (NINR)); MedEd Portal/Josiah Macy Foundation IPE Award; Practical Reviews in Hospital Medicine; ORNIM medical manufacturing; Pelvalon; Medtronics, Inc.; Karl Storz Endoscopy America; Covidien","Sue Radcliff, Independent Researcher, Denver, CO, and Christine Weston, Independent Researcher, Baltimore, MD, led the literature review efforts of the panel. Additional research assistance was provided by Sneeha Patil, Gina Rocco, and Jirong Yue. Susan E. Aiello, DVM, ELS, provided editorial services. Marianna Drootin, MPA, Elvy Ickowicz, MPH, and Mary Jordan Samuel provided additional research and administrative support. The development of this paper was supported in part by the American Geriatrics Society Geriatrics-for-Specialists Initiative (AGS-GSI) through an unrestricted grant from the John A. Hartford Foundation.; Conflict of Interest: Drs. Blaum, Boustani, Chalian, Inouye, Katlic, Kempton, Kennedy, Kimchi, Ko, Mattison, Mohanty, and Nana indicated no conflicts of interest. Dr. Busby-Whitehead indicated her spouse is a paid consultant for Ironwood Pharma, Ono Pharma: Fecal Incontinence and Irritable Bowel Syndrome, and her spouse has received a grant from Salix Pharma, Ono Pharma: Fecal Incontinence and Irritable Bowel Syndrome. Dr. Deiner has received grants from the NIH, ADRC, and AGS Foundation for Anesthesia Education and Research, and Dr. Deiner's spouse has received grants from NIH, ADRC, AGS Foundation for Anesthesia Education and Research, and Brookdale. Dr. Deiner's spouse is also on the speaker's panel for Baxter. Both Dr. Deiner and spouse receive product support from Covidien and Aspect. Dr. Fick is a paid consultant for SLACK Inc. as Editor of the Journal of Gerontological Nursing. Dr. Fick has current R01 funding from the NIH and from the National Institute of Nursing Research. Ms. Giovannetti is employed by the National Committee for Quality Assurance (NCQA) which conducts healthcare quality research, develops healthcare quality measures, publishes healthcare quality data, and distributes healthcare quality products (e.g., Accreditation, Certification). Dr. Hutchison received grants from MedEd Portal/Josiah Macy Foundation IPE Award, and Dr. Hutchison and spouse hold shares in Cardinal Health and Care Fusion. Dr. Johanning received a royalty on Isolation Station from Harloff Corporation. Dr. Mattison is a paid consultant for Practical Reviews in Hospital Medicine and is an UpToDate contributor. Dr. Leung and her husband receive funding from the NIH. Dr. Leung's husband is the cofounder of Mynosys Inc. Dr. Needham is Chair of the Early Mobility Committee for the upcoming Society of Critical Care Medicine Clinical Practice Guideline for pain, agitation, delirium, early mobility, and sleep. Dr. Neufeld is participating on a grant from ORNIM medical manufacturing that is funding a portion of her salary. Dr. Richter is a paid consultant for and has received a research grant from Pelvalon. She has also received royalties from UpToDate. Dr. Robinson has received research grants from Medtronics, Inc., Karl Storz Endoscopy America, and Covidien. Gina Rocco and Jirong Yue have no conflicts of interest to disclose. Sneha Patil has commercial interest in Oracle.","",35,237,252,6,92,"WILEY","HOBOKEN","111 RIVER ST, HOBOKEN 07030-5774, NJ USA","0002-8614","1532-5415","","J AM GERIATR SOC","J. Am. Geriatr. Soc.","JAN",2015,63,1,"","","","",142,150,"","10.1111/jgs.13281","http://dx.doi.org/10.1111/jgs.13281","","",9,"Geriatrics & Gerontology; Gerontology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Geriatrics & Gerontology","AZ7BW",25495432,"Green Accepted, Green Submitted, Bronze","","","2023-11-07","WOS:000348374200020","View Full Record in Web of Science"]
["J","Raats, JW; van Eijsden, WA; Crolla, RMPH; Steyerberg, EW; van der Laan, L","","","","Raats, Jelle W.; van Eijsden, Wilbert A.; Crolla, Rogier M. P. H.; Steyerberg, Ewout W.; van der Laan, Lijckle","","","Risk Factors and Outcomes for Postoperative Delirium after Major Surgery in Elderly Patients","PLOS ONE","","","English","Article","","","","","","","ABDOMINAL AORTIC-ANEURYSM; COLORECTAL SURGERY; COGNITIVE DYSFUNCTION; GERIATRIC POPULATION; VASCULAR-SURGERY; ADVERSE OUTCOMES; HIP FRACTURE; OPEN REPAIR; IMPLEMENTATION; VALIDATION","Background Early identification of patients at risk for delirium is important, since adequate well timed interventions could prevent occurrence of delirium and related detrimental outcomes. The aim of this study is to evaluate prognostic factors for delirium, including factors describing frailty, in elderly patients undergoing major surgery. Methods We included patients of 65 years and older, who underwent elective surgery from March 2013 to November 2014. Patients had surgery for Abdominal Aortic Aneurysm (AAA) or colorectal cancer. Delirium was scored prospectively using the Delirium Observation Screening Scale. Pre- and peri-operative predictors of delirium were analyzed using regression analysis. Outcomes after delirium included adverse events, length of hospital stay, discharge destination and mortality. Results We included 232 patients. 51 (22%) underwent surgery for AAA and 181 (78%) for colorectal cancer. Postoperative delirium occurred in 35 patients (15%). Predictors of postoperative delirium included: delirium in medical history (Odds Ratio 12 [95% Confidence Interval 2.7-50]), advancing age (Odds Ratio 2.0 [95% Confidence Interval 1.1-3.8]) per 10 years, and ASA-score >= 3 (Odds Ratio 2.6 [95% Confidence Interval 1.1-5.9]). Occurrence of delirium was related to an increase in adverse events, length of hospital stay and mortality. Conclusion Postoperative delirium is a frequent complication after major surgery in elderly patients and is related to an increase in adverse events, length of hospital stay, and mortality. A delirium in the medical history, advanced age, and ASA-score may assist in defining patients at increased risk for delirium. Further attention to prevention of delirium is essential in elderly patients undergoing major surgery.","[Raats, Jelle W.; van Eijsden, Wilbert A.; Crolla, Rogier M. P. H.; van der Laan, Lijckle] Amphia Hosp, Dept Surg, Breda, Netherlands; [Steyerberg, Ewout W.] Erasmus MC, Dept Publ Hlth, Rotterdam, Netherlands","Amphia Hospital; Erasmus University Rotterdam; Erasmus MC","Raats, JW (通讯作者)，Amphia Hosp, Dept Surg, Breda, Netherlands.","JRaats@amphia.nl","Crolla, Rogier/L-9847-2019; Steyerberg, Ewout W/C-1509-2018","Crolla, Rogier/0000-0003-2617-1791; Steyerberg, Ewout W/0000-0002-7787-0122; van der laan, lijckle/0000-0001-5631-594X","","","","",43,159,161,0,27,"PUBLIC LIBRARY SCIENCE","SAN FRANCISCO","1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA","1932-6203","","","PLOS ONE","PLoS One","AUG 20",2015,10,8,"","","","","","","e0136071","10.1371/journal.pone.0136071","http://dx.doi.org/10.1371/journal.pone.0136071","","",12,"Multidisciplinary Sciences","Science Citation Index Expanded (SCI-EXPANDED)","Science & Technology - Other Topics","CP5KH",26291459,"Green Published, gold, Green Submitted","","","2023-11-07","WOS:000359919900049","View Full Record in Web of Science"]
["J","Androsova, G; Krause, R; Winterer, G; Schneider, R","","","","Androsova, Ganna; Krause, Roland; Winterer, Georg; Schneider, Reinhard","","","Biomarkers of postoperative delirium and cognitive dysfunction","FRONTIERS IN AGING NEUROSCIENCE","","","English","Review","","","","","","postoperative delirium; postoperative cognitive dysfunction; biomarker; systems biology; POD; POCD","SERUM ANTICHOLINERGIC ACTIVITY; C-REACTIVE PROTEIN; CRITICALLY-ILL PATIENTS; DOPAMINE TRANSPORTER GENE; NEURON-SPECIFIC ENOLASE; EPSILON 4 ALLELE; ELDERLY-PATIENTS; CEREBROSPINAL-FLUID; ALZHEIMERS-DISEASE; APOLIPOPROTEIN-E","Elderly surgical patients frequently experience postoperative delirium (POD) and the subsequent development of postoperative cognitive dysfunction (POCD). Clinical features include deterioration in cognition, disturbance in attention and reduced awareness of the environment and result in higher morbidity, mortality and greater utilization of social financial assistance. The aging Western societies can expect an increase in the incidence of POD and POCD. The underlying pathophysiological mechanisms have been studied on the molecular level albeit with unsatisfying small research efforts given their societal burden. Here, we review the known physiological and immunological changes and genetic risk factors, identify candidates for further studies and integrate the information into a draft network for exploration on a systems level. The pathogenesis of these postoperative cognitive impairments is multifactorial; application of integrated systems biology has the potential to reconstruct the underlying network of molecular mechanisms and help in the identification of prognostic and diagnostic biomarkers.","[Androsova, Ganna; Krause, Roland; Schneider, Reinhard] Univ Luxembourg, Bioinformat Core, Luxembourg Ctr Syst Biomed, L-4362 Belvaux, Luxembourg; [Winterer, Georg] Charite, Expt & Clin Res Ctr, Dept Anesthesiol & Operat Intens Care Med, D-13353 Berlin, Germany","University of Luxembourg; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin","Androsova, G (通讯作者)，Univ Luxembourg, Bioinformat Core, Luxembourg Ctr Syst Biomed, Ave Hauts Fourneaux 7, L-4362 Belvaux, Luxembourg.","ganna.androsova@uni.lu","Schneider, Reinhard/C-5441-2009","Schneider, Reinhard/0000-0002-8278-1618; Krause, Roland/0000-0001-9938-7126; Fournier, Anna/0000-0002-5417-4001","EU","EU(European Union (EU))","The research leading to these results has received funding from the framework of the EU-funded FP7 research program: BioCog (Biomarker Development for Postoperative Cognitive Impairment in the Elderly): www.biocog.eu","",221,152,168,3,81,"FRONTIERS MEDIA SA","LAUSANNE","AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND","1663-4365","","","FRONT AGING NEUROSCI","Front. Aging Neurosci.","JUN 9",2015,7,"","","","","","","",112,"10.3389/fnagi.2015.00112","http://dx.doi.org/10.3389/fnagi.2015.00112","","",16,"Geriatrics & Gerontology; Neurosciences","Science Citation Index Expanded (SCI-EXPANDED)","Geriatrics & Gerontology; Neurosciences & Neurology","CM0QU",26106326,"Green Published, gold, Green Accepted","","","2023-11-07","WOS:000357384000002","View Full Record in Web of Science"]
["J","Hirsch, J; DePalma, G; Tsai, TT; Sands, LP; Leung, JM","","","","Hirsch, J.; DePalma, G.; Tsai, T. T.; Sands, L. P.; Leung, J. M.","","","Impact of intraoperative hypotension and blood pressure fluctuations on early postoperative delirium after non-cardiac surgery","BRITISH JOURNAL OF ANAESTHESIA","","","English","Article","","","","","","arterial blood pressure; delirium; hypotension","IMPAIRED CEREBRAL AUTOREGULATION; RISK-FACTORS; ELDERLY-PATIENTS; HALOPERIDOL PROPHYLAXIS; PROGNOSTIC-SIGNIFICANCE; COGNITIVE DYSFUNCTION; PREDISPOSING FACTORS; HIP FRACTURE; FLOW; ASSOCIATION","Introduction: Postoperative delirium is common in older patients. Despite its prognostic significance, the pathophysiology is incompletely understood. Although many risk factors have been identified, no reversible factors, particularly ones potentially modifiable by anaesthetic management, have been identified. The goal of this prospective cohort study was to investigate whether intraoperative hypotension was associated with postoperative delirium in older patients undergoing major non-cardiac surgery. Methods: Study subjects were patients >65 years of age, undergoing major non-cardiac surgery, who were enrolled in an ongoing prospective observational study of the pathophysiology of postoperative delirium. Intraoperative blood pressure was measured and predefined criteria were used to define hypotension. Delirium was measured by the Confusion Assessment Method on the first two postoperative days. Data were analysed using t-tests, two-sample proportion tests and ordered logistic regression multivariable models, including correction for multiple comparisons. Results: Data from 594 patients with a mean age of 73.6 years (SD 6.2) were studied. Of these 178 (30%) developed delirium on day 1 and 176 (30%) on day 2. Patients developing delirium were older, more often female, had lower preoperative cognitive scores, and underwent longer operations. Relative hypotension (decreases by 20, 30, or 40%) or absolute hypotension [mean arterial pressure (MAP)<50 mm Hg] were not significantly associated with postoperative delirium, nor was the duration of hypotension (MAP<50 mm Hg). Conversely, intraoperative blood pressure variance was significantly associated with postoperative delirium. Discussion: These results showed that increased blood pressure fluctuation, not absolute or relative hypotension, was predictive of postoperative delirium.","[Hirsch, J.; Tsai, T. T.; Leung, J. M.] Univ Calif San Francisco, Dept Anaesthesia & Perioperat Care, San Francisco, CA 94143 USA; [DePalma, G.; Sands, L. P.] Purdue Univ, Dept Stat, W Lafayette, IN 47907 USA","University of California System; University of California San Francisco; Purdue University System; Purdue University West Lafayette Campus; Purdue University","Hirsch, J (通讯作者)，Univ Calif San Francisco, San Francisco VAMC, San Francisco Anesthesiol Serv, Dept Anaesthesia & Perioperat Care, 4150 Clement St,Mail 129, San Francisco, CA 94121 USA.","jan.hirsch@ucsf.edu","Leung, Joyce/JCE-3061-2023; Sands, Laura P/E-8919-2015","Sands, Laura P/0000-0003-2446-4486","Anesthesia Patient Safety Foundation (Indianapolis, IN, USA); National Institutes of Health of the United States (NIH) [1RO1AG031795-05]","Anesthesia Patient Safety Foundation (Indianapolis, IN, USA); National Institutes of Health of the United States (NIH)(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA)","This work was supported by funding from the Anesthesia Patient Safety Foundation (Indianapolis, IN, USA), and the National Institutes of Health of the United States (NIH 1RO1AG031795-05) (to J.M.L.).","",71,143,164,2,26,"ELSEVIER SCI LTD","OXFORD","THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND","0007-0912","1471-6771","","BRIT J ANAESTH","Br. J. Anaesth.","SEP",2015,115,3,"","","","",418,426,"","10.1093/bja/aeu458","http://dx.doi.org/10.1093/bja/aeu458","","",9,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","CR2WL",25616677,"Green Published, hybrid, Green Submitted","","","2023-11-07","WOS:000361191400015","View Full Record in Web of Science"]
["J","Soehle, M; Dittmann, A; Ellerkmann, RK; Baumgarten, G; Putensen, C; Guenther, U","","","","Soehle, Martin; Dittmann, Alexander; Ellerkmann, Richard K.; Baumgarten, Georg; Putensen, Christian; Guenther, Ulf","","","Intraoperative burst suppression is associated with postoperative delirium following cardiac surgery: a prospective, observational study","BMC ANESTHESIOLOGY","","","English","Article","","","","","","Cardiac surgery; Postoperative delirium; Outcome; Electroencephalogram; Burst suppression; Bispectral Index","INTENSIVE-CARE-UNIT; MECHANICALLY VENTILATED PATIENTS; BYPASS GRAFT-SURGERY; PATIENT STATE INDEX; BISPECTRAL INDEX; RISK-FACTORS; MORTALITY; EEG; ANESTHESIA; TRIAL","Background: Postoperative delirium (POD) occurs frequently after cardiac surgery and is associated with increased morbidity and mortality. We analysed whether perioperative bilateral BIS monitoring may detect abnormalities before the onset of POD in cardiac surgery patients. Methods: In a prospective observational study, 81 patients undergoing cardiac surgery were included. Bilateral Bispectral Index (BIS)-monitoring was applied during the pre-, intra- and postoperative period, and BIS, EEG Asymmetry (ASYM), and Burst Suppression Ratio (BSR) were recorded. POD was diagnosed according to the Confusion Assessment Method for the Intensive Care Unit, and patients were divided into a delirium and non-delirium group. Results: POD was detected in 26 patients (32%). A trend towards a lower ASYM was observed in the delirium group as compared to the non-delirium group on the preoperative day (ASYM = 48.2 +/- 3.6% versus 50.0 +/- 4.7%, mean +/- sd, p = 0.087) as well as before induction of anaesthesia, with oral midazolam anxiolysis (median ASYM = 49.5%, IQR [47.4;51.5] versus 50.6%, IQR [49.1;54.2], p = 0.081). Delirious patients remained significantly (p = 0.018) longer in a burst suppression state intraoperatively (107 minutes, IQR [47;170] versus 44 minutes, IQR [11;120]) than non-delirious patients. Receiver operating analysis revealed burst suppression duration (area under the curve = 0.73, p = 0.001) and BSR (AUC = 0.68, p = 0.009) as predictors of POD. Conclusions: Intraoperative assessment of BSR may identify patients at risk of POD and should be investigated in further studies. So far it remains unknown whether there is a causal relationship or rather an association between intraoperative burst suppression and the development of POD.","[Soehle, Martin; Ellerkmann, Richard K.; Baumgarten, Georg; Putensen, Christian; Guenther, Ulf] Univ Bonn, Dept Anaesthesiol & Intens Care Med, Bonn, Germany; [Dittmann, Alexander] LVR Clin, Dept Neurol & Psychiat, Bonn, Germany","University of Bonn","Soehle, M (通讯作者)，Univ Bonn, Dept Anaesthesiol & Intens Care Med, Bonn, Germany.","martin.soehle@ukb.uni-bonn.de","","","Covidien AG (Neuhausen, Switzerland)","Covidien AG (Neuhausen, Switzerland)","This study was funded in part by a grant of Covidien AG (Neuhausen, Switzerland) to MS. The sponsor had no influence on study design, study conductance, data analysis, preparation of the manuscript and the decision to submit the manuscript for publication.","",38,130,142,1,22,"BIOMED CENTRAL LTD","LONDON","236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND","1471-2253","","","BMC ANESTHESIOL","BMC Anesthesiol.","APR 28",2015,15,"","","","","","","",61,"10.1186/s12871-015-0051-7","http://dx.doi.org/10.1186/s12871-015-0051-7","","",8,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","CH2RY",25928189,"Green Published, gold","","","2023-11-07","WOS:000353873500001","View Full Record in Web of Science"]
