Risk Factors for Delirium After Spine Surgery in Extremely Elderly Patients Aged 80 Years or Older and Review of the Literature: Japan Association of Spine Surgeons with Ambition Multicenter Study
نویسندگان
چکیده
STUDY DESIGN Retrospective database analysis. OBJECTIVE Spine surgeries in elderly patients have increased in recent years due to aging of society and recent advances in surgical techniques, and postoperative complications have become more of a concern. Postoperative delirium is a common complication in elderly patients that impairs recovery and increases morbidity and mortality. The objective of the study was to analyze postoperative delirium associated with spine surgery in patients aged 80 years or older with cervical, thoracic, and lumbar lesions. METHODS A retrospective multicenter study was performed in 262 patients 80 years of age or older who underwent spine surgeries at 35 facilities. Postoperative complications, incidence of postoperative delirium, and hazard ratios of patient-specific and surgical risk factors were examined. RESULTS Postoperative complications occurred in 59 of the 262 spine surgeries (23%). Postoperative delirium was the most frequent complication, occurring in 15 of 262 patients (5.7%), and was significantly associated with hypertension, cerebrovascular disease, cervical lesion surgery, and greater estimated blood loss (P < .05). In multivariate logistic regression using perioperative factors, cervical lesion surgery (odds ratio = 4.27, P < .05) and estimated blood loss ≥300 mL (odds ratio = 4.52, P < .05) were significantly associated with postoperative delirium. CONCLUSIONS Cervical lesion surgery and greater blood loss were perioperative risk factors for delirium in extremely elderly patients after spine surgery. Hypertension and cerebrovascular disease were significant risk factors for postoperative delirium, and careful management is required for patients with such risk factors.
منابع مشابه
Complications Associated With Spine Surgery in Patients Aged 80 Years or Older: Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study
STUDY DESIGN Retrospective study of registry data. OBJECTIVES Aging of society and recent advances in surgical techniques and general anesthesia have increased the demand for spinal surgery in elderly patients. Many complications have been described in elderly patients, but a multicenter study of perioperative complications in spinal surgery in patients aged 80 years or older has not been rep...
متن کاملPediatric spine injuries after trauma: a review of 43 cases
Abstract Objective: To evaluate and review our experience with pediatric spinal injuries and factors affecting outcome, the authors conducted a retrospective clinical study of 43 cases (32 boys, 11 girls) of pediatric spine injuries treated during four years (January 1999 to December 2003). Methods: Forty-three children with spinal injuries were studied retrospectively over four y...
متن کاملA challenge on Orthopedic Sciences: The Influence of Spinal Disease and Deformities on Total Hip Arthroplasty: A Review on Literature
Background: Adult degenerative disorders of hip and spine are common. The recent studies inconsistently havediscussed about the influence of spinal disorders on total hip arthroplasty (THA). In this review, we discussed clearlyabout these relationships and their effects on the most appropriate position of the acetabular component.Methods: We searched on databases and evaluated the articles abou...
متن کاملOsteoporosis and the Management of Spinal Degenerative Disease (II)
Osteoporosis has become a major medical problem as the aged population of the world rapidly grows. Osteoporosis predisposes patients to fracture, progressive spinal deformities, and stenosis, and is subject to be a major concern before performing spine surgery, especially with bone fusions and instrumentation. Osteoporosis has often been considered a contraindication for spinal surgery, while i...
متن کاملOsteoporosis and the Management of Spinal Degenerative Disease
Osteoporosis has become a major medical problem as the aged population of the world rapidly grows. Osteoporosispredisposes patients to fracture, progressive spinal deformities, and stenosis, and is subject to be a major concernbefore performing spine surgery, especially with bone fusions and instrumentation. Osteoporosis has often beenconsidered a contraindication for spinal surgery, while in s...
متن کامل