12/21/2023 0 Comments Matthew banks neurologyThe average onset of delirium was 2.2 days after surgery and the average duration of delirium was 2.8 days. In 42.8% of patients the onset of delirium noted on postoperative day 1 (Fig. In 118 of the 173 patients, 68.2%, delirium was noted on more than one day (Fig. From this sample, 173 patients screened positive for delirium on at least one day in the first week following surgery (24.6%). Only patients ResultsĪll 702 patients 65 years of age or older had DOSS or CAM-ICU data available. The procedures were performed both by neurosurgeons and orthopedic surgeons. 615 of these procedures were done on an elective basis and 87 were performed on an urgent/emergent basis. 202007546), we queried our institution’s electronic medical record for patients ≥ 65 years of age who underwent posterior thoracolumbar or lumbosacral fusion between November 2017 and January 2021. Section snippets Data source and patient cohortĪfter obtaining Institutional Review Board approval (IRB No. The primary objective of this study was to determine the incidence of POD in older adult patients undergoing spinal surgery, associated risk factors, as well as the consequences of delirium. While there have been many studies looking at risk factors for postoperative delirium, few have examined the perioperative risk factors after spinal fusions. , However, previous research suggests that delirium is associated with neuroinflammation, a breakdown of the blood-brain barrier, and intraoperative blood loss. Currently, there is a poor understanding of the underlying mechanisms of delirium. This problem will only be exacerbated by a growing elderly population. ,, Prolonged length of hospital stay due to delirium in the elderly population contributes in a large measure to an annual cost of $152 billion in the USA. , Higher complications, functional decline, morbidity and mortality due to postoperative delirium confer a huge burden on healthcare and society. It is highly prevalent, especially in the elderly population, and occurs in up to 50–80% of critically ill patients, , and approximately 20% of spinal surgical patients. Delirium is an abrupt disturbance of cognition and consciousness and is characterized by a decreased ability to sustain or shift attention, an impairment of memory and executive function, and a fluctuation in arousal levels.
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