["J","Jung, P; Pereira, MA; Hiebert, B; Song, XW; Rockwood, K; Tangri, N; Arora, RC","","","","Jung, Patrick; Pereira, Michael Ashley; Hiebert, Brett; Song, Xiaiwei; Rockwood, Kenneth; Tangri, Navdeep; Arora, Rakesh C.","","","The impact of frailty on postoperative delirium in cardiac surgery patients","JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY","","","English","Article","","","","","","","INTENSIVE-CARE-UNIT; CONFUSION ASSESSMENT METHOD; GERIATRIC DEPRESSION SCALE; ELDERLY-PATIENTS; MAJOR MORBIDITY; OLDER-PEOPLE; MORTALITY; RISK; PREDICTOR; DISEASE","Objective: To determine if adding frailty measures to the EuroSCORE II improves model performance in predicting postoperative delirium. Methods: In a prospective observational study in elective cardiac surgery patients, frailty was defined using the Modified Fried Criteria (MFC), the Short Physical Performance Battery (SPPB) and a 35-item Frailty Index (FI). The primary outcome was postoperative delirium, assessed using the Confusion Assessment Method (CAM). Results: Seventy-two (54.1%) of the 133 participants met the MFC definition for frailty and 69 (51.9%) met the SPPB definition. Eighty-eight (66.2%) participants had an FI score >= 0.2, and 47 (35.3%) had a score >= 0.3. After adjusting for the EuroSCORE II, frail patients as identified by the MFC were at increased risk of postoperative delirium (adjusted odds ratio [OR], 5.05, 95% confidence interval [CI], 1.58-16.13). Patients in the high risk frailty SPPB category had even greater risk (adjusted OR, 8.26, 95% CI, 2.23-30.64). FI scores >= 0.3 were also associated with higher risk of delirium (adjusted OR, 3.72, 95% CI, 1.39-9.92). The inclusion of any of these definitions of frailty improved the discrimination of the EuroSCORE II in predicting postoperative delirium. Conclusions: Frailty results in a 3- to 8-fold increase in risk of postoperative delirium, independent of the EuroSCORE II. Frail and fit may be considered 2 ends of a continuum, and the risk of postoperative delirium grows as one becomes increasingly frail. The addition of frailty improves the ability of the EuroSCORE II to predict postoperative delirium, pointing to opportunities for improved prevention and management.","[Jung, Patrick; Pereira, Michael Ashley] Univ Manitoba, Winnipeg, MB, Canada; [Hiebert, Brett] Cardiac Sci Program, Winnipeg, MB, Canada; [Song, Xiaiwei; Rockwood, Kenneth] QEII Hlth Sci Ctr, Halifax, NS, Canada; [Song, Xiaiwei; Rockwood, Kenneth] Dalhousie Univ, Halifax, NS, Canada; [Tangri, Navdeep] Seven Oaks Hosp, Winnipeg, MB, Canada; [Tangri, Navdeep; Arora, Rakesh C.] Univ Manitoba, Winnipeg, MB, Canada; [Arora, Rakesh C.] St Boniface Gen Hosp, Winnipeg, MB R2H 2A6, Canada","University of Manitoba; Queen Elizabeth II Health Sciences Centre; Dalhousie University; University of Manitoba; University of Manitoba; Children's Hospital Research Institute of Manitoba","Arora, RC (通讯作者)，St Boniface Gen Hosp, IH Asper CRI, CR3012-369 Tache Ave, Winnipeg, MB R2H 2A6, Canada.","rakeshcarora@gmail.com","Rockwood, Kenneth/AAD-8951-2019; Arora, Rakesh/D-2245-2014","Tangri, Navdeep/0000-0002-5075-6370; Arora, Rakesh/0000-0002-5799-3619","Pfizer Canada Inc","Pfizer Canada Inc","Dr Arora has received funding in the way of an unrestricted educational grant from Pfizer Canada Inc for work not related to the data presented in this manuscript. All other authors have nothing to disclose with regard to commercial support.","",33,116,119,1,15,"MOSBY-ELSEVIER","NEW YORK","360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA","0022-5223","1097-685X","","J THORAC CARDIOV SUR","J. Thorac. Cardiovasc. Surg.","MAR",2015,149,3,"","","","",869,875,"","10.1016/j.jtcvs.2014.10.118","http://dx.doi.org/10.1016/j.jtcvs.2014.10.118","","",7,"Cardiac & Cardiovascular Systems; Respiratory System; Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Cardiovascular System & Cardiology; Respiratory System; Surgery","CE6EX",25486976,"hybrid","","","2023-11-07","WOS:000351930600066","View Full Record in Web of Science"]
["J","Oh, ES; Li, M; Fafowora, TM; Inouye, SK; Chen, CH; Rosman, LM; Lyketsos, CG; Sieber, FE; Puhan, MA","","","","Oh, Esther S.; Li, Meng; Fafowora, Tolulope M.; Inouye, Sharon K.; Chen, Cathy H.; Rosman, Lori M.; Lyketsos, Constantine G.; Sieber, Frederick E.; Puhan, Milo A.","","","Preoperative risk factors for postoperative delirium following hip fracture repair: a systematic review","INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY","","","English","Article","","","","","","risk factors; postoperative; delirium; hip fracture","ELDER LIFE PROGRAM; FUNCTIONAL DECLINE; SURGERY; STATE; MODEL; PAIN","Objective: Systematically identify preoperative clinical risk factors for incident postoperative delirium in individuals undergoing hip fracture repair in order to guide clinicians in identifying high risk patients at admission. Methods: This is a systematic review of prospective observational studies with estimation of association between preoperative risk factors and incident postoperative delirium in multivariate models. Electronic searches were conducted in PubMed, Embase, PsycINFO, CINAHL, Cochrane Library, Proquest Dissertations and Theses, and WorldCatDissertations. Hand searches were conducted in selected journals and their supplements. Results: Search yielded 6380 titles and abstracts from electronic databases and 72 titles from hand searches, and 10 studies met inclusion criteria. The following risk factors were significant in bivariate models: cognitive impairment, age, gender, institutionalization, functional impairment, body mass index (BMI), albumin, comorbidities, American Society of Anesthesiologist classification, acute medical conditions, polypharmacy, and vision impairment. Among all of these risk factors, cognitive impairment most consistently remained statistically significant after adjusting for other risk factors in multivariate models, followed by BMI/albumin and multiple comorbidities. Conclusion: In our systematic review, cognitive impairment was one of the strongest preoperative risk factors for postoperative delirium after hip fracture surgery. Preoperative cognitive assessment may be one of the most useful methods of identifying those who are at high risk for postoperative delirium and prioritizing delivery of delirium prevention measures. Copyright (C) 2014 John Wiley & Sons, Ltd.","[Oh, Esther S.; Fafowora, Tolulope M.] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA; [Oh, Esther S.; Lyketsos, Constantine G.] Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21205 USA; [Oh, Esther S.] Johns Hopkins Univ, Sch Med, Dept Pathol, Baltimore, MD 21205 USA; [Sieber, Frederick E.] Johns Hopkins Univ, Sch Med, Dept Anesthesiol & Crit Care Med, Baltimore, MD 21205 USA; [Rosman, Lori M.] Johns Hopkins Univ, Sch Med, Dept Welch Med Lib, Baltimore, MD 21205 USA; [Oh, Esther S.] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA; [Li, Meng] Univ Washington, Pharmaceut Outcomes Res & Policy Program, Seattle, WA 98195 USA; [Inouye, Sharon K.] Hebrew SeniorLife, Inst Aging Res, Aging Brain Ctr, Boston, MA USA; [Inouye, Sharon K.] Harvard Univ, Sch Med, Dept Med, Beth Israel Deaconess Med Ctr, Boston, MA USA; [Chen, Cathy H.] Princeton Univ, Princeton, NJ 08544 USA; [Puhan, Milo A.] Univ Zurich, Inst Social & Prevent Med, CH-8006 Zurich, Switzerland","Johns Hopkins University; Johns Hopkins University; Johns Hopkins University; Johns Hopkins University; Johns Hopkins University; Johns Hopkins University; Johns Hopkins Bloomberg School of Public Health; University of Washington; University of Washington Seattle; Harvard University; Hebrew SeniorLife; Harvard University; Beth Israel Deaconess Medical Center; Harvard Medical School; Princeton University; University of Zurich","Oh, ES (通讯作者)，Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA.","eoh9@jhmi.edu","Puhan, Milo/ABE-6298-2020; Rosman, Lori/HSG-4344-2023; Lyketsos, Constantine/HJI-2492-2023; Inouye, Sharon/R-7216-2019","Puhan, Milo/0000-0003-4721-1879; Chen, Cathy/0000-0001-8120-1362; Rosman, Lori/0000-0002-6935-1672","Johns Hopkins Institute for Clinical and Translational Research (ICTR) - National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) [5KL2RR025006, UL1 TR 001079]; NIA/NIH [1K23AG043504-01, R21AG0337695, K07AG041835]; HRSA [UB4HP19193-03]; Rosalinde and Arthur Gilbert Foundation/AFAR; Roberts Gift Fund; Hobson Gift Fund; Milton and Shirley F. Levy Family Chair; [P50 AG005146]","Johns Hopkins Institute for Clinical and Translational Research (ICTR) - National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH); NIA/NIH(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA)); HRSA(United States Department of Health & Human ServicesUnited States Health Resources & Service Administration (HRSA)); Rosalinde and Arthur Gilbert Foundation/AFAR; Roberts Gift Fund; Hobson Gift Fund; Milton and Shirley F. Levy Family Chair;","Dr. Oh was supported by 5KL2RR025006 [Johns Hopkins Institute for Clinical and Translational Research (ICTR), which is funded in part by Grant Number UL1 TR 001079 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH)], 1K23AG043504-01 (NIA/NIH), R21AG0337695 (NIA/NIH), P50 AG005146, UB4HP19193-03 (HRSA), The Rosalinde and Arthur Gilbert Foundation/AFAR New Investigator Award in Alzheimer's disease, the Roberts Gift Fund, and the Hobson Gift Fund. Dr. Inouye was supported in part by K07AG041835 (NIA/NIH) and the Milton and Shirley F. Levy Family Chair.","",37,102,107,3,26,"WILEY","HOBOKEN","111 RIVER ST, HOBOKEN 07030-5774, NJ USA","0885-6230","1099-1166","","INT J GERIATR PSYCH","Int. J. Geriatr. Psychiatr.","SEP",2015,30,9,"","","","",900,910,"","10.1002/gps.4233","http://dx.doi.org/10.1002/gps.4233","","",11,"Geriatrics & Gerontology; Gerontology; Psychiatry","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Geriatrics & Gerontology; Psychiatry","CS8JH",25503071,"Green Accepted","","","2023-11-07","WOS:000362333000002","View Full Record in Web of Science"]
["J","Vasunilashorn, SM; Ngo, L; Inouye, SK; Libermann, TA; Jones, RN; Alsop, DC; Guess, J; Jastrzebski, S; McElhaney, JE; Kuchel, GA; Marcantonio, ER","","","","Vasunilashorn, Sarinnapha M.; Ngo, Long; Inouye, Sharon K.; Libermann, Towia A.; Jones, Richard N.; Alsop, David C.; Guess, Jamey; Jastrzebski, Sandra; McElhaney, Janet E.; Kuchel, George A.; Marcantonio, Edward R.","","","Cytokines and Postoperative Delirium in Older Patients Undergoing Major Elective Surgery","JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES","","","English","Article","","","","","","Inflammation; Delirium; Postoperative","CARDIAC-SURGERY; INFLAMMATION; ASSOCIATION; COAGULATION","A proinflammatory state has been associated with several age-associated conditions; however, the inflammatory mechanisms of delirium remain poorly characterized. Using the Successful Aging after Elective Surgery Study of adults age a parts per thousand yen70 undergoing major noncardiac surgery, 12 cytokines were measured at four timepoints: preoperative, postanesthesia care unit, postoperative day 2 (POD2) and 30 days later (POD1M). We conducted a nested, longitudinal matched (on age, sex, surgery type, baseline cognition, vascular comorbidity, and Apolipoprotein E genotype) case-control study: delirium cases and no-delirium controls were selected from the overall cohort (N = 566; 24% delirium). Analyses were independently conducted in discovery, replication, and pooled cohorts (39, 36, 75 matched pairs, respectively). Nonparametric signed-rank tests evaluating differences in cytokine levels between matched pairs were used to identify delirium-associated cytokines. In the discovery and replication cohorts, matching variables were similar in cases and controls. Compared to controls, cases had (p < .05, p < .01) significantly higher interleukin-6 on POD2 in the discovery, replication, and pooled cohorts (median difference [pg/mL] 50.44**, 20.17*, 39.35**, respectively). In the pooled cohort, cases were higher than controls for interleukin-2 (0.99*, 0.77*, 1.07**, 0.73* at preoperative, postanesthesia care unit, POD2, POD1M, respectively), vascular endothelial growth factor (4.10* at POD2), and tumor necrosis factor-alpha (3.10* at POD1M), while cases had lower interleukin-12 at POD1M (-4.24*). In this large, well-characterized cohort assessed at multiple timepoints, we observed an inflammatory signature of delirium involving elevated interleukin-6 at POD2, which may be an important disease marker for delirium. We also observed preliminary evidence for involvement of other cytokines.","[Vasunilashorn, Sarinnapha M.; Ngo, Long; Inouye, Sharon K.; Libermann, Towia A.; Marcantonio, Edward R.] Harvard Univ, Sch Med, Boston, MA 02115 USA; [Vasunilashorn, Sarinnapha M.; Inouye, Sharon K.; Jones, Richard N.; Alsop, David C.; Marcantonio, Edward R.] Hebrew SeniorLife, Inst Aging Res, Aging Brain Ctr, Boston, MA USA; [Vasunilashorn, Sarinnapha M.; Ngo, Long; Inouye, Sharon K.; Libermann, Towia A.; Guess, Jamey; Marcantonio, Edward R.] Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02215 USA; [Alsop, David C.] Beth Israel Deaconess Med Ctr, Dept Radiol, Boston, MA 02215 USA; [Jones, Richard N.] Brown Univ, Warren Alpert Med Sch, Dept Psychiat & Human Behav, Providence, RI 02912 USA; [Jastrzebski, Sandra; Kuchel, George A.] Univ Connecticut, Ctr Hlth, UConn Ctr Aging, Farmington, CT USA; [McElhaney, Janet E.] Adv Med Res Inst Canada, Sudbury, ON, Canada","Harvard University; Harvard Medical School; Harvard University; Hebrew SeniorLife; Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Beth Israel Deaconess Medical Center; Brown University; University of Connecticut","Vasunilashorn, SM (通讯作者)，Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, CO 212,330 Brookline Ave, Boston, MA 02215 USA.","svasunil@bidmc.harvard.edu","Inouye, Sharon/R-7216-2019; Marcantonio, Edward R/U-3929-2017; Alsop, David C/J-5764-2013; Libermann, Towia A/F-9866-2010; Jones, Richard Norman/J-3488-2013","Marcantonio, Edward R/0000-0002-2911-4250; Alsop, David C/0000-0002-8206-1995; Jones, Richard Norman/0000-0002-1049-218X; Kuchel, George/0000-0001-8387-7040; Libermann, Towia/0000-0002-4006-8179","National Institute on Aging [T32AG023480, P01AG031720, K07AG041835, R01AG030618, K24AG035075]","National Institute on Aging(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","This research was supported by National Institute on Aging grants (T32AG023480, P01AG031720, K07AG041835, R01AG030618, K24AG035075).","",28,87,88,1,15,"OXFORD UNIV PRESS INC","CARY","JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA","1079-5006","1758-535X","","J GERONTOL A-BIOL","J. Gerontol. Ser. A-Biol. Sci. Med. Sci.","OCT",2015,70,10,"","","","",1289,1295,"","10.1093/gerona/glv083","http://dx.doi.org/10.1093/gerona/glv083","","",7,"Geriatrics & Gerontology; Gerontology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Geriatrics & Gerontology","CU4FD",26215633,"Green Published","","","2023-11-07","WOS:000363481600016","View Full Record in Web of Science"]
["J","Fritz, BA; Kalarickal, PL; Maybrier, HR; Muench, MR; Dearth, D; Chen, Y; Escallier, KE; Ben Abdallah, A; Lin, N; Avidan, MS","","","","Fritz, Bradley A.; Kalarickal, Philip L.; Maybrier, Hannah R.; Muench, Maxwell R.; Dearth, Doug; Chen, Yulong; Escallier, Krisztina E.; Ben Abdallah, Arbi; Lin, Nan; Avidan, Michael S.","","","Intraoperative Electroencephalogram Suppression Predicts Postoperative Delirium","ANESTHESIA AND ANALGESIA","","","English","Article","","","","","","","CRITICALLY-ILL PATIENTS; BURST SUPPRESSION; CARDIAC OPERATIONS; GENERAL-ANESTHESIA; ELDERLY-PATIENTS; MORTALITY; DEPTH; TRIAL; VALIDATION; DECREASES","","[Fritz, Bradley A.; Kalarickal, Philip L.; Maybrier, Hannah R.; Muench, Maxwell R.; Dearth, Doug; Chen, Yulong; Escallier, Krisztina E.; Ben Abdallah, Arbi; Avidan, Michael S.] Washington Univ, Sch Med, Dept Anesthesiol, St Louis, MO 63110 USA; [Lin, Nan] Washington Univ, Dept Math, St Louis, MO 63110 USA","Washington University (WUSTL); Washington University (WUSTL)","Avidan, MS (通讯作者)，Washington Univ, Sch Med, Dept Anesthesiol, Campus Box 8054,660 S Euclid Ave, St Louis, MO 63110 USA.","avidanm@anest.wustl.edu","","Avidan, Michael/0000-0001-6248-044X","Washington University Institute of Clinical and Translational Sciences from the National Center for Advancing Translational Sciences [UL1 TR000448, TL1 TR000449]; National Institute on Aging [1UH2AG050312-01]; Barnes-Jewish Hospital Foundation [7937-77]; Washington University Department of Anesthesiology; Barnes-Jewish Hospital Foundation","Washington University Institute of Clinical and Translational Sciences from the National Center for Advancing Translational Sciences; National Institute on Aging(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA)); Barnes-Jewish Hospital Foundation; Washington University Department of Anesthesiology; Barnes-Jewish Hospital Foundation","This work was supported by the Washington University Institute of Clinical and Translational Sciences grants UL1 TR000448 and TL1 TR000449 from the National Center for Advancing Translational Sciences. This work was also supported by grant 1UH2AG050312-01 from the National Institute on Aging and grant BJHF#7937-77 from the Barnes-Jewish Hospital Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work was also supported by the Washington University Department of Anesthesiology and the Barnes-Jewish Hospital Foundation.","",37,182,189,2,27,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-2999","","","ANESTH ANALG","Anesth. Analg.","JAN",2016,122,1,"","","","",234,242,"","","","","",9,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","CY9EK",26418126,"Green Accepted","","","2023-11-07","WOS:000366710000004","View Full Record in Web of Science"]
["J","Scholz, AFM; Oldroyd, C; McCarthy, K; Quinn, TJ; Hewitt, J","","","","Scholz, A. F. M.; Oldroyd, C.; McCarthy, K.; Quinn, T. J.; Hewitt, J.","","","Systematic review and meta-analysis of risk factors for postoperative delirium among older patients undergoing gastrointestinal surgery","BRITISH JOURNAL OF SURGERY","","","English","Review","","","","","","","COMPREHENSIVE GERIATRIC ASSESSMENT; ELDERLY-PATIENTS; COLORECTAL SURGERY; ABDOMINAL-SURGERY; PREVENTION; PREDICTION; VALIDATION; CONFUSION; MORTALITY; SCALE","Background: Postoperative delirium (POD) is common after surgery. As age is a known risk factor, the increased ageing of the population undergoing surgery emphasizes the importance of the subject. Knowledge of other potential risk factors in older patients with surgical gastrointestinal diseases is lacking. The aim here was to collate and synthesize the published literature on risk factors for delirium in this group. Methods: Five databases were searched (MEDLINE, Web of Science, Embase, CINAHL (R) and PSYCinfo (R)) between January 1987 and November 2014. The Newcastle-Ottawa Scale was used to rate study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods. Results: Eleven studies met the inclusion criteria; they provided a total of 1427 patients (318 with delirium and 1109 without), and predominantly included patients undergoing elective colorectal surgery. The incidence of POD ranged from 8.2 to 54.4 per cent. A total of 95 risk factors were investigated, illustrating wide heterogeneity in study design. Seven statistically significant risk factors were identified in pooled analysis: old age, American Society of Anesthesiologists (ASA) physical status grade at least III, body mass index, lower serum level of albumin, intraoperative hypotension, perioperative blood transfusion and history of alcohol excess. Patients with POD had a significantly increased duration of hospital stay and a higher mortality rate compared with those without delirium. Conclusion: Delirium is common in older patients undergoing gastrointestinal surgery. Several risk factors were consistently associated with POD.","[Scholz, A. F. M.; Hewitt, J.] Cardiff Univ, Univ Hosp, Inst Primary Care & Publ Hlth, Cardiff CF10 3AX, S Glam, Wales; [Oldroyd, C.; Quinn, T. J.] Glasgow Royal Infirm, Inst Cardiovasc & Med Sci, Glasgow G4 0SF, Lanark, Scotland; [McCarthy, K.] North Bristol NHS Trust, Dept Colorectal Surg, Bristol, Avon, England","Cardiff University; University of Glasgow; North Bristol NHS Trust","Hewitt, J (通讯作者)，Cardiff Univ, Univ Hosp, Inst Primary Care & Publ Hlth, Cardiff CF10 3AX, S Glam, Wales.;Hewitt, J (通讯作者)，Cardiff Univ, Univ Hosp, Cardiff CF64 2XX, S Glam, Wales.","hewittj2@cardiff.ac.uk","HEWITT, JONATHAN/AAC-9713-2019; Oldroyd, Christopher/GVU-0537-2022; Quinn, Terence Joseph/H-7000-2019; Oldroyd, Christopher/JCN-9333-2023","HEWITT, JONATHAN/0000-0002-7924-1792; Quinn, Terence Joseph/0000-0003-1401-0181; Oldroyd, Christopher/0000-0002-4934-8345","Stroke Association [TSA15LECT05, PPA2015/01_CSO] Funding Source: researchfish","Stroke Association","","",44,139,147,4,23,"OXFORD UNIV PRESS","OXFORD","GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND","0007-1323","1365-2168","","BRIT J SURG","Br. J. Surg.","FEB",2016,103,2,"","","SI","","E21","E28","","10.1002/bjs.10062","http://dx.doi.org/10.1002/bjs.10062","","",8,"Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Surgery","DB8ZO",26676760,"Bronze","","","2023-11-07","WOS:000368805900006","View Full Record in Web of Science"]
["J","Crocker, E; Beggs, T; Hassan, A; Denault, A; Lamarche, Y; Bagshaw, S; Elmi-Sarabi, M; Hiebert, B; Macdonald, K; Giles-Smith, L; Tangri, N; Arora, RC","","","","Crocker, Elise; Beggs, Thomas; Hassan, Ansar; Denault, Andre; Lamarche, Yoan; Bagshaw, Sean; Elmi-Sarabi, Mahsa; Hiebert, Brett; Macdonald, Kerry; Giles-Smith, Lori; Tangri, Navdeep; Arora, Rakesh C.","","","Long-Term Effects of Postoperative Delirium in Patients Undergoing Cardiac Operation: A Systematic Review","ANNALS OF THORACIC SURGERY","","","English","Review","","","","","","","RISK-FACTORS; SURGERY; VALIDATION","Delirium is an acute syndrome that involves fluctuating changes in attention and cognition. Although delirium is the most common neurologic complication after cardiac operation, data about its impact on long-term outcomes are lacking. The purpose of this systematic review was to examine the effect of postoperative delirium (PoD) on long-term outcomes, including morbidity, probability of death, cognitive decline, institutionalization, and health-related quality of life (HRQoL) in patients undergoing cardiac operation. After performing this systematic review we determined that PoD after cardiac operation is associated with an increased risk of probability of death and readmission to the hospital and a decrease in cognitive function, overall function, and HRQoL. (C) 2016 by The Society of Thoracic Surgeons","Univ Manitoba, Fac Med, Winnipeg, MB, Canada; Royal Coll Surgeons Ireland, Sch Med, Dublin, Ireland; St Johns Hosp, St John, NB, Canada; Montreal Heart Inst, Montreal, PQ, Canada; Univ Alberta, Fac Med & Dent, Edmonton, AB, Canada; Univ Alberta, Sch Publ Hlth, Edmonton, AB, Canada; St Boniface Gen Hosp, Winnipeg, MB, Canada; Univ Manitoba Lib, Winnipeg, MB, Canada; Seven Oaks Gen Hosp, Renal Program, Winnipeg, MB, Canada; Univ Manitoba, Nephrol Sect, Dept Med, Winnipeg, MB, Canada; Univ Manitoba, Dept Surg Cardiac Surg, Winnipeg, MB, Canada","University of Manitoba; Royal College of Surgeons - Ireland; Universite de Montreal; University of Alberta; University of Alberta; University of Manitoba; Children's Hospital Research Institute of Manitoba; University of Manitoba; University of Manitoba; Children's Hospital Research Institute of Manitoba; University of Manitoba; University of Manitoba","Arora, RC (通讯作者)，St Boniface Gen Hosp, IH Asper Inst, CR3012,369 Tache Ave, Winnipeg, MB R2H 2A6, Canada.","rakeshcarora@gmail.com","Macdonald, Kerry/F-7706-2015; Arora, Rakesh/D-2245-2014; Giles-Smith, Lori/C-9768-2016","Macdonald, Kerry/0000-0001-8237-3035; Tangri, Navdeep/0000-0002-5075-6370; Bagshaw, Sean/0000-0003-3633-6596; Elmi-Sarabi, Mahsa/0000-0002-1178-2074; Arora, Rakesh/0000-0002-5799-3619; Giles-Smith, Lori/0000-0002-2248-9164","KRESCENT New Investigator Award; MHRC Establishment Award; F.W. Duval Clinical Research Award from the Manitoba Health Research Council/Manitoba Medical Service Foundation/University of Manitoba","KRESCENT New Investigator Award(Canadian Institutes of Health Research (CIHR)); MHRC Establishment Award; F.W. Duval Clinical Research Award from the Manitoba Health Research Council/Manitoba Medical Service Foundation/University of Manitoba","Dr Navdeep Tangri is supported by the KRESCENT New Investigator Award and the MHRC Establishment Award and has received honoraria from Takeda Inc and Otsuka Inc. The KRESCENT New Investigator Award is a joint initiative of the Canadian Institute of Health Research, the Kidney Foundation of Canada, and the Canadian Society of Nephrology. Dr Rakesh C. Arora is supported by the F.W. Duval Clinical Research Award from the Manitoba Health Research Council/Manitoba Medical Service Foundation/University of Manitoba.","",22,86,95,0,11,"ELSEVIER SCIENCE INC","NEW YORK","STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA","0003-4975","1552-6259","","ANN THORAC SURG","Ann. Thorac. Surg.","OCT",2016,102,4,"","","","",1391,1399,"","10.1016/j.athoracsur.2016.04.071","http://dx.doi.org/10.1016/j.athoracsur.2016.04.071","","",9,"Cardiac & Cardiovascular Systems; Respiratory System; Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Cardiovascular System & Cardiology; Respiratory System; Surgery","EE4AI",27344279,"Bronze","","","2023-11-07","WOS:000389543600081","View Full Record in Web of Science"]
["J","Aldecoa, C; Bettelli, G; Bilotta, F; Sanders, RD; Audisio, R; Borozdina, A; Cherubini, A; Jones, C; Kehlet, H; MacLullich, A; Radtke, F; Riese, F; Slooter, AJC; Veyckemans, F; Kramer, S; Neuner, B; Weiss, B; Spies, CD","","","","Aldecoa, Cesar; Bettelli, Gabriella; Bilotta, Federico; Sanders, Robert D.; Audisio, Riccardo; Borozdina, Anastasia; Cherubini, Antonio; Jones, Christina; Kehlet, Henrik; MacLullich, Alasdair; Radtke, Finn; Riese, Florian; Slooter, Arjen J. C.; Veyckemans, Francis; Kramer, Sylvia; Neuner, Bruno; Weiss, Bjoern; Spies, Claudia D.","","","European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium","EUROPEAN JOURNAL OF ANAESTHESIOLOGY","","","English","Article","","","","","","","INTENSIVE-CARE-UNIT; HIP FRACTURE PATIENTS; PATIENT-CONTROLLED ANALGESIA; ACUTE CONFUSIONAL STATES; GERIATRIC CONSULTATION SERVICES; ALCOHOL-WITHDRAWAL SYNDROME; MINI NUTRITIONAL ASSESSMENT; PROPOFOL INFUSION SYNDROME; PRESCHOOL-AGED CHILDREN; INDEPENDENT RISK-FACTOR","The purpose of this guideline is to present evidence-based and consensus-based recommendations for the prevention and treatment of postoperative delirium. The cornerstones of the guideline are the preoperative identification and handling of patients at risk, adequate intraoperative care, postoperative detection of delirium and management of delirious patients. The scope of this guideline is not to cover ICU delirium. Considering that many medical disciplines are involved in the treatment of surgical patients, a team-based approach should be implemented into daily practice. This guideline is aimed to promote knowledge and education in the preoperative, intraoperative and postoperative setting not only among anaesthesiologists but also among all other healthcare professionals involved in the care of surgical patients.","[Radtke, Finn; Kramer, Sylvia; Neuner, Bruno; Spies, Claudia D.] Charite Univ Med Berlin, Dept Anaesthesiol & Intens Care Med Charite, Charite Campus Virchow Klinikum & Charite Campus, D-10117 Berlin, Germany; [Aldecoa, Cesar] Hosp Univ Rio Hortega, Fac Med Valladolid, Dept Anesthesiol, Valladolid, Spain; [Bettelli, Gabriella] Italian Natl Res Ctr Aging, IRCCS, Dept Anaesthesia Analgesia & Intens Care, Dept Geriatr Surg, Ancona, Italy; [Bilotta, Federico] Sapienza Univ Rome, Dept Anesthesiol Crit Care & Pain Med, Rome, Italy; [Sanders, Robert D.] Univ Wisconsin, Dept Anaesthesiol, Madison, WI USA; [Audisio, Riccardo] Merseyside Univ Liverpool, St Helens Hosp, Dept Surg, Liverpool, Merseyside, England; [Borozdina, Anastasia] Petrovsky Natl Res Ctr Surg, Moscow, Russia; [Cherubini, Antonio] IRCCS INRCA, Geriatria Accettaz Geriatr Urgenza, Ancona, Italy; [Jones, Christina] Whiston Hosp, Prescot, Merseyside, England; [Kehlet, Henrik] Copenhagen Univ Hosp, Sect Surg Pathophysiol, Rigshospitalet, Copenhagen, Denmark; [Kehlet, Henrik] Copenhagen Univ Hosp, Lundbeck Ctr Fast track Hip & Knee Arthroplasty, Rigshospitalet, Copenhagen, Denmark; [MacLullich, Alasdair] Univ Edinburgh, Edinburgh Delirium Res Grp, Geriatr Med Unit, Edinburgh, Midlothian, Scotland; [Riese, Florian] Anaestesiologisk Afdeling, Dept Anaesthesia, Naestved, Denmark; [Riese, Florian] Psychiat Univ Hosp, Zurich, Switzerland; [Slooter, Arjen J. C.] Univ Med Ctr Utrecht, Dept Intens Care, Utrecht, Netherlands; [Slooter, Arjen J. C.] Univ Med Ctr Utrecht, Brain Ctr Rudolf Magnus, Utrecht, Netherlands; [Veyckemans, Francis] Clin Univ St Luc, Anesthesiol Serv, Brussels, Belgium","Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Hospital del Rio Hortega; IRCCS INRCA; Sapienza University Rome; University of Wisconsin System; University of Wisconsin Madison; Petrovsky National Research Centre of Surgery; IRCCS INRCA; Whiston Hospital; University of Copenhagen; University of Copenhagen; University of Edinburgh; Utrecht University; Utrecht University Medical Center; Utrecht University; Utrecht University Medical Center; Universite Catholique Louvain; Cliniques Universitaires Saint-Luc","Spies, CD (通讯作者)，Charite Univ Med Berlin, Dept Anaesthesiol & Intens Care Med Charite, Charite Campus Virchow Klinikum & Charite Campus, D-10117 Berlin, Germany.","claudia.spies@charite.de","Bettelli, Gabriella/AAA-6987-2022; Sanders, Robert D/A-7844-2012; Riese, Florian/I-1887-2019; Jones, Christina/M-9509-2019; Aldecoa, Cesar/G-6779-2016; Cherubini, Antonio/AAL-4632-2020","Riese, Florian/0000-0001-5531-5833; Aldecoa, Cesar/0000-0001-9096-0387; Weiss, Bjorn/0000-0003-3139-595X; Sanders, Robert/0000-0003-0113-0328; Kehlet, Henrik/0000-0002-2209-1711; Audisio, Riccardo A./0000-0002-7538-4809; Radtke, Finn M./0000-0001-5260-5384; Spies, Claudia/0000-0002-1062-0495; Aldecoa, Cesar/0000-0001-8789-5959","European Society of Anaesthesia (ESA); Medical Research Council [MR/K026992/1, G108/646] Funding Source: researchfish; MRC [G108/646] Funding Source: UKRI","European Society of Anaesthesia (ESA); Medical Research Council(UK Research & Innovation (UKRI)Medical Research Council UK (MRC)); MRC(UK Research & Innovation (UKRI)Medical Research Council UK (MRC))","this guideline was financed solely by the European Society of Anaesthesia (ESA) and by institutional resources of the members of the Task Force and the Advisory Board.","",402,553,613,8,140,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0265-0215","1365-2346","","EUR J ANAESTH","Eur. J. Anaesth.","APR",2017,34,4,"","","","",192,214,"","10.1097/EJA.0000000000000594","http://dx.doi.org/10.1097/EJA.0000000000000594","","",23,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Anesthesiology","EN3JW",28187050,"","","","2023-11-07","WOS:000395905800003","View Full Record in Web of Science"]
["J","Avidan, MS; Maybrier, HR; Ben Abdallah, A; Jacobsohn, E; Vlisides, PE; Pryor, KO; Veselis, RA; Grocott, HP; Emmert, DA; Rogers, EM; Downey, RJ; Yulico, H; Noh, GJ; Lee, YH; Waszynski, CM; Arya, VK; Pagel, PS; Hudetz, JA; Muench, MR; Fritz, BA; Waberski, W; Inouye, SK; Mashour, GA","","","","Avidan, Michael S.; Maybrier, Hannah R.; Ben Abdallah, Arbi; Jacobsohn, Eric; Vlisides, Phillip E.; Pryor, Kane O.; Veselis, Robert A.; Grocott, Hilary P.; Emmert, Daniel A.; Rogers, Emma M.; Downey, Robert J.; Yulico, Heidi; Noh, Gyu-Jeong; Lee, Yonghun H.; Waszynski, Christine M.; Arya, Virendra K.; Pagel, Paul S.; Hudetz, Judith A.; Muench, Maxwell R.; Fritz, Bradley A.; Waberski, Witold; Inouye, Sharon K.; Mashour, George A.","","PODCAST Res Grp","Intraoperative ketamine for prevention of postoperative delirium or pain after major surgery in older adults: an international, multicentre, double-blind, randomised clinical trial","LANCET","","","English","Article","","","","","","","CONFUSION ASSESSMENT METHOD; ANESTHESIA; METAANALYSIS; RELIABILITY; DEPRESSION; VALIDITY; TIME; ICU","Background Delirium is a common and serious postoperative complication. Subanaesthetic ketamine is often administered intraoperatively for postoperative analgesia, and some evidence suggests that ketamine prevents delirium. The primary purpose of this trial was to assess the effectiveness of ketamine for prevention of postoperative delirium in older adults. Methods The Prevention of Delirium and Complications Associated with Surgical Treatments [PODCAST] study is a multicentre, international randomised trial that enrolled adults older than 60 years undergoing major cardiac and non-cardiac surgery under general anaesthesia. Using a computer-generated randomisation sequence we randomly assigned patients to one of three groups in blocks of 15 to receive placebo (normal saline), low-dose ketamine (0.5 mg/kg), or high dose ketamine (1.0 mg/kg) after induction of anaesthesia, before surgical incision. Participants, clinicians, and investigators were blinded to group assignment. Delirium was assessed twice daily in the first 3 postoperative days using the Confusion Assessment Method. We did analyses by intention-to-treat and assessed adverse events. This trial is registered with clinicaltrials. gov, number NCT01690988. Findings Between Feb 6, 2014, and June 26, 2016, 1360 patients were assessed, and 672 were randomly assigned, with 222 in the placebo group, 227 in the 0.5 mg/kg ketamine group, and 223 in the 1.0 mg/kg ketamine group. There was no difference in delirium incidence between patients in the combined ketamine groups and the placebo group (19.45% vs 19.82%, respectively; absolute difference 0.36%, 95% CI -6.07 to 7.38, p=0.92). There were more postoperative hallucinations (p=0.01) and nightmares (p=0.03) with increasing ketamine doses compared with placebo. Adverse events (cardiovascular, renal, infectious, gastrointestinal, and bleeding), whether viewed individually (p value for each > 0.40) or collectively (36.9% in placebo, 39.6% in 0.5 mg/kg ketamine, and 40.8% in 1.0 mg/kg ketamine groups, p=0.69), did not differ significantly across groups. Interpretation A single subanaesthetic dose of ketamine did not decrease delirium in older adults after major surgery, and might cause harm by inducing negative experiences.","[Avidan, Michael S.; Maybrier, Hannah R.; Ben Abdallah, Arbi; Emmert, Daniel A.; Muench, Maxwell R.; Fritz, Bradley A.] Washington Univ, Sch Med, Dept Anesthesiol, St Louis, MO 63110 USA; [Jacobsohn, Eric] Univ Manitoba, Dept Anesthesiol, Winnipeg, MB, Canada; [Jacobsohn, Eric] Univ Manitoba, Dept Internal Med, Winnipeg, MB, Canada; [Grocott, Hilary P.] Univ Manitoba, Dept Anesthesia & Perioperat Med, Winnipeg, MB, Canada; [Vlisides, Phillip E.; Mashour, George A.] Univ Michigan, Dept Anesthesiol, Ann Arbor, MI 48109 USA; [Pryor, Kane O.; Rogers, Emma M.] Weill Cornell Med, Dept Anesthesiol, New York, NY USA; [Veselis, Robert A.] Mem Sloan Kettering Canc Ctr, Dept Neuroanesthesiol, 1275 York Ave, New York, NY 10021 USA; [Downey, Robert J.] Mem Sloan Kettering Canc Ctr, Dept Surg, 1275 York Ave, New York, NY 10021 USA; [Yulico, Heidi] Mem Sloan Kettering Canc Ctr, Dept Anesthesiol, 1275 York Ave, New York, NY 10021 USA; [Noh, Gyu-Jeong; Lee, Yonghun H.] Asan Med Ctr, Dept Anesthesiol, Seoul, South Korea; [Waszynski, Christine M.] Hartford Hosp, Dept Med, Hartford, CT 06115 USA; [Arya, Virendra K.] Postgrad Inst Med Educ & Res, Dept Anaesthesiol & Intens Care, Chandigarh, India; [Pagel, Paul S.; Hudetz, Judith A.] Med Coll Wisconsin, Dept Anesthesiol, Milwaukee, WI 53226 USA; [Waberski, Witold] Hartford Hosp, Dept Anesthesiol, Hartford, CT 06115 USA; [Inouye, Sharon K.] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA USA; [Inouye, Sharon K.] Hebrew SeniorLife, Inst Aging Res, Boston, MA USA","Washington University (WUSTL); University of Manitoba; University of Manitoba; University of Manitoba; University of Michigan System; University of Michigan; Cornell University; Weill Cornell Medicine; Memorial Sloan Kettering Cancer Center; Memorial Sloan Kettering Cancer Center; Memorial Sloan Kettering Cancer Center; University of Ulsan; Asan Medical Center; Hartford Hospital; Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh; Medical College of Wisconsin; Hartford Hospital; Harvard University; Harvard Medical School; Beth Israel Deaconess Medical Center; Harvard University; Hebrew SeniorLife","Avidan, MS (通讯作者)，Washington Univ, Sch Med, Dept Anesthesiol, St Louis, MO 63110 USA.","avidanm@wustl.edu","Inouye, Sharon/R-7216-2019; Ivascu, Natalia S/F-2760-2019; Kashani, Hessam H./S-7968-2017; Arya, Virendra/AAE-3278-2021; Pryor, Kane O/I-8632-2017; Jayant, Aveek/B-6042-2014","Ivascu, Natalia S/0000-0003-3230-4239; Kashani, Hessam H./0000-0003-2581-1769; Pryor, Kane O/0000-0002-9212-5526; Lee, Yong-Hun/0000-0002-1724-7996; Funk, Duane/0000-0002-3155-9793; Tellor Pennington, Bethany R./0000-0003-1571-6434; Arya, Virendra K/0000-0002-6291-0187; Avidan, Michael/0000-0001-6248-044X; Jayant, Aveek/0000-0002-3465-1229; Vlisides, Phillip/0000-0003-3899-5536; Jayant, Arvind/0000-0002-6715-3023; Lenze, Eric/0000-0002-0471-9368; Mickle, Angela/0000-0001-9175-5342","National Institutes of Health; Cancer Center Support","National Institutes of Health(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA); Cancer Center Support","National Institutes of Health and Cancer Center Support.","",36,235,249,2,64,"ELSEVIER SCIENCE INC","NEW YORK","STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA","0140-6736","1474-547X","","LANCET","Lancet","JUL 15",2017,390,10091,"","","","",267,275,"","10.1016/S0140-6736(17)31467-8","http://dx.doi.org/10.1016/S0140-6736(17)31467-8","","",9,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","General & Internal Medicine","FA5IZ",28576285,"Green Accepted","","","2023-11-07","WOS:000405477900027","View Full Record in Web of Science"]
["J","Deiner, S; Luo, XD; Lin, HM; Sessler, DI; Saager, L; Sieber, FE; Lee, HB; Sano, M","","","","Deiner, Stacie; Luo, Xiaodong; Lin, Hung-Mo; Sessler, Daniel I.; Saager, Leif; Sieber, Frederick E.; Lee, Hochang B.; Sano, Mary","","Dexlirium Writing Grp","Intraoperative Infusion of Dexmedetomidine for Prevention of Postoperative Delirium and Cognitive Dysfunction in Elderly Patients Undergoing Major Elective Noncardiac Surgery A Randomized Clinical Trial","JAMA SURGERY","","","English","Article","","","","","","","CONFUSION ASSESSMENT METHOD; CRITICALLY-ILL PATIENTS; CARDIAC-SURGERY; BYPASS; MANAGEMENT; SEDATION","IMPORTANCE Postoperative delirium occurs in 10% to 60% of elderly patients having major surgery and is associated with longer hospital stays, increased hospital costs, and 1-year mortality. Emerging literature suggests that dexmedetomidine sedation in critical care units is associated with reduced incidence of delirium. However, intraoperative use of dexmedetomidine for prevention of delirium has not been well studied. OBJECTIVE To evaluate whether an intraoperative infusion of dexmedetomidine reduces postoperative delirium. DESIGN, SETTING, AND PARTICIPANTS This study was a multicenter, double-blind, randomized, placebo-controlled trial that randomly assigned patients to dexmedetomidine or saline placebo infused during surgery and for 2 hours in the recovery room. Patients were assessed daily for postoperative delirium (primary outcome) and secondarily for postoperative cognitive decline. Participants were elderly (> 68 years) patients undergoing major elective noncardiac surgery. The study dates were February 2008 to May 2014. INTERVENTIONS Dexmedetomidine infusion (0.5 mu g/kg/h) during surgery and up to 2 hours in the recovery room. MAIN OUTCOMES AND MEASURES The primary hypothesis tested was that intraoperative dexmedetomidine administration would reduce postoperative delirium. Secondarily, the study examined the correlation between dexmedetomidine use and postoperative cognitive change. RESULTS In total, 404 patients were randomized; 390 completed in-hospital delirium assessments (median [interquartile range] age, 74.0 [71.0-78.0] years; 51.3%[200 of 390] female). There was no difference in postoperative delirium between the dexmedetomidine and placebo groups (12.2%[23 of 189] vs 11.4%[23 of 201], P = .94). After adjustment for age and educational level, there was no difference in the postoperative cognitive performance between treatment groups at 3 months and 6 months. Adverse events were comparably distributed in the treatment groups. CONCLUSIONS AND RELEVANCE Intraoperative dexmedetomidine does not prevent postoperative delirium. The reduction in delirium previously demonstrated in numerous surgical intensive care unit studies was not observed, which underscores the importance of timing when administering the drug to prevent delirium. (C) 2017 American Medical Association. All rights reserved.","[Deiner, Stacie; Lin, Hung-Mo] Icahn Sch Med Mt Sinai, Dept Anesthesiol, One Gustave L Levy Pl,Campus Box 1010, New York, NY 10029 USA; [Deiner, Stacie] Icahn Sch Med Mt Sinai, Dept Neurosurg, New York, NY 10029 USA; [Deiner, Stacie] Icahn Sch Med Mt Sinai, Dept Geriatr & Palliat Care, New York, NY 10029 USA; [Luo, Xiaodong] Icahn Sch Med Mt Sinai, Dept Psychiat, New York, NY 10029 USA; [Lin, Hung-Mo] Icahn Sch Med Mt Sinai, Dept Hlth Evidence & Policy, New York, NY 10029 USA; [Sessler, Daniel I.; Sano, Mary] Cleveland Clin, Dept Anesthesiol, Cleveland, OH 44106 USA; [Sessler, Daniel I.; Saager, Leif] Cleveland Clin, Outcomes Res, Cleveland, OH 44106 USA; [Sieber, Frederick E.] Johns Hopkins Univ, Dept Anesthesiol & Crit Care Med, Baltimore, MD USA; [Lee, Hochang B.] Yale Univ, Dept Psychiat, New Haven, CT 06520 USA","Icahn School of Medicine at Mount Sinai; Icahn School of Medicine at Mount Sinai; Icahn School of Medicine at Mount Sinai; Icahn School of Medicine at Mount Sinai; Icahn School of Medicine at Mount Sinai; Cleveland Clinic Foundation; Cleveland Clinic Foundation; Johns Hopkins University; Yale University","Deiner, S (通讯作者)，Icahn Sch Med Mt Sinai, Dept Anesthesiol, One Gustave L Levy Pl,Campus Box 1010, New York, NY 10029 USA.","stacie.deiner@mountsinai.org","Saager, Leif/AHB-6208-2022; Sessler, Daniel Ira/D-3504-2011","Saager, Leif/0000-0003-3416-4727; Sessler, Daniel Ira/0000-0001-9932-3077; Lee, Hochang/0000-0001-8379-4018; Bergese, Sergio/0000-0001-5641-5908","Sano","Sano","Sano.","",28,186,200,0,43,"AMER MEDICAL ASSOC","CHICAGO","330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA","2168-6254","2168-6262","","JAMA SURG","JAMA Surg.","AUG",2017,152,8,"","","","","","","e171505","10.1001/jamasurg.2017.1505","http://dx.doi.org/10.1001/jamasurg.2017.1505","","",8,"Surgery","Science Citation Index Expanded (SCI-EXPANDED)","Surgery","FD7EQ",28593326,"Green Published, Bronze","","","2023-11-07","WOS:000407689800001","View Full Record in Web of Science"]
["J","Yang, YJ; Zhao, X; Dong, TH; Yang, ZY; Zhang, Q; Zhang, YZ","","","","Yang, Yanjiang; Zhao, Xin; Dong, Tianhua; Yang, Zongyou; Zhang, Qi; Zhang, Yingze","","","Risk factors for postoperative delirium following hip fracture repair in elderly patients: a systematic review and meta-analysis","AGING CLINICAL AND EXPERIMENTAL RESEARCH","","","English","Review","","","","","","Delirium; Elderly patients; Hip fracture; Postoperative; Risk factors","ACUTE CONFUSIONAL STATES; OLDER PATIENTS; SURGERY; DEMENTIA; VALIDATION; PAIN; COMPLICATIONS; PREDICTORS; MANAGEMENT; PROGNOSIS","Background No formal systematic review or meta-analysis was performed up to now to summarize the risk factors of delirium after hip surgery. Aims The present study aimed to quantitatively and comprehensively conclude the risk factors of delirium after hip surgery in elderly patients. Methods A search was applied to CNKI, Embase, Medline, and Cochrane central database (all up to August 2015). All studies assessing the risk factors of delirium after hip surgery in elderly patients without language restriction were reviewed, and qualities of included studies were assessed using the Newcastle-Ottawa Scale. Data were pooled and a meta-analysis was completed. Results A total of 24 studies were selected, which altogether included 5364 patients with hip fracture. One thousand and ninety of them were cases of delirium occurred after surgery, suggesting the accumulated incidence of 24.0 %. Results of meta-analyses showed that elderly patients with preoperative cognitive impairment [odds ratio (OR) 3.21, 95 % confidence interval (CI) 2.26-4.56), advanced age (standardized mean difference 0.50, 95 % CI 0.33-0.67), living in an institution (OR 2.94; 95 % CI 1.65-5.23), heart failure (OR 2.46; 95 % CI 1.72-3.53), total hip arthroplasty (OR 2.21; 95 % CI 1.16-4.22), multiple comorbidities (OR 1.37; 95 % CI 1.12-1.68) and morphine usage (OR 3.01; 95 % CI 1.30-6.94) were more likely to sustain delirium after hip surgery. Females were less likely to develop delirium after hip surgery (OR 0.83; 95 % CI 0.70-0.98). Conclusions Related prophylaxis strategies should be implemented in elderly patients involved with above-mentioned risk factors to prevent delirium after hip surgery.","[Yang, Yanjiang; Dong, Tianhua; Yang, Zongyou; Zhang, Qi; Zhang, Yingze] Hebei Med Univ, Dept Orthopaed Surg, Hosp 3, 139 Ziqiang Rd, Shijiazhuang 050051, Hebei, Peoples R China; [Zhang, Yingze] Key Lab Biomech Hebei Prov, Shijiazhuang 050051, Hebei, Peoples R China; [Zhao, Xin] Hebei Gen Hosp, Dept Funct & Phys Examinat, Shijiazhuang 050051, Hebei, Peoples R China","Hebei Medical University","Zhang, YZ (通讯作者)，Hebei Med Univ, Dept Orthopaed Surg, Hosp 3, 139 Ziqiang Rd, Shijiazhuang 050051, Hebei, Peoples R China.;Zhang, YZ (通讯作者)，Key Lab Biomech Hebei Prov, Shijiazhuang 050051, Hebei, Peoples R China.","dryingzezhang@163.com","Zhang, Cheng/JAD-2236-2023; Zhang, Hui/HHN-8494-2022","Zhang, YIngze/0000-0001-8042-6105","","","","",53,138,147,2,29,"SPRINGER","NEW YORK","233 SPRING ST, NEW YORK, NY 10013 USA","1594-0667","1720-8319","","AGING CLIN EXP RES","Aging Clin. Exp. Res.","APR",2017,29,2,"","","","",115,126,"","10.1007/s40520-016-0541-6","http://dx.doi.org/10.1007/s40520-016-0541-6","","",12,"Geriatrics & Gerontology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Geriatrics & Gerontology","ET6EN",26873816,"","","","2023-11-07","WOS:000400383800002","View Full Record in Web of Science"]
["J","Sprung, J; Roberts, RO; Weingarten, TN; Cavalcante, AN; Knopman, DS; Petersen, RC; Hanson, AC; Schroeder, DR; Warner, DO","","","","Sprung, J.; Roberts, R. O.; Weingarten, T. N.; Cavalcante, A. Nunes; Knopman, D. S.; Petersen, R. C.; Hanson, A. C.; Schroeder, D. R.; Warner, D. O.","","","Postoperative delirium in elderly patients is associated with subsequent cognitive impairment","BRITISH JOURNAL OF ANAESTHESIA","","","English","Article","","","","","","aged, humans, male, female; anaesthesia, general; delirium; dementia; mild cognitive impairment; surgery","CONFUSION ASSESSMENT METHOD; AGITATION-SEDATION SCALE; FUNCTIONAL DECLINE; DEMENTIA; RISK; RELIABILITY; GUIDELINES; VALIDITY; SURGERY; POPULATION","Background. We examined the risk for postoperative delirium (POD) in patients with mild cognitive impairment (MCI) or dementia, and the association between POD and subsequent development of MCI or dementia in cognitively normal elderly patients. Methods. Patients >= 65 yr of age enrolled in the Mayo Clinic Study of Aging who were exposed to any type of anaesthesia from 2004 to 2014 were included. Cognitive status was evaluated before and after surgery by neuropsychological testing and clinical assessment, and was defined as normal or MCI/dementia. Postoperative delirium was detected with the Confusion Assessment Method for the intensive care unit. Logistic regression analyses were performed. Results. Among 2014 surgical patients, 74 (3.7%) developed POD. Before surgery, 1667 participants were cognitively normal, and 347 met MCI/dementia criteria. The frequency of POD was higher in patients with pre-existing MCI/dementia compared with no MCI/dementia {8.7 vs 2.6%; odds ratio (OR) 2.53, [95% confidence interval (CI) 1.52-4.21]; P<0.001}. Postoperative delirium was associated with lower education [OR, 3.40 (95% CI, 1.60-7.40); P=0.002 for those with <12 vs >= 16 yr of schooling]. Of the 1667 patients cognitively normal at their most recent assessment, 1152 returned for postoperative evaluation, and 109 (9.5%) met MCI/dementia criteria. The frequency of MCI/dementia at the first postoperative evaluation was higher in patients who experienced POD compared with those who did not [33.3 vs 9.0%; adjusted OR, 3.00 (95% CI, 1.12-8.05); P=0.029]. Conclusions. Mild cognitive impairment or dementia is a risk for POD. Elderly patients who have not been diagnosed with MCI or dementia but experience POD are more likely to be diagnosed subsequently with MCI or dementia.","[Sprung, J.; Weingarten, T. N.; Cavalcante, A. Nunes] Mayo Clin, Div Multispecialty Anesthesia, Coll Med & Sci, 200 First St SW, Rochester, MN 55905 USA; [Roberts, R. O.] Mayo Clin, Div Epidemiol, Coll Med & Sci, 200 First St SW, Rochester, MN 55905 USA; [Knopman, D. S.; Petersen, R. C.] Mayo Clin, Div Behav Neurol, Coll Med & Sci, 200 First St SW, Rochester, MN 55905 USA; [Hanson, A. C.; Schroeder, D. R.] Mayo Clin, Div Biomed Stat & Informat, Coll Med & Sci, 200 First St SW, Rochester, MN 55905 USA; [Warner, D. O.] Mayo Clin, Div Pediat Anesthesiol, Coll Med & Sci, 200 First St SW, Rochester, MN 55905 USA","Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic","Sprung, J (通讯作者)，Mayo Clin, Div Multispecialty Anesthesia, Coll Med & Sci, 200 First St SW, Rochester, MN 55905 USA.","sprung.juraj@mayo.edu","Weingarten, Toby/T-2329-2019","","US National Institutes of Health [P50 AG016574, U01 AG006786]; Robert H. and Clarice Smith and Abigail van Buren Alzheimer's Disease Research Program; Rochester Epidemiology Project [NIH R01 AG034676]; Mayo Clinic Center for Translational Sciences Activities (National Center for Advancing Translational Sciences) [UL1 TR000135]; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic","US National Institutes of Health(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA); Robert H. and Clarice Smith and Abigail van Buren Alzheimer's Disease Research Program; Rochester Epidemiology Project; Mayo Clinic Center for Translational Sciences Activities (National Center for Advancing Translational Sciences); Department of Anesthesiology and Perioperative Medicine, Mayo Clinic","US National Institutes of Health (grants P50 AG016574 and U01 AG006786 to R.C.P.); Robert H. and Clarice Smith and Abigail van Buren Alzheimer's Disease Research Program, the Rochester Epidemiology Project (grant number NIH R01 AG034676; principal investigators: Walter A. Rocca, MD, and Jennifer St Sauver, PhD); Mayo Clinic Center for Translational Sciences Activities (grant no. UL1 TR000135 from the National Center for Advancing Translational Sciences); Financial support for statistical analyses was provided by the; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic (financial support for statistical analyses).","",52,126,131,0,22,"ELSEVIER SCI LTD","OXFORD","THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND","0007-0912","1471-6771","","BRIT J ANAESTH","Br. J. Anaesth.","AUG",2017,119,2,"","","","",316,323,"","10.1093/bja/aex130","http://dx.doi.org/10.1093/bja/aex130","","",8,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Anesthesiology","FC0SV",28854531,"hybrid","","","2023-11-07","WOS:000406549900073","View Full Record in Web of Science"]
["J","Duan, X; Coburn, M; Rossaint, R; Sanders, RD; Waesberghe, JV; Kowark, A","","","","Duan, X.; Coburn, M.; Rossaint, R.; Sanders, R. D.; Waesberghe, J. V.; Kowark, A.","","","Efficacy of perioperative dexmedetomidine on postoperative delirium: systematic review and meta-analysis with trial sequential analysis of randomised controlled trials","BRITISH JOURNAL OF ANAESTHESIA","","","English","Review","","","","","","intensive care; sedation; surgery, noncardiac","SEDATION REDUCES DELIRIUM; CARDIAC-SURGERY; DOUBLE-BLIND; PROPOFOL; RISK; PREVENTION; ANALGESIA; AGITATION","Background: The influence of dexmedetomidine on postoperative delirium (POD) in adult surgical patients remains controversial. We aimed to analyse whether dexmedetomidine use could decrease POD incidence in this population and its relation to timing of dexmedetomidine administration and patient age. Methods: We used random-effects modelled meta-analysis, trial sequential analysis, and followed Cochrane methodology with Grading of Recommendations Assessment, Development, and Evaluation (GRADE). PubMed and Cochrane library were searched up to July 2017 for randomised controlled trials that analysed POD incidence of adult surgical patients (age >= 18 yr) after dexmedetomidine administration. Results: Eighteen studies (comprising 3309 patients) were included. There was decreased risk of POD with dexmedetomidine use for the entire adult surgical population [ odds ratio (OR) 0.35; 95% confidence interval (CI) 0.24-0.51)], with firm evidence from trial sequential analysis. Pre-specified subgroup analyses confirmed this result with firm evidence for cardiac and non-cardiac surgical patients, (OR 0.41; 95% CI 0.26-0.63) and (OR 0.33; 95% CI 0.18-0.59), respectively. We also found firm evidence for reduction of POD if dexmedetomidine is administered during the postoperative period (OR 0.30; 95% CI 0.21-0.44), in patients aged <65 yr (OR 0.19; 95% CI 0.10-0.36) or >= 65 yr (OR 0.44; 95% CI 0.30-0.65). Evidence for dexmedetomidine's influence on secondary outcomes (in-hospital mortality, intensive care unit and hospital length of stay, bradycardia, and hypotension) is thus far insufficient to draw conclusions. Conclusion: Dexmedetomidine can reduce POD incidence for adult cardiac and non-cardiac surgical patients. The optimal dose and timing of dexmedetomidine and influence on other outcomes or particular patient populations with risk factors warrants further studies.","[Duan, X.] Southwest Med Univ, Dept Anaesthesiol, Affiliated Hosp, Luzhou, Peoples R China; [Duan, X.; Coburn, M.; Rossaint, R.; Waesberghe, J. V.; Kowark, A.] Univ Hosp RWTH Aachen, Dept Anaesthesiol, Aachen, Germany; [Sanders, R. D.] Univ Wisconsin, Dept Anesthesiol, Sch Med & Publ Hlth, Madison, WI USA","Southwest Medical University; RWTH Aachen University; RWTH Aachen University Hospital; University of Wisconsin System; University of Wisconsin Madison","Coburn, M (通讯作者)，Univ Hosp RWTH Aachen, Dept Anaesthesiol, Aachen, Germany.","mcoburn@ukaachen.de","Duan, xiaoxia/GMW-7041-2022; Sanders, Robert D/A-7844-2012","Duan, xiaoxia/0000-0002-6162-0428; Sanders, Robert/0000-0003-0113-0328","China Scholarship Council [201608515124]; Affiliated Hospital of South West Medical University [2017-PT-45]","China Scholarship Council(China Scholarship Council); Affiliated Hospital of South West Medical University","China Scholarship Council to X.D. (grant number 201608515124); and Affiliated Hospital of South West Medical University to X.D. (grant number 2017-PT-45).","",44,125,136,2,26,"ELSEVIER SCI LTD","OXFORD","THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND","0007-0912","1471-6771","","BRIT J ANAESTH","Br. J. Anaesth.","AUG",2018,121,2,"","","","",384,397,"","10.1016/j.bja.2018.04.046","http://dx.doi.org/10.1016/j.bja.2018.04.046","","",14,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","GT5CE",30032877,"hybrid","","","2023-11-07","WOS:000444522700010","View Full Record in Web of Science"]
["J","Liu, XL; Yu, Y; Zhu, SM","","","","Liu, Xuling; Yu, Yang; Zhu, Shengmei","","","Inflammatory markers in postoperative delirium (POD) and cognitive dysfunction (POCD): A meta-analysis of observational studies","PLOS ONE","","","English","Article","","","","","","","C-REACTIVE PROTEIN; CONFUSION ASSESSMENT METHOD; MECHANICALLY VENTILATED PATIENTS; CRITICALLY-ILL PATIENTS; GROWTH-FACTOR-I; ELDERLY-PATIENTS; INTERLEUKIN-6 RECEPTOR; REGIONAL ANESTHESIA; BRAIN-DYSFUNCTION; CARDIAC-SURGERY","Background The aim of this study was to summarize and discuss the similarities and differences in inflammatory biomarkers in postoperative delirium (POD) and cognitive dysfunction (POCD). Methods A systematic retrieval of literature up to June 2017 in PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure database, and the Wanfang database was conducted. Extracted data were analyzed with STATA (version 14). The standardized mean difference (SMD) and the 95% confidence interval (95% CI) of each indicator were calculated using a random effect model. We also performed tests of heterogeneity, sensitivity analysis, assessments of bias, and meta-regression in this meta-analysis. Results A total of 54 observational studies were included. By meta-analysis we found significantly increased C-reactive protein (CRP) (9 studies, SMD 0.883, 95% CI 0.130 to 1.637, P = 0.022 in POD; 10 studies, SMD -0.133, 95% CI -0.512 to 0.246, P = 0.429 in POCD) and interleukin (IL)-6 (7 studies, SMD 0.386, 95% CI 0.054 to 0.717, P = 0.022 in POD; 16 studies, SMD 0.089, 95% CI -0.133 to 0.311, P = 0.433 in POCD) concentrations in both POD and POCD patients. We also found that the SMDs of CRP and IL-6 from POCD patients were positively correlated with surgery type in the meta-regression (CRP: Coefficient = 1.555365, P = 0.001, 10 studies; IL-6: Coefficient = -0.6455521, P = 0.086, 16 studies). Conclusion Available evidence from medium-to-high quality observational studies suggests that POD and POCD are indeed correlated with the concentration of peripheral and cerebrospinal fluid (CSF) inflammatory markers. Some of these markers, such as CRP and IL-6, play roles in both POD and POCD, while others are specific to either one of them.","[Liu, Xuling; Yu, Yang; Zhu, Shengmei] Zhejiang Univ, Sch Med, Hangzhou, Zhejiang, Peoples R China; [Zhu, Shengmei] Zhejiang Univ, Sch Med, Affiliated Hosp 1, Dept Anesthesiol, Hangzhou, Zhejiang, Peoples R China","Zhejiang University; Zhejiang University","Zhu, SM (通讯作者)，Zhejiang Univ, Sch Med, Hangzhou, Zhejiang, Peoples R China.;Zhu, SM (通讯作者)，Zhejiang Univ, Sch Med, Affiliated Hosp 1, Dept Anesthesiol, Hangzhou, Zhejiang, Peoples R China.","1185027@zju.edu.cn","yu, yang/HIZ-9682-2022","","National Natural Science Foundation of China [81471171]","National Natural Science Foundation of China(National Natural Science Foundation of China (NSFC))","This work is supported by the National Natural Science Foundation of China (Grant No. 81471171). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","",111,125,133,2,16,"PUBLIC LIBRARY SCIENCE","SAN FRANCISCO","1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA","1932-6203","","","PLOS ONE","PLoS One","APR 11",2018,13,4,"","","","","","","e0195659","10.1371/journal.pone.0195659","http://dx.doi.org/10.1371/journal.pone.0195659","","",22,"Multidisciplinary Sciences","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Science & Technology - Other Topics","GC4GL",29641605,"Green Submitted, Green Published, gold","","","2023-11-07","WOS:000429742900081","View Full Record in Web of Science"]
["J","Sieber, FE; Neufeld, KJ; Gottschalk, A; Bigelow, GE; Oh, ES; Rosenberg, PB; Mears, SC; Stewart, KJ; Ouanes, JPP; Jaberi, M; Hasenboehler, EA; Li, TJ; Wang, NY","","","","Sieber, Frederick E.; Neufeld, Karin J.; Gottschalk, Allan; Bigelow, George E.; Oh, Esther S.; Rosenberg, Paul B.; Mears, Simon C.; Stewart, Kerry J.; Ouanes, Jean-Pierre P.; Jaberi, Mahmood; Hasenboehler, Erik A.; Li, Tianjing; Nae-Yuh Wang","","","Effect of Depth of Sedation in Older Patients Undergoing Hip Fracture Repair on Postoperative Delirium The STRIDE Randomized Clinical Trial","JAMA SURGERY","","","English","Article","","","","","","","INTENSIVE-CARE-UNIT; COGNITIVE IMPAIRMENT; ELDERLY-PATIENTS; RISK-FACTORS; ANESTHESIA; PROPOFOL; SURGERY; ADULTS; TRANSFUSION; VALIDATION","IMPORTANCE Postoperative delirium is the most common complication following major surgery in older patients. Intraoperative sedation levels are a possible modifiable risk factor for postoperative delirium. OBJECTIVE To determine whether limiting sedation levels during spinal anesthesia reduces incident delirium overall. DESIGN, SETTING, AND PARTICIPANTS This double-blind randomized clinical trial (A Strategy to Reduce the Incidence of Postoperative Delirum in Elderly Patients [STRIDE]) was conducted from November 18,2011, to May 19, 2016, at a single academic medical center and included a consecutive sample of older patients ( >= 65 years) who were undergoing nonelective hip fracture repair with spinal anesthesia and propofol sedation. Patients were excluded for preoperative delirium or severe dementia. Of 538 hip fractures screened, 225 patients (41.8%) were eligible, 10 (1.9%) declined participation, 15 (2.8%) became ineligible between the time of consent and surgery, and 200 (37.2%) were randomized. The follow-up included postoperative days 1 to 5 or until hospital discharge. INTERVENTIONS Heavier (modified observer's assessment of sedation score of 0-2) or lighter (observer's assessment of sedation score of 3-5) propofol sedation levels intraoperatively. MAIN OUTCOMES AND MEASURES Delirium on postoperative days 1 to 5 or until hospital discharge determined via consensus panel using Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) criteria. The incidence of delirium was compared between intervention groups with and without stratification by the Charlson comorbidity index (CCI). RESULTS Of 200 participants, the mean (SD) age was 82 (8) years, 146 (73%) were women, 194(97%) were white, and the mean (SD) CCI was 1.5 (1.8). One hundred participants each were randomized to receive lighter sedation levels or heavier sedation levels. A good separation of intraoperative sedation levels was confirmed by multiple indices. The overall incident delirium risk was 36.5% (n = 73) and 39% (n = 39) vs 34% (n = 34) in heavier and lighter sedation groups, respectively (P = .46). Intention-to-treat analyses indicated no statistically significant difference between groups in the risk of incident delirium (log-rank test x 2 , 0.46; P = .46). However, in a prespecified subgroup analysis, when stratified by CCI, sedation levels did effect the delirium risk (P for interaction = .04); in low comorbid states (CCI = 0), heavier vs lighter sedation levels doubled the risk of delirium (hazard ratio, 2.3; 95% CI, 1.1-4.9). The level of sedation did not affect delirium risk with a CCI of more than 0. CONCLUSIONS AND RELEVANCE In the primary analysis, limiting the level of sedation provided no significant benefit in reducing incident delirium. However, in a prespecified subgroup analysis, lighter sedation levels benefitted reducing postoperative delirium for persons with a CCI of 0.","[Sieber, Frederick E.; Jaberi, Mahmood] Johns Hopkins Bayview Med Ctr, Dept Anesthesiol & Crit Care Med, 4940 Eastern Ave, Baltimore, MD 21224 USA; [Neufeld, Karin J.; Rosenberg, Paul B.] Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21205 USA; [Gottschalk, Allan; Ouanes, Jean-Pierre P.] Johns Hopkins Univ Hosp, Dept Anesthesiol & Crit Care Med, Baltimore, MD 21287 USA; [Gottschalk, Allan] Johns Hopkins Univ Hosp, Dept Neurosurg, Baltimore, MD 21287 USA; [Bigelow, George E.] Johns Hopkins Univ, Sch Med, Behav Pharmacol Res Unit, JV Brady Behav Biol Res Ctr, Johns Hopkins Bayview Campus, Baltimore, MD USA; [Oh, Esther S.] Johns Hopkins Univ, Sch Med, Div Geriatr Med & Gerontol Psychiat & Behav Sci &, Baltimore, MD USA; [Mears, Simon C.] Univ Arkansas Med Sci, Dept Orthoped Surg, Little Rock, AR 72205 USA; [Stewart, Kerry J.] Johns Hopkins Univ, Sch Med, Johns Hopkins Bayview Med Ctr, Baltimore, MD USA; [Hasenboehler, Erik A.] Johns Hopkins Bayview Med Ctr, Adult & Trauma Surg, Dept Orthopaed Surg, Baltimore, MD USA; [Li, Tianjing] Johns Hopkins Bloomberg Sch Publ Hlth, Ctr Clin Trials & Evidence Synth, Dept Epidemiol, Baltimore, MD USA; [Nae-Yuh Wang] Johns Hopkins Univ, Dept Med Gen Internal Med, Baltimore, MD USA; [Nae-Yuh Wang] Johns Hopkins Univ, Dept Biostat, Baltimore, MD 21205 USA; [Nae-Yuh Wang] Johns Hopkins Univ, Dept Epidemiol, Baltimore, MD USA; [Nae-Yuh Wang] Johns Hopkins Univ, Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD USA","Johns Hopkins University; Johns Hopkins Medicine; Johns Hopkins University; Johns Hopkins University; Johns Hopkins Medicine; Johns Hopkins University; Johns Hopkins Medicine; Johns Hopkins University; Johns Hopkins University; University of Arkansas System; University of Arkansas Medical Sciences; Johns Hopkins University; Johns Hopkins Medicine; Johns Hopkins University; Johns Hopkins Medicine; Johns Hopkins University; Johns Hopkins Bloomberg School of Public Health; Johns Hopkins University; Johns Hopkins University; Johns Hopkins University; Johns Hopkins University","Sieber, FE (通讯作者)，Johns Hopkins Bayview Med Ctr, Dept Anesthesiol & Crit Care Med, 4940 Eastern Ave, Baltimore, MD 21224 USA.","fsieber1@jhmi.edu","","Neufeld, Karin/0000-0002-2395-1883; Li, Tianjing/0000-0001-5371-4558; Wang, Nae-Yuh/0000-0001-6513-9730","National Institute on Aging [R01 AG033615]","National Institute on Aging(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute on Aging (NIA))","This research was supported by National Institute on Aging grant R01 AG033615.","",37,92,97,0,14,"AMER MEDICAL ASSOC","CHICAGO","330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA","2168-6254","2168-6262","","JAMA SURG","JAMA Surg.","NOV",2018,153,11,"","","","",987,995,"","10.1001/jamasurg.2018.2602","http://dx.doi.org/10.1001/jamasurg.2018.2602","","",9,"Surgery","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Surgery","HB0PM",30090923,"Green Published, Bronze","","","2023-11-07","WOS:000450718300008","View Full Record in Web of Science"]
["J","Wildes, TS; Mickle, AM; Ben Abdallah, A; Maybrier, HR; Oberhaus, J; Budelier, TP; Kronzer, A; McKinnon, SL; Park, D; Torres, BA; Graetz, TJ; Emmert, DA; Palanca, BJ; Goswami, S; Jordan, K; Lin, N; Fritz, BA; Stevens, T; Jacobsohn, E; Schmitt, E; Inouye, SK; Stark, S; Lenze, EJ; Avidan, MS; Ben Abdallah, A; Apakama, G; Aranake-Chrisinger, A; Avidan, MS; Bolzenius, J; Budelier, TP; Burton, J; Cui, V; Emmert, DA; Fritz, BA; Goswami, S; Graetz, TJ; Gupta, S; Jordan, K; Kronzer, A; Maybrier, HR; McKinnon, SL; Mickle, AM; Muench, MR; Murphy, MR; Oberhaus, J; Palanca, BJ; Park, D; Patel, A; Spencer, J; Stevens, TW; Strutz, P; Tedeschi, CM; Torres, BA; Trammel, ER; Upadhyayula, RT; Wildes, TS; Winter, AC; Lin, N; Jacobsohn, E; Fongmd, T; Gallagher, J; Inouye, SK; Schmitt, E; Somerville, E; Stark, S; Lenze, EJ; Melby, SJ; Tappenden, J","","","","Wildes, Troy S.; Mickle, Angela M.; Ben Abdallah, Arbi; Maybrier, Hannah R.; Oberhaus, Jordan; Budelier, Thaddeus P.; Kronzer, Alex; McKinnon, Sherry L.; Park, Daniel; Torres, Brian A.; Graetz, Thomas J.; Emmert, Daniel A.; Palanca, Ben J.; Goswami, Shreya; Jordan, Katherine; Lin, Nan; Fritz, Bradley A.; Stevens, TraceyW.; Jacobsohn, Eric; Schmitt, Evam.; Inouye, Sharon K.; Stark, Susan; Lenze, Eric J.; Avidan, Michael S.; Ben Abdallah, Arbi; Apakama, Ginika; Aranake-Chrisinger, Amrita; Avidan, Michael S.; Bolzenius, Jacob; Budelier, Thaddeus P.; Burton, Jamila; Cui, Victoria; Emmert, Daniel A.; Fritz, Bradley A.; Goswami, Shreya; Graetz, Thomas J.; Gupta, Shelly; Jordan, Katherine; Kronzer, Alex; Maybrier, Hannah R.; McKinnon, Sherry L.; Mickle, Angela M.; Muench, Maxwell R.; Murphy, Matthew R.; Oberhaus, Jordan; Palanca, Ben J.; Park, Daniel; Patel, Aamil; Spencer, JamesW.; Stevens, Tracey W.; Strutz, Patricia; Tedeschi, Catherine M.; Torres, Brian A.; Trammel, Emma R.; Upadhyayula, Ravi T.; Wildes, Troy S.; Winter, Anke C.; Lin, Nan; Jacobsohn, Eric; Fongmd, Tamara; Gallagher, Jackie; Inouye, Sharon K.; Schmitt, Evam.; Somerville, Emily; Stark, Susan; Lenze, Eric J.; Melby, Spencer J.; Tappenden, Jennifer","","ENGAGES Res Grp","Effect of Electroencephalography-Guided Anesthetic Administration on Postoperative Delirium Among Older Adults Undergoing Major Surgery The ENGAGES Randomized Clinical Trial","JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION","","","English","Article","","","","","","","CONFUSION ASSESSMENT METHOD; SUPPRESSION; DEPTH; DECREASES; SEVERITY; SOCIETY; PATIENT; DESIGN","IMPORTANCE Intraoperative electroencephalogram (EEG) waveform suppression, often suggesting excessive general anesthesia, has been associated with postoperative delirium. OBJECTIVE To assess whether EEG-guided anesthetic administration decreases the incidence of postoperative delirium. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 1232 adults aged 60 years and older undergoing major surgery and receiving general anesthesia at Barnes-Jewish Hospital in St Louis. Recruitment was from January 2015 to May 2018, with follow-up until July 2018. INTERVENTIONS Patients were randomized 1:1 (stratified by cardiac vs noncardiac surgery and positive vs negative recent fall history) to receive EEG-guided anesthetic administration (n = 614) or usual anesthetic care (n = 618). MAIN OUTCOMES AND MEASURES The primary outcome was incident delirium during postoperative days 1 through 5. Intraoperative measures included anesthetic concentration, EEG suppression, and hypotension. Adverse events included undesirable intraoperative movement, intraoperative awareness with recall, postoperative nausea and vomiting, medical complications, and death. RESULTS Of the 1232 randomized patients (median age, 69 years [range, 60 to 95]; 563 women [45.7%]), 1213 (98.5%) were assessed for the primary outcome. Delirium during postoperative days 1 to 5 occurred in 157 of 604 patients (26.0%) in the guided group and 140 of 609 patients (23.0%) in the usual care group (difference, 3.0%[95% CI, -2.0% to 8.0%]; P = .22). Median end-tidal volatile anesthetic concentration was significantly lower in the guided group than the usual care group (0.69 vs 0.80 minimum alveolar concentration; difference, -0.11 [95% CI, -0.13 to -0.10), and median cumulative time with EEG suppression was significantly less (7 vs 13 minutes; difference, -6.0[95% CI, -9.9 to -2.1]). There was no significant difference between groups in the median cumulative time with mean arterial pressure below 60 mmHg (7 vs 7 minutes; difference, 0.0[95% CI, -1.7 to 1.7]). Undesirable movement occurred in 137 patients (22.3%) in the guided and 95 (15.4%) in the usual care group. No patients reported intraoperative awareness. Postoperative nausea and vomiting was reported in 48 patients (7.8%) in the guided and 55 patients (8.9%) in the usual care group. Serious adverse events were reported in 124 patients (20.2%) in the guided and 130 (21.0%) in the usual care group. Within 30 days of surgery, 4 patients (0.65%) in the guided group and 19 (3.07%) in the usual care group died. CONCLUSIONS AND RELEVANCE Among older adults undergoing major surgery, EEG-guided anesthetic administration, compared with usual care, did not decrease the incidence of postoperative delirium. This finding does not support the use of EEG-guided anesthetic administration for this indication.","[Wildes, Troy S.; Mickle, Angela M.; Ben Abdallah, Arbi; Maybrier, Hannah R.; Oberhaus, Jordan; Budelier, Thaddeus P.; Kronzer, Alex; McKinnon, Sherry L.; Park, Daniel; Torres, Brian A.; Graetz, Thomas J.; Emmert, Daniel A.; Palanca, Ben J.; Goswami, Shreya; Jordan, Katherine; Fritz, Bradley A.; Stevens, TraceyW.; Avidan, Michael S.; Ben Abdallah, Arbi; Apakama, Ginika; Aranake-Chrisinger, Amrita; Avidan, Michael S.; Bolzenius, Jacob; Budelier, Thaddeus P.; Burton, Jamila; Cui, Victoria; Emmert, Daniel A.; Fritz, Bradley A.; Goswami, Shreya; Graetz, Thomas J.; Gupta, Shelly; Jordan, Katherine; Kronzer, Alex; Maybrier, Hannah R.; McKinnon, Sherry L.; Mickle, Angela M.; Muench, Maxwell R.; Murphy, Matthew R.; Oberhaus, Jordan; Palanca, Ben J.; Park, Daniel; Patel, Aamil; Spencer, JamesW.; Stevens, Tracey W.; Strutz, Patricia; Tedeschi, Catherine M.; Torres, Brian A.; Trammel, Emma R.; Upadhyayula, Ravi T.; Wildes, Troy S.; Winter, Anke C.] Washington Univ, Sch Med, Dept Anesthesiol, 660 S Euclid Ave,Campus Box 8054, St Louis, MO 63110 USA; [Lin, Nan] Washington Univ, Sch Med, Dept Math, St Louis, MO USA; [Jacobsohn, Eric] Univ Manitoba, Dept Anesthesiol, Winnipeg, MB, Canada; [Schmitt, Evam.; Inouye, Sharon K.; Stark, Susan; Fongmd, Tamara; Gallagher, Jackie; Inouye, Sharon K.; Schmitt, Evam.] Harvard Med Sch, Dept Med, Beth Israel Deaconess Med Ctr, Hebrew Senior Life, Boston, MA USA; [Lenze, Eric J.; Somerville, Emily; Stark, Susan] Washington Univ, Dept Occupat Therapy, Sch Med, St Louis, MO USA; [Lenze, Eric J.] Washington Univ, Sch Med, Dept Psychiat, St Louis, MO USA; [Melby, Spencer J.; Tappenden, Jennifer] Washington Univ, Sch Med, Dept Surg, St Louis, MO 63110 USA","Washington University (WUSTL); Washington University (WUSTL); University of Manitoba; Harvard University; Hebrew SeniorLife; Beth Israel Deaconess Medical Center; Harvard Medical School; Washington University (WUSTL); Washington University (WUSTL); Washington University (WUSTL)","Avidan, MS (通讯作者)，Washington Univ, Sch Med, Dept Anesthesiol, 660 S Euclid Ave,Campus Box 8054, St Louis, MO 63110 USA.","avidanm@wustl.edu","Lenze, Eric J/AAW-8652-2021; Inouye, Sharon/R-7216-2019; Palanca, Ben Julian Agustin/GRD-4146-2022","Palanca, Ben Julian Agustin/0000-0001-7535-5701; Avidan, Michael/0000-0001-6248-044X; Mickle, Angela/0000-0001-9175-5342; Wildes, Troy/0000-0002-9042-571X; Lenze, Eric/0000-0002-0471-9368","National Institutes of Health [1 UH2 HL125141, 5 UH3 AG050312]; National Institutes of Health NIDUS Grant [NIA R24AG054259]; Dr Seymour and Rose T. Brown Endowed Chair at Washington University","National Institutes of Health(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA); National Institutes of Health NIDUS Grant(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA); Dr Seymour and Rose T. Brown Endowed Chair at Washington University","This study was funded by a National Institutes of Health grant to support pragmatic trials (1 UH2 HL125141, 5 UH3 AG050312). This study was also funded by the National Institutes of Health NIDUS Grant (NIA R24AG054259) and the Dr Seymour and Rose T. Brown Endowed Chair at Washington University.","",38,236,250,3,75,"AMER MEDICAL ASSOC","CHICAGO","330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA","0098-7484","1538-3598","","JAMA-J AM MED ASSOC","JAMA-J. Am. Med. Assoc.","FEB 5",2019,321,5,"","","","",473,483,"","10.1001/jama.2018.22005","http://dx.doi.org/10.1001/jama.2018.22005","","",11,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED)","General & Internal Medicine","HK2JH",30721296,"Green Published, Bronze","","","2023-11-07","WOS:000457735900017","View Full Record in Web of Science"]
["J","Subramaniam, B; Shankar, P; Shaefi, S; Mueller, A; O'Gara, B; Banner-Goodspeed, V; Gallagher, J; Gasangwa, D; Patxot, M; Packiasabapathy, S; Mathur, P; Eikermann, M; Talmor, D; Marcantonio, ER","","","","Subramaniam, Balachundhar; Shankar, Puja; Shaefi, Shahzad; Mueller, Ariel; O'Gara, Brian; Banner-Goodspeed, Valerie; Gallagher, Jackie; Gasangwa, Doris; Patxot, Melissa; Packiasabapathy, Senthil; Mathur, Pooja; Eikermann, Matthias; Talmor, Daniel; Marcantonio, Edward R.","","","Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery The DEXACET Randomized Clinical Trial","JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION","","","English","Article","","","","","","","IMPORTANT DIFFERENCE; BARIATRIC SURGERY; PAIN; PARACETAMOL; INFUSION","IMPORTANCE Postoperative delirium is common following cardiac surgery and may be affected by choice of analgesic and sedative. OBJECTIVE To evaluate the effect of postoperative intravenous (IV) acetaminophen (paracetamol) vs placebo combined with IV propofol vs dexmedetomidine on postoperative delirium among older patients undergoing cardiac surgery. DESIGN, SETTING, AND PARTICIPANTS Randomized, placebo-controlled, factorial clinical trial among 120 patients aged 60 years or older undergoing on-pump coronary artery bypass graft (CABG) surgery or combined CABG/valve surgeries at a US center. Enrollment was September 2015 to April 2018, with follow-up ending in April 2019. INTERVENTIONS Patients were randomized to 1 of 4 groups receiving postoperative analgesia with IV acetaminophen or placebo every 6 hours for 48 hours and postoperative sedation with dexmedetomidine or propofol starting at chest closure and continued for up to 6 hours (acetaminophen and dexmedetomidine: n = 29; placebo and dexmedetomidine: n = 30; acetaminophen and propofol: n = 31; placebo and propofol: n = 30). MAIN OUTCOMES AND MEASURES The primary outcome was incidence of postoperative in-hospital delirium by the Confusion Assessment Method. Secondary outcomes included delirium duration, cognitive decline, breakthrough analgesia within the first 48 hours, and ICU and hospital length of stay. RESULTS Among 121 patients randomized (median age, 69 years; 19 women [15.8%]), 120 completed the trial. Patients treated with IV acetaminophen had a significant reduction in delirium (10% vs 28% placebo; difference, -18%[95% CI, -32% to -5%]; P = .01; HR, 2.8 [95% CI, 1.1-7.8]). Patients receiving dexmedetomidine vs propofol had no significant difference in delirium (17% vs 21%; difference, -4%[95% CI, -18% to 10%]; P = .54; HR, 0.8 [95% CI, 0.4-1.9]). There were significant differences favoring acetaminophen vs placebo for 3 prespecified secondary outcomes: delirium duration (median, 1 vs 2 days; difference, -1 [95% CI, -2 to 0]), ICU length of stay (median, 29.5 vs 46.7 hours; difference, -16.7 [95% CI, -20.3 to -0.8]), and breakthrough analgesia (median, 322.5 vs 405.3 mu g morphine equivalents; difference, -83 [95% CI, -154 to -14]). For dexmedetomidine vs propofol, only breakthrough analgesia was significantly different (median, 328.8 vs 397.5 mu g; difference, -69 [95% CI, -155 to -4]; P = .04). Fourteen patients in both the placebo-dexmedetomidine and acetaminophen-propofol groups (46% and 45%) and 7 in the acetaminophen-dexmedetomidine and placebo-propofol groups (24% and 23%) had hypotension. CONCLUSIONS AND RELEVANCE Among older patients undergoing cardiac surgery, postoperative scheduled IV acetaminophen, combined with IV propofol or dexmedetomidine, reduced in-hospital delirium vs placebo. Additional research, including comparison of IV vs oral acetaminophen and other potentially opioid-sparing analgesics, on the incidence of postoperative delirium is warranted. (c) 2019 American Medical Association. All rights reserved.","[Subramaniam, Balachundhar; Shankar, Puja; Shaefi, Shahzad; Mueller, Ariel; O'Gara, Brian; Banner-Goodspeed, Valerie; Gasangwa, Doris; Patxot, Melissa; Packiasabapathy, Senthil; Mathur, Pooja; Eikermann, Matthias; Talmor, Daniel] Harvard Med Sch, Dept Anesthesia Crit Care & Pain Med, Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA; [Gallagher, Jackie; Marcantonio, Edward R.] Harvard Med Sch, Dept Med, Div Gerontol, Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA","Harvard University; Beth Israel Deaconess Medical Center; Harvard Medical School; Harvard University; Harvard Medical School; Beth Israel Deaconess Medical Center","Subramaniam, B (通讯作者)，Beth Israel Deaconess Med Ctr, 375 Longwood Ave,W-MS-414, Boston, MA 02215 USA.","bsubrama@bidmc.harvard.edu","Marcantonio, Edward R/U-3929-2017","Marcantonio, Edward R/0000-0002-2911-4250; Mathur, Pooja A./0000-0003-3339-9567; Goodspeed, Valerie/0000-0002-7644-2521; Packiasabapathy, Senthil/0000-0002-0248-5430","Mallinckrodt Pharmaceuticals","Mallinckrodt Pharmaceuticals","The study was funded by Mallinckrodt Pharmaceuticals: funds were allotted to support time and effort of study personnel, sample acquisition, processing, storage, and regulatory compliance and to assist in paying for the study drugs and placebo.","",32,160,172,3,42,"AMER MEDICAL ASSOC","CHICAGO","330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA","0098-7484","1538-3598","","JAMA-J AM MED ASSOC","JAMA-J. Am. Med. Assoc.","FEB 19",2019,321,7,"","","","",686,696,"","10.1001/jama.2019.0234","http://dx.doi.org/10.1001/jama.2019.0234","","",11,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED)","General & Internal Medicine","HL9MZ",30778597,"Bronze, Green Published","","","2023-11-07","WOS:000459068300017","View Full Record in Web of Science"]
["J","Daiello, LA; Racine, AM; Gou, RY; Marcantonio, ER; Xie, ZC; Kunze, LJ; Vlassakov, KV; Inouye, SK; Jones, RN; Alsop, D; Jones, R; Travison, T; Marcantonio, ER; Arnold, S; Cooper, Z; Dickerson, B; Fong, T; Metzger, E; Pascual-Leone, A; Schmitt, EM; Shafi, M; Cavallari, M; Dai, WY; Dillon, ST; McElhaney, J; Guttmann, C; Hshieh, T; Kuchel, G; Libermann, T; Ngo, L; Press, D; Saczynski, J; Vasunilashorn, S; O'Connor, M; Kimchi, E; Strauss, J; Wong, B; Belkin, M; Ayres, D; Callery, M; Pomposelli, F; Wright, J; Schermerhorn, M; Abrantes, T; Albuquerque, A; Bertrand, S; Brown, A; Callahan, A; D'Aquila, M; Dowal, S; Fox, M; Gallagher, J; Gersten, RA; Hodara, A; Helfand, B; Inloes, J; Kettell, J; Kuczmarska, A; Nee, J; Nemeth, E; Ochsner, L; Palihnich, K; Parisi, K; Puelle, M; Rastegar, S; Vella, M; Xu, GQ; Bryan, M; Guess, J; Enghorn, D; Gross, A; Gou, Y; Habtemariam, D; Isaza, I; Kosar, C; Rockett, C; Tommet, D; Gruen, T; Ross, M; Tasker, K; Gee, J; Kolanowski, A; Pisani, M; de Rooij, S; Rogers, S; Studenski, S; Stern, Y; Whittemore, A; Gottlieb, G; Orav, J; Sperling, R","","","","Daiello, Lori A.; Racine, Annie M.; Gou, Ray Yun; Marcantonio, Edward R.; Xie, Zhongcong; Kunze, Lisa J.; Vlassakov, Kamen V.; Inouye, Sharon K.; Jones, Richard N.; Alsop, David; Jones, Richard; Travison, Thomas; Marcantonio, Edward R.; Arnold, Steven; Cooper, Zara; Dickerson, Bradford; Fong, Tamara; Metzger, Eran; Pascual-Leone, Alvaro; Schmitt, Eva M.; Shafi, Mouhsin; Cavallari, Michele; Dai, Weiying; Dillon, Simon T.; McElhaney, Janet; Guttmann, Charles; Hshieh, Tammy; Kuchel, George; Libermann, Towia; Ngo, Long; Press, Daniel; Saczynski, Jane; Vasunilashorn, Sarinnapha; O'Connor, Margaret; Kimchi, Eyal; Strauss, Jason; Wong, Bonnie; Belkin, Michael; Ayres, Douglas; Callery, Mark; Pomposelli, Frank; Wright, John; Schermerhorn, Marc; Abrantes, Tatiana; Albuquerque, Asha; Bertrand, Sylvie; Brown, Amanda; Callahan, Amy; D'Aquila, Madeline; Dowal, Sarah; Fox, Meaghan; Gallagher, Jacqueline; Gersten, Rebecca Anna; Hodara, Ariel; Helfand, Ben; Inloes, Jennifer; Kettell, Jennifer; Kuczmarska, Aleksandra; Nee, Jacqueline; Nemeth, Emese; Ochsner, Lisa; Palihnich, Kerry; Parisi, Katelyn; Puelle, Margaret; Rastegar, Sarah; Vella, Margaret; Xu, Guoquan; Bryan, Margaret; Guess, Jamey; Enghorn, Dee; Gross, Alden; Gou, Yun; Habtemariam, Daniel; Isaza, Ilean; Kosar, Cyrus; Rockett, Christopher; Tommet, Douglas; Gruen, Ted; Ross, Meg; Tasker, Katherine; Gee, James; Kolanowski, Ann; Pisani, Margaret; de Rooij, Sophia; Rogers, Selwyn; Studenski, Stephanie; Stern, Yaakov; Whittemore, Anthony; Gottlieb, Gary; Orav, John; Sperling, Reisa","","SAGES Study Grp","Postoperative Delirium and Postoperative Cognitive Dysfunction Overlap and Divergence","ANESTHESIOLOGY","","","English","Article","","","","","","","SURGERY PATIENTS; CARDIAC-SURGERY; SHORT-TERM; DECLINE; ASSOCIATION; DEMENTIA; OUTCOMES; RISK; TRAJECTORIES; PERFORMANCE","Background: Postoperative delirium and postoperative cognitive dysfunction share risk factors and may co-occur, but their relationship is not well established. The primary goals of this study were to describe the prevalence of postoperative cognitive dysfunction and to investigate its association with in-hospital delirium. The authors hypothesized that delirium would be a significant risk factor for postoperative cognitive dysfunction during follow-up. Methods: This study used data from an observational study of cognitive outcomes after major noncardiac surgery, the Successful Aging after Elective Surgery study. Postoperative delirium was evaluated each hospital day with confusion assessment method-based interviews supplemented by chart reviews. Postoperative cognitive dysfunction was determined using methods adapted from the International Study of Postoperative Cognitive Dysfunction. Associations between delirium and postoperative cognitive dysfunction were examined at 1, 2, and 6 months. Results: One hundred thirty-four of 560 participants (24%) developed delirium during hospitalization. Slightly fewer than half (47%, 256 of 548) met the International Study of Postoperative Cognitive Dysfunction-defined threshold for postoperative cognitive dysfunction at 1 month, but this proportion decreased at 2 months (23%, 123 of 536) and 6 months (16%, 85 of 528). At each follow-up, the level of agreement between delirium and postoperative cognitive dysfunction was poor (kappa less than .08) and correlations were small (r less than .16). The relative risk of postoperative cognitive dysfunction was significantly elevated for patients with a history of postoperative delirium at 1 month (relative risk = 1.34; 95% CI, 1.07-1.67), but not 2 months (relative risk = 1.08; 95% CI, 0.72-1.64), or 6 months (relative risk = 1.21; 95% CI, 0.71-2.09). Conclusions: Delirium significantly increased the risk of postoperative cognitive dysfunction in the first postoperative month; this relationship did not hold in longer-term follow-up. At each evaluation, postoperative cognitive dysfunction was more common among patients without delirium. Postoperative delirium and postoperative cognitive dysfunction may be distinct manifestations of perioperative neurocognitive deficits.","[Daiello, Lori A.] Rhode Isl Hosp, Alzheimers Dis & Memory Disorders Ctr, 593 Eddy St, Providence, RI 02903 USA; [Racine, Annie M.; Gou, Ray Yun; Inouye, Sharon K.] Hebrew SeniorLife, Inst Aging Res, Boston, MA USA; [Racine, Annie M.; Marcantonio, Edward R.; Xie, Zhongcong; Kunze, Lisa J.; Vlassakov, Kamen V.; Inouye, Sharon K.] Harvard Med Sch, Boston, MA 02115 USA; [Marcantonio, Edward R.; Inouye, Sharon K.] Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02215 USA; [Kunze, Lisa J.] Beth Israel Deaconess Med Ctr, Dept Anesthesia & Crit Care, Boston, MA 02215 USA; [Xie, Zhongcong] Massachusetts Gen Hosp, Dept Anesthesia, Boston, MA 02114 USA; [Vlassakov, Kamen V.] Brigham & Womens Hosp, Dept Anesthesiol Perioperat & Pain Med, 75 Francis St, Boston, MA 02115 USA; [Jones, Richard N.] Brown Univ, Warren Alpert Med Sch, Dept Psychiat & Human Behav, Providence, RI 02912 USA; [Daiello, Lori A.; Jones, Richard N.] Brown Univ, Warren Alpert Med Sch, Dept Neurol, Providence, RI 02912 USA","Lifespan Health Rhode Island; Rhode Island Hospital; Harvard University; Hebrew SeniorLife; Harvard University; Harvard Medical School; Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Beth Israel Deaconess Medical Center; Harvard University; Massachusetts General Hospital; Harvard University; Brigham & Women's Hospital; Brown University; Brown University","Daiello, LA (通讯作者)，Rhode Isl Hosp, Alzheimers Dis & Memory Disorders Ctr, 593 Eddy St, Providence, RI 02903 USA.","lori_daiello@brown.edu","Jones, Richard Norman/J-3488-2013; Pascual-Leone, Alvaro/AAC-5101-2019; Vlassakov, Kamen/AAH-8166-2021; Guttmann, Charles RG/J-3093-2018; Marcantonio, Edward R/U-3929-2017; Alsop, David C/J-5764-2013; Shafi, Mouhsin/AFU-9843-2022","Jones, Richard Norman/0000-0002-1049-218X; Pascual-Leone, Alvaro/0000-0001-8975-0382; Vlassakov, Kamen/0000-0002-7704-3709; Marcantonio, Edward R/0000-0002-2911-4250; Alsop, David C/0000-0002-8206-1995; Kuchel, George/0000-0001-8387-7040; Gersten, Rebecca/0000-0002-1136-223X; Helfand, Benjamin/0000-0002-3651-3372; Guttmann, Charles/0000-0002-7006-9762; Kosar, Cyrus/0000-0003-0533-7529","National Institutes of Health (Bethesda, Maryland) [P01AG031720, K07AG041835, R24AG054259, R01AG044518, R01AG030618, K24AG035075, T32AG023480]","National Institutes of Health (Bethesda, Maryland)(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA)","This work was supported by the National Institutes of Health (Bethesda, Maryland) grant Nos. P01AG031720 (to Dr. Inouye), K07AG041835 (to Dr. Inouye), R24AG054259 (to Dr. Inouye), R01AG044518 (to Drs. Inouye and Jones), R01AG030618 (to Dr. Marcantonio), K24AG035075 (to Dr. Marcantonio), and T32AG023480 (to Dr. Racine). Dr. Inouye holds the Milton and Shirley F. Levy Family Chair. The funding sources had no role in the design, conduct, or reporting of this study.","",73,140,151,8,61,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-3022","1528-1175","","ANESTHESIOLOGY","Anesthesiology","SEP",2019,131,3,"","","","",477,491,"","10.1097/ALN.0000000000002729","http://dx.doi.org/10.1097/ALN.0000000000002729","","",15,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Anesthesiology","IV3FY",31166241,"Bronze, Green Accepted","","","2023-11-07","WOS:000484161900008","View Full Record in Web of Science"]
["J","Hesse, S; Kreuzer, M; Hight, D; Gaskell, A; Devari, P; Singh, D; Taylor, NB; Whalin, MK; Lee, S; Sleigh, JW; García, PS","","","","Hesse, S.; Kreuzer, M.; Hight, D.; Gaskell, A.; Devari, P.; Singh, D.; Taylor, N. B.; Whalin, M. K.; Lee, S.; Sleigh, J. W.; Garcia, P. S.","","","Association of electroencephalogram trajectories during emergence from anaesthesia with delirium in the postanaesthesia care unit: an early sign of postoperative complications","BRITISH JOURNAL OF ANAESTHESIA","","","English","Article","","","","","","EEG; delirium; general anaesthesia; complications; intraoperative monitoring; neurocognitive disorders; postoperative outcome; recovery room","CONFUSION ASSESSMENT METHOD; SLOW-WAVE ACTIVITY; SLEEP SPINDLES; RISK-FACTORS; GENERAL-ANESTHESIA; INADEQUATE EMERGENCE; EEG; PROPOFOL; SURGERY; DYNAMICS","Background: Postoperative delirium is associated with an increased risk of morbidity and mortality, especially in the elderly. Delirium in the postanaesthesia care unit (PACU) could predict adverse clinical outcomes. Methods: We investigated a potential link between intraoperative EEG patterns and PACU delirium as well as an association of PACU delirium with perioperative outcomes, readmission and length of hospital stay. The risk factors for PACU delirium were also explored. Data were collected from 626 patients receiving general anaesthesia for procedures that would not interfere with frontal EEG recording. Results: Of the 626 subjects enrolled, 125 tested positive for PACU delirium. Whilst age, renal failure, and pre-existing neurological disease were associated with PACU delirium in the univariable analysis, the multivariable analysis revealed the importance of information derived from the EEG, anaesthetic technique, anaesthesia duration, and history of stroke or neurodegenerative disease. The occurrence of EEG burst suppression during maintenance [odds ratio (OR)=1.86 (1.13-3.05)] and the type of EEG emergence trajectory may be predictive of PACU delirium. Specifically, EEG emergence trajectories lacking significant spindle power were strongly associated with PACU delirium, especially in cases that involved ketamine or nitrous oxide [OR=6.51 (3.00-14.12)]. Additionally, subjects with PACU delirium were at an increased risk for readmission [OR=2.17 (1.13-4.17)] and twice as likely to stay >6 days in the hospital. Conclusions: Specific EEG patterns were associated with PACU delirium. These findings provide valuable information regarding how the brain reacts to surgery and anaesthesia that may lead to strategies to predict PACU delirium and identify key areas of investigation for its prevention.","[Hesse, S.; Kreuzer, M.; Devari, P.; Singh, D.; Taylor, N. B.; Whalin, M. K.; Lee, S.; Garcia, P. S.] Emory Univ, Sch Med, Dept Anesthesiol, Atlanta, GA 30322 USA; [Hesse, S.; Kreuzer, M.; Devari, P.; Singh, D.; Taylor, N. B.; Garcia, P. S.] Atlanta VA Med Ctr, Res Div, Atlanta, GA 30322 USA; [Kreuzer, M.] Tech Univ Munich, Klinikum Rechts Isar, Dept Anaesthesiol & Intens Care, Munich, Germany; [Hight, D.; Gaskell, A.; Sleigh, J. W.] Univ Auckland, Dept Anaesthesiol, Waikato Clin Sch, Hamilton, New Zealand; [Whalin, M. K.] Grady Mem Hosp, Dept Anesthesiol, Atlanta, GA USA; [Lee, S.] Emory Univ Hosp Midtown, Dept Anesthesiol, Atlanta, GA USA; [Garcia, P. S.] Columbia Univ, NewYork Presbyterian Hosp Irving, Med Ctr, Dept Anesthesiol, New York, NY 10027 USA","Emory University; US Department of Veterans Affairs; Veterans Health Administration (VHA); Atlanta VA Health Care System; Atlanta VA Medical Center; Technical University of Munich; University of Auckland; Columbia University; NewYork-Presbyterian Hospital","García, PS (通讯作者)，Emory Univ, Sch Med, Dept Anesthesiol, Atlanta, GA 30322 USA.;García, PS (通讯作者)，Atlanta VA Med Ctr, Res Div, Atlanta, GA 30322 USA.;García, PS (通讯作者)，Columbia Univ, NewYork Presbyterian Hosp Irving, Med Ctr, Dept Anesthesiol, New York, NY 10027 USA.","pg2618@cumc.columbia.edu","Kreuzer, Matthias/AAX-6501-2021; Hight, Darren/AAJ-4247-2021","Hight, Darren/0000-0002-8950-7806","US Department of Veteran Affairs, Biomedical Laboratory Research and Development Service [BX00167]; James S. McDonnell Foundation [220023046]; National Institutes of Health [5T32NS007480-15]; Burroughs Wellcome Fund Collaborative Research Travel Grant [1015183]","US Department of Veteran Affairs, Biomedical Laboratory Research and Development Service; James S. McDonnell Foundation; National Institutes of Health(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA); Burroughs Wellcome Fund Collaborative Research Travel Grant(Burroughs Wellcome Fund)","Career Development Award #BX00167 from the US Department of Veteran Affairs, Biomedical Laboratory Research and Development Service, and the James S. McDonnell Foundation (Grant number 220023046) to P.S.G.; National Institutes of Health (T32 grant 5T32NS007480-15) to Emory University for Translational Research in Neurology and a Burroughs Wellcome Fund Collaborative Research Travel Grant (1015183) to S.H.","",60,104,113,0,34,"ELSEVIER SCI LTD","OXFORD","THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND","0007-0912","1471-6771","","BRIT J ANAESTH","Br. J. Anaesth.","MAY",2019,122,5,"","","","",622,634,"","10.1016/j.bja.2018.09.016","http://dx.doi.org/10.1016/j.bja.2018.09.016","","",13,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED)","Anesthesiology","HT2OF",30915984,"Green Accepted, Green Published, hybrid","","","2023-11-07","WOS:000464401400012","View Full Record in Web of Science"]
["J","Janssen, TL; Alberts, AR; Hooft, L; Mattace-Raso, FUS; Mosk, CA; van der Laan, L","","","","Janssen, T. L.; Alberts, A. R.; Hooft, L.; Mattace-Raso, F. U. S.; Mosk, C. A.; van der Laan, L.","","","Prevention of postoperative delirium in elderly patients planned for elective surgery: systematic review and meta-analysis","CLINICAL INTERVENTIONS IN AGING","","","English","Review","","","","","","prevention; postoperative delirium; elderly; elective surgery","COMPREHENSIVE GERIATRIC ASSESSMENT; OBSTRUCTIVE SLEEP-APNEA; HIP FRACTURE; LIFE PROGRAM; OLDER-ADULTS; DOUBLE-BLIND; RISK-FACTORS; HALOPERIDOL PROPHYLAXIS; COGNITIVE DYSFUNCTION; REGIONAL ANESTHESIA","Introduction: Vulnerable or frail patients are susceptible to the development of delirium when exposed to triggers such as surgical procedures. Once delirium occurs, interventions have little effect on severity or duration, emphasizing the importance of primary prevention. This review provides an overview of interventions to prevent postoperative delirium in elderly patients undergoing elective surgery. Methods: A literature search was conducted in March 2018. Randomized controlled trials (RCTs) and before-and-after studies on interventions with potential effects on postoperative delirium in elderly surgical patients were included. Acute admission, planned ICU admission, and cardiac patients were excluded. Full texts were reviewed, and quality was assessed by two independent reviewers. Primary outcome was the incidence of delirium. Secondary outcomes were severity and duration of delirium. Pooled risk ratios (RRs) were calculated for incidences of delirium where similar intervention techniques were used. Results: Thirty-one RCTs and four before-and-after studies were included for analysis. In 19 studies, intervention decreased the incidences of postoperative delirium. Severity was reduced in three out of nine studies which reported severity of delirium. Duration was reduced in three out of six studies. Pooled analysis showed a significant reduction in delirium incidence for dexmedetomidine treatment, and bispectral index (BIS)-guided anaesthesia. Based on sensitivity analyses, by leaving out studies with a high risk of bias, multicomponent interventions and antipsychotics can also significantly reduce the incidence of delirium. Conclusion: Multicomponent interventions, the use of antipsychotics, BIS-guidance, and dexmedetomidine treatment can successfully reduce the incidence of postoperative delirium in elderly patients undergoing elective, non-cardiac surgery. However, present studies are heterogeneous, and high-quality studies are scarce. Future studies should add these preventive methods to already existing multimodal and multidisciplinary interventions to tackle as many precipitating factors as possible, starting in the pre-admission period.","[Janssen, T. L.; Alberts, A. R.; Mosk, C. A.; van der Laan, L.] Amphia Hosp Breda, Dept Surg, Breda, Netherlands; [Hooft, L.] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Cochrane Netherlands, Utrecht, Netherlands; [Mattace-Raso, F. U. S.] Erasmus MC Univ Hosp Rotterdam, Dept Geriatr, Rotterdam, Netherlands","Amphia Hospital; Utrecht University; Utrecht University Medical Center; Erasmus University Rotterdam; Erasmus MC","Janssen, TL (通讯作者)，Amphia Hosp, Dept Surg, Box 90518, NL-4800 RK Breda, Netherlands.","TJanssen@amphia.nl","","Mattace-Raso, Francesco/0000-0002-1688-6497","","","","",106,99,105,4,25,"DOVE MEDICAL PRESS LTD","ALBANY","PO BOX 300-008, ALBANY, AUCKLAND 0752, NEW ZEALAND","","1178-1998","","CLIN INTERV AGING","Clin. Interv. Aging","",2019,14,"","","","","",1095,1117,"","10.2147/CIA.S201323","http://dx.doi.org/10.2147/CIA.S201323","","",23,"Geriatrics & Gerontology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Geriatrics & Gerontology","IE6MX",31354253,"Green Published, Green Submitted, gold","","","2023-11-07","WOS:000472491400002","View Full Record in Web of Science"]
["J","Jin, ZS; Hu, J; Ma, DQ","","","","Jin, Zhaosheng; Hu, Jie; Ma, Daqing","","","Postoperative delirium: perioperative assessment, risk reduction, and management","BRITISH JOURNAL OF ANAESTHESIA","","","English","Article","","","","","","delirium; neurocognitive dysfunction; pharmacotherapy; postoperative cognitive dysfunction; prevention; risk management","RANDOMIZED CLINICAL-TRIAL; BYPASS GRAFT-SURGERY; INTENSIVE-CARE-UNIT; BLOOD-BRAIN-BARRIER; ELDERLY-PATIENTS; GENERAL-ANESTHESIA; CARDIAC-SURGERY; INTRAOPERATIVE HYPOTENSION; XENON ANESTHESIA; OLDER PATIENTS","Postoperative delirium is a relatively common and serious complication. It increases hospital stay by 2-3 days and is associated with a 30-day mortality of 7-10%. It is most prevalent in older patients, those with existing neurocognitive disorders, and those undergoing complex or emergency procedures. Preclinical and clinical research in recent years has uncovered more about the pathophysiology of postoperative delirium and may yield more potential therapeutic options. Using the enhanced recovery pathway framework of risk stratification, risk reduction, and rescue treatment, we have reviewed the current clinical evidence on the validity of delirium prediction scores for the surgical population, the effectiveness of perioperative delirium risk reduction interventions, and management options for established delirium. Effective perioperative interventions include depth of anaesthesia monitoring, intraoperative dexmedetomidine infusion, and multimodal analgesia. Choice of general anaesthetic agent may not be associated with significant difference in delirium risk. Several other factors, such as preoperative fasting, temperature control, and blood pressure management have some association with the risk of postoperative delirium; these will require further studies. Because of the limited treatment options available for established delirium, we propose that risk assessment and perioperative risk reduction may be the most effective approaches in managing postoperative delirium.","[Jin, Zhaosheng; Ma, Daqing] Imperial Coll London, Fac Med, Dept Surg & Canc,Chelsea & Westminster Hosp, Div Anaesthet Pain Med & Intens Care, London, England; [Hu, Jie] Zhengzhou Univ, Dept Anesthesiol, Luoyang Cent Hosp, Zhengzhou, Henan, Peoples R China","Imperial College London; Zhengzhou University","Ma, DQ (通讯作者)，Imperial Coll London, Fac Med, Dept Surg & Canc,Chelsea & Westminster Hosp, Div Anaesthet Pain Med & Intens Care, London, England.","d.ma@imperial.ac.uk","Ma, Daqing/GLT-2735-2022","Ma, Daqing/0000-0003-1235-0537","British Journal of Anaesthesia/Royal College of Anaesthetists (BJA/RCoA) Research Fellowship Grant, London, UK; Science and Technology Development Project, Henan Province, China [192102310128]; Medical Science and Technology Research Project, Henan Province, China [2018020904]","British Journal of Anaesthesia/Royal College of Anaesthetists (BJA/RCoA) Research Fellowship Grant, London, UK; Science and Technology Development Project, Henan Province, China; Medical Science and Technology Research Project, Henan Province, China","The British Journal of Anaesthesia/Royal College of Anaesthetists (BJA/RCoA) Research Fellowship Grant, London, UK (DM). The Science and Technology Development Project (192102310128) and Medical Science and Technology Research Project (2018020904), Henan Province, China (JH).","",157,172,201,17,74,"ELSEVIER SCI LTD","OXFORD","THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND","0007-0912","1471-6771","","BRIT J ANAESTH","Br. J. Anaesth.","OCT",2020,125,4,"","","","",492,504,"","10.1016/j.bja.2020.06.063","http://dx.doi.org/10.1016/j.bja.2020.06.063","","",13,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Anesthesiology","NT0WX",32798069,"hybrid","","","2023-11-07","WOS:000572673400041","View Full Record in Web of Science"]
["J","Hughes, CG; Boncyk, CS; Culley, DJ; Fleisher, LA; Leung, JM; McDonagh, DL; Gan, TJ; McEvoy, MD; Miller, TE","","","","Hughes, Christopher G.; Boncyk, Christina S.; Culley, Deborah J.; Fleisher, Lee A.; Leung, Jacqueline M.; McDonagh, David L.; Gan, Tong J.; McEvoy, Matthew D.; Miller, Timothy E.","","Perioperative Quality","American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Delirium Prevention","ANESTHESIA AND ANALGESIA","","","English","Review","","","","","","","INTENSIVE-CARE-UNIT; CRITICALLY-ILL PATIENTS; ELDER LIFE PROGRAM; INTRAOPERATIVE ELECTROENCEPHALOGRAM SUPPRESSION; MECHANICALLY VENTILATED PATIENTS; OLDER SURGICAL-PATIENTS; FAST-TRACK HIP; CARDIAC-SURGERY; RISK-FACTORS; DOUBLE-BLIND","Postoperative delirium is a geriatric syndrome that manifests as changes in cognition, attention, and levels of consciousness after surgery. It occurs in up to 50% of patients after major surgery and is associated with adverse outcomes, including increased hospital length of stay, higher cost of care, higher rates of institutionalization after discharge, and higher rates of readmission. Furthermore, it is associated with functional decline and cognitive impairments after surgery. As the age and medical complexity of our surgical population increases, practitioners need the skills to identify and prevent delirium in this high-risk population. Because delirium is a common and consequential postoperative complication, there has been an abundance of recent research focused on delirium, conducted by clinicians from a variety of specialties. There have also been several reviews and recommendation statements; however, these have not been based on robust evidence. The Sixth Perioperative Quality Initiative (POQI-6) consensus conference brought together a team of multidisciplinary experts to formally survey and evaluate the literature on postoperative delirium prevention and provide evidence-based recommendations using an iterative Delphi process and Grading of Recommendations Assessment, Development and Evaluation (GRADE) Criteria for evaluating biomedical literature.","[Hughes, Christopher G.; Boncyk, Christina S.] Vanderbilt Univ, Med Ctr, Dept Anesthesiol, Crit Illness Brain Dysfunct & Survivorship CIBS, Nashville, TN USA; [Hughes, Christopher G.; Boncyk, Christina S.] Vanderbilt Univ, Med Ctr, Ctr Hlth Serv Res, Nashville, TN USA; [Culley, Deborah J.] Harvard Med Sch, Brigham & Womens Hosp, Dept Anesthesiol Perioperat & Pain Med, Boston, MA 02115 USA; [Fleisher, Lee A.] Univ Penn, Dept Anesthesiol & Crit Care, Penn Ctr Perioperat Outcomes Res & Transformat, Perelman Sch Med, Philadelphia, PA 19104 USA; [Leung, Jacqueline M.] Univ Calif San Francisco, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA; [McDonagh, David L.] Univ Texas Southwestern Med Ctr Dallas, Dept Anesthesiol & Pain Management, Dallas, TX 75390 USA; [McDonagh, David L.] Univ Texas Southwestern Med Ctr Dallas, Dept Neurol Surg, Dallas, TX 75390 USA; [McDonagh, David L.] Univ Texas Southwestern Med Ctr Dallas, Dept Neurol & Neurotherapeut, Dallas, TX 75390 USA; [Gan, Tong J.] SUNY Stony Brook, Dept Anesthesiol, Renaissance Sch Med, Stony Brook, NY 11794 USA; [McEvoy, Matthew D.] Vanderbilt Univ, Med Ctr, Dept Anesthesiol, Nashville, TN USA; [Miller, Timothy E.] Duke Univ, Med Ctr, Dept Anesthesiol, DUMC 3094, Durham, NC 27710 USA","Vanderbilt University; Vanderbilt University; Harvard University; Harvard Medical School; Brigham & Women's Hospital; University of Pennsylvania; Pennsylvania Medicine; University of California System; University of California San Francisco; University of Texas System; University of Texas Southwestern Medical Center Dallas; University of Texas System; University of Texas Southwestern Medical Center Dallas; University of Texas System; University of Texas Southwestern Medical Center Dallas; State University of New York (SUNY) System; State University of New York (SUNY) Stony Brook; Stony Brook University Hospital; Vanderbilt University; Duke University","Miller, TE (通讯作者)，Duke Univ, Med Ctr, Dept Anesthesiol, DUMC 3094, Durham, NC 27710 USA.","timothy.miller2@duke.edu","Boncyk, Christina/HQY-3477-2023","Boncyk, Christina/0000-0001-9661-4696; Miller, Timothy/0000-0001-8567-6680","American Society; Perioperative Quality Initiative; Baxter; Bev MD; Cadence; Cheetah Medical; Edwards; Heron Pharmaceutical; Mallinckrodt; Masimo; Medtronic; Merck; Trevena; Pacira","American Society(American Cancer Society); Perioperative Quality Initiative; Baxter; Bev MD; Cadence; Cheetah Medical; Edwards; Heron Pharmaceutical; Mallinckrodt; Masimo; Medtronic(Medtronic); Merck(Merck & Company); Trevena; Pacira","The Perioperative Quality Initiative-6 consensus conference was supported by unrestricted educational grants from the American Society for Enhanced Recovery and the Perioperative Quality Initiative, which have received grants from Baxter, Bev MD, Cadence, Cheetah Medical, Edwards, Heron Pharmaceutical, Mallinckrodt, Masimo, Medtronic, Merck, Trevena, and Pacira.","",216,113,128,6,37,"LIPPINCOTT WILLIAMS & WILKINS","PHILADELPHIA","TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA","0003-2999","","","ANESTH ANALG","Anesth. Analg.","JUN",2020,130,6,"","","","",1572,1590,"","10.1213/ANE.0000000000004641","http://dx.doi.org/10.1213/ANE.0000000000004641","","",19,"Anesthesiology","Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)","Anesthesiology","LS4DM",32022748,"Green Accepted, Green Submitted, Bronze","","","2023-11-07","WOS:000536336300029","View Full Record in Web of Science"]
["J","Li, T; Li, J; Yuan, LY; Wu, JZ; Jiang, CC; Daniels, J; Mehta, RL; Wang, MC; Yeung, OC; Jackson, T; Melody, T; Jin, SW; Yao, YG; Wu, JM; Chen, JP; Smith, FG; Lian, QQ","","","","Li, Ting; Li, Jun; Yuan, Liyong; Wu, Jinze; Jiang, Chenchen; Daniels, Jane; Mehta, Rajnikant Laxmishanker; Wang, Mingcang; Yeung, Joyce; Jackson, Thomas; Melody, Teresa; Jin, Shengwei; Yao, Yinguang; Wu, Jimin; Chen, Junping; Smith, Fang Gao; Lian, Qingquan","","RAGA Study Investigators","Effect of Regional vs General Anesthesia on Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery The RAGA Randomized Trial","JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION","","","English","Article","","","","","","","ELDERLY-PATIENTS; CONSENSUS; OUTCOMES; MODE","IMPORTANCE In adults undergoing hip fracture surgery, regional anesthesia may reduce postoperative delirium, but there is uncertainty about its effectiveness. OBJECTIVE To investigate, in older adults undergoing surgical repair for hip fracture, the effects of regional anesthesia on the incidence of postoperative delirium compared with general anesthesia. DESIGN, SETTING, AND PARTICIPANTS A randomized, allocation-concealed, open-label, multicenter clinical trial of 950 patients, aged 65 years and older, with or without preexisting dementia, and a fragility hip fracture requiring surgical repair from 9 university teaching hospitals in Southeastern China. Participants were enrolled between October 2014 and September 2018; 30-day follow-up ended November 2018. INTERVENTIONS Patients were randomized to receive either regional anesthesia (spinal, epidural, or both techniques combined with no sedation; n = 476) or general anesthesia (intravenous, inhalational, or combined anesthetic agents; n = 474). MAIN OUTCOMES AND MEASURES Primary outcome was incidence of delirium during the first 7 postoperative days. Secondary outcomes analyzed in this article include delirium severity, duration, and subtype; postoperative pain score; length of hospitalization; 30-day all-cause mortality; and complications. RESULTS Among 950 randomized patients (mean age, 76.5 years; 247 [26.8%] male). 941 were evaluable for the primary outcome (6 canceled surgery and 3 withdrew consent). Postoperative delirium occurred in 29 (6.2%) in the regional anesthesia group vs 24 (5.1%) in the general anesthesia group (unadjusted risk difference [RD], 1.1%; 95% Cl. -1.7% to 3.8%; P = .48; unadjusted relative risk [RR], 1.2 [95% CI, 0.7 to 2.0]; P = .57]). Mean severity score of delirium was 23.0 vs 24.1, respectively (unadjusted difference. -1.1; 95% Cl. -4.6 to 3.1). A single delirium episode occurred in 16 (3.4%) vs 10 (2.1%) (unadjusted RD, 1.1%; 95% CI, -1.7% to 3.9%; RR, 1.6 [95% CI, 0.7 to 3.5]). Hypoactive subtype in 11(37.9%) vs 5 (20.8%) (RD, 11.5; 95% CI, -11.0% to 35.7%; RR, 2.2 [95% CI, 0.8 to 6.3]). Median worst pain score was 0 (IQR, 0 to 20) vs 0 (IQR, 0 to 10) (difference 0; 95% CI, 0 to 0). Median length of hospitalization was 7 days (IQR, 5 to 10) vs 7 days (IQR, 6 to 10) (difference 0; 95% CI, 0 to 0). Death occurred in 8 (1.7%) vs 4 (0.9%) (unadjusted RD, -0.8%; 95% Cl, -2.2% to 0.7%; RR, 2.0 [95% CI, 0.6 to 6.5]). Adverse events were reported in 106 episodes in the regional anesthesia group and 102 in the general anesthesia group; the most frequently reported adverse events were nausea and vomiting (47 [44.3%] vs 34 [33.3%]) and postoperative hypotension (13 [12.3%] vs 10 [9.8%]). CONCLUSIONS AND RELEVANCE In patients aged 65 years and older undergoing hip fracture surgery, regional anesthesia without sedation did not significantly reduce the incidence of postoperative delirium compared with general anesthesia.","[Li, Ting; Li, Jun; Jin, Shengwei; Smith, Fang Gao; Lian, Qingquan] Wenzhou Med Univ, Dept Anesthesiol & Perioperat Med, Affiliated Hosp 2, 1111 Wenzhou Ave, Wenzhou 325038, Zhejiang, Peoples R China; [Li, Ting; Li, Jun; Jiang, Chenchen; Jin, Shengwei; Smith, Fang Gao; Lian, Qingquan] Wenzhou Med Univ, Yuying Childrens Hosp, 1111 Wenzhou Ave, Wenzhou 325038, Zhejiang, Peoples R China; [Li, Ting; Jiang, Chenchen] Wenzhou Med Univ, Clin Res Unit, Affiliated Hosp 2, Wenzhou, Zhejiang, Peoples R China; [Yuan, Liyong] Ningbo 6 Hosp, Dept Anesthesiol & Perioperat Med, Ningbo, Zhejiang, Peoples R China; [Wu, Jinze] Wenzhou Med Univ, Prov Wenzhou Hosp Zhejiang 1, Dept Anesthesiol & Perioperat Med, Affiliated Hosp 1, Wenzhou, Zhejiang, Peoples R China; [Daniels, Jane] Univ Nottingham, Nottingham Clin Trials Unit, Nottingham, England; [Mehta, Rajnikant Laxmishanker] Univ Birmingham, Birmingham Clin Trials Unit, Birmingham, W Midlands, England; [Wang, Mingcang] Taizhou Hosp Zhejiang Prov, Dept Anesthesiol & Perioperat Med, Taizhou, Zhejiang, Peoples R China; [Yeung, Joyce] Univ Warwick, Warwick Clin Trials Unit, Warwick, England; [Yeung, Joyce; Melody, Teresa; Smith, Fang Gao] Univ Hosp Birmingham NHS Fdn Trust, Birmingham, W Midlands, England; [Jackson, Thomas; Smith, Fang Gao] Univ Birmingham, Inst Inflammat & Ageing, Birmingham, W Midlands, England; [Yao, Yinguang] Lishui Cent Hosp, Lishui Municipal Peoples Hosp, Dept Anesthesia & Crit Care, Lishui, Zhejiang, Peoples R China; [Yao, Yinguang] Wenzhou Med Coll, Affiliated Hosp 5, Lishui, Zhejiang, Peoples R China; [Wu, Jimin] Lishui City Peoples Hosp, Dept Anesthesia & Crit Care, Lishui, Zhejiang, Peoples R China; [Chen, Junping] Univ Chinese Acad Sci, Hwa Mei Hosp, Dept Anesthesia & Crit Care, Ningbo 2 Hosp, Ningbo, Zhejiang, Peoples R China","Wenzhou Medical University; Wenzhou Medical University; Wenzhou Medical University; Wenzhou Medical University; University of Nottingham; University of Birmingham; University of Warwick; University of Birmingham; University of Birmingham; Wenzhou Medical University; Chinese Academy of Sciences; University of Chinese Academy of Sciences, CAS","Lian, QQ (通讯作者)，Wenzhou Med Univ, Dept Anesthesiol & Perioperat Med, Affiliated Hosp 2, 1111 Wenzhou Ave, Wenzhou 325038, Zhejiang, Peoples R China.;Lian, QQ (通讯作者)，Wenzhou Med Univ, Yuying Childrens Hosp, 1111 Wenzhou Ave, Wenzhou 325038, Zhejiang, Peoples R China.;Smith, FG (通讯作者)，Univ Birmingham, Res Labs, Inst Inflammat Arid Ageing, Birmingham Acute Care Res Ctr, Birmingham B15 2WB, W Midlands, England.","f.gaosmith@bham.ac.uk; lqq13889@163.com","wu, ji/IAR-8520-2023; Li, Ting/J-5960-2014; jiang, chen/HZL-9276-2023; Daniels, Jane P/HKF-1798-2023; yuan, liyong/GQY-7536-2022; Smith, Fang G/H-8451-2018","Li, Ting/0000-0001-5625-3339; Daniels, Jane P/0000-0003-3324-6771; Jin, Shengwei/0000-0002-4734-8114; Smith, Fang G/0000-0002-8095-0609; Yeung, Joyce/0000-0003-2950-4758; Jackson, Thomas/0000-0001-6320-9600; Melody, Teresa/0000-0002-4424-8310","Recruitment Program of Global Experts, China; Zhejiang Province Basic PublicWelfare Research Project [LGF21H250004]; Zhejiang Health and Family Planning Commission Programme [2014PYA015]; NIHR Senior Investigator Award; Health Commission of Zhejiang Province; Zhejiang Provincial Department of Science and Technology; Second Affiliated Hospital of Wenzhou Medical University; Yuying Children's Hospital of Wenzhou Medical University","Recruitment Program of Global Experts, China; Zhejiang Province Basic PublicWelfare Research Project; Zhejiang Health and Family Planning Commission Programme; NIHR Senior Investigator Award; Health Commission of Zhejiang Province; Zhejiang Provincial Department of Science and Technology; Second Affiliated Hospital of Wenzhou Medical University; Yuying Children's Hospital of Wenzhou Medical University","This trial was funded by Recruitment Program of Global Experts, China; Zhejiang Province Basic PublicWelfare Research Project (LGF21H250004); Zhejiang Health and Family Planning Commission Programme 2014PYA015); an NIHR Senior Investigator Award; the Health Commission of Zhejiang Province; Zhejiang Provincial Department of Science and Technology; and sponsored by the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University.","",40,88,98,20,91,"AMER MEDICAL ASSOC","CHICAGO","330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA","0098-7484","1538-3598","","JAMA-J AM MED ASSOC","JAMA-J. Am. Med. Assoc.","JAN 4",2022,327,1,"","","","",50,58,"","10.1001/jama.2021.22647","http://dx.doi.org/10.1001/jama.2021.22647","","DEC 2021",9,"Medicine, General & Internal","Science Citation Index Expanded (SCI-EXPANDED)","General & Internal Medicine","YF7YT",34928310,"Green Published","","","2023-11-07","WOS:000734928000004","View Full Record in Web of Science"]