Postoperative delirium in elderly patients with critical limb ischemia undergoing major leg amputation: a retrospective study

Background Critical limb ischemia has been identified as a risk factor for the incidence of postoperative delirium in elderly patients. Limb amputation is the last option in critical limb ischemia treatments. We investigated the incidence and predisposing factors of postoperative delirium in patient...

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Main Authors: Young-Hee Shin, Jin Sun Yoon, Hee Jung Jeon, Youngbae B Kim, Young Soo Kim, Ju Young Park
Format: Article
Language:English
Published: Korean Society of Anesthesiologists 2018-08-01
Series:Korean Journal of Anesthesiology
Subjects:
Online Access:http://ekja.org/upload/pdf/kja-d-18-27108.pdf
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author Young-Hee Shin
Jin Sun Yoon
Hee Jung Jeon
Youngbae B Kim
Young Soo Kim
Ju Young Park
author_facet Young-Hee Shin
Jin Sun Yoon
Hee Jung Jeon
Youngbae B Kim
Young Soo Kim
Ju Young Park
author_sort Young-Hee Shin
collection DOAJ
description Background Critical limb ischemia has been identified as a risk factor for the incidence of postoperative delirium in elderly patients. Limb amputation is the last option in critical limb ischemia treatments. We investigated the incidence and predisposing factors of postoperative delirium in patients undergoing major leg amputation. Methods From January 2012 to December 2016, 121 patients aged over 60 years who had undergone major leg amputation were enrolled in this study. Various factors related to the patients’ outcomes were assessed, including demographic, preoperative laboratory, anesthetic, surgical, and postoperative indicators. Results Twenty two patients were excluded and 99 patients were assigned to either the delirium group or no delirium group. Forty of them (40%) developed a delirium during 30 days postoperatively. Univariate analysis implied that end-stage renal disease on hemodialysis, alcohol consumption, C-reactive protein, staying in an intensive care unit (ICU), duration of an ICU stay, occurrence of complications, and mortality during six months, were the factors that accounted for significant differences between the two groups. In multivariate analysis, three factors were significantly related to the development of delirium: mortality during six months (odds ratio [OR] = 13.86, 95% CI [2.10–31.90]), alcohol (OR = 8.18, 95% CI [1.13–16.60]), and hemodialysis (OR = 4.34, 95% CI [2.06–93.08]). Conclusions Approximately 40% of the elderly patients suffered from postoperative delirium in major leg amputation. Identifying those with risk factors for postoperative delirium and intervening at the early stage will be of great benefit in major leg amputations for the elderly population.
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spelling doaj.art-1cef9aaa5b4d426a9c0a7b7f97a9bf092022-12-21T20:17:40ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632018-08-0171431131610.4097/kja.d.18.271088405Postoperative delirium in elderly patients with critical limb ischemia undergoing major leg amputation: a retrospective studyYoung-Hee Shin0Jin Sun Yoon1Hee Jung Jeon2Youngbae B Kim3Young Soo Kim4Ju Young Park5 Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Veterans Health Service Medical Center, Seoul, Korea Department of Anesthesiology and Pain Medicine, Veterans Health Service Medical Center, Seoul, Korea Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, Korea Department of Anesthesiology and Pain Medicine, Veterans Health Service Medical Center, Seoul, Korea Department of Anesthesiology and Pain Medicine, Veterans Health Service Medical Center, Seoul, KoreaBackground Critical limb ischemia has been identified as a risk factor for the incidence of postoperative delirium in elderly patients. Limb amputation is the last option in critical limb ischemia treatments. We investigated the incidence and predisposing factors of postoperative delirium in patients undergoing major leg amputation. Methods From January 2012 to December 2016, 121 patients aged over 60 years who had undergone major leg amputation were enrolled in this study. Various factors related to the patients’ outcomes were assessed, including demographic, preoperative laboratory, anesthetic, surgical, and postoperative indicators. Results Twenty two patients were excluded and 99 patients were assigned to either the delirium group or no delirium group. Forty of them (40%) developed a delirium during 30 days postoperatively. Univariate analysis implied that end-stage renal disease on hemodialysis, alcohol consumption, C-reactive protein, staying in an intensive care unit (ICU), duration of an ICU stay, occurrence of complications, and mortality during six months, were the factors that accounted for significant differences between the two groups. In multivariate analysis, three factors were significantly related to the development of delirium: mortality during six months (odds ratio [OR] = 13.86, 95% CI [2.10–31.90]), alcohol (OR = 8.18, 95% CI [1.13–16.60]), and hemodialysis (OR = 4.34, 95% CI [2.06–93.08]). Conclusions Approximately 40% of the elderly patients suffered from postoperative delirium in major leg amputation. Identifying those with risk factors for postoperative delirium and intervening at the early stage will be of great benefit in major leg amputations for the elderly population.http://ekja.org/upload/pdf/kja-d-18-27108.pdfamputationdeliriumelderly patientsischemialeg
spellingShingle Young-Hee Shin
Jin Sun Yoon
Hee Jung Jeon
Youngbae B Kim
Young Soo Kim
Ju Young Park
Postoperative delirium in elderly patients with critical limb ischemia undergoing major leg amputation: a retrospective study
Korean Journal of Anesthesiology
amputation
delirium
elderly patients
ischemia
leg
title Postoperative delirium in elderly patients with critical limb ischemia undergoing major leg amputation: a retrospective study
title_full Postoperative delirium in elderly patients with critical limb ischemia undergoing major leg amputation: a retrospective study
title_fullStr Postoperative delirium in elderly patients with critical limb ischemia undergoing major leg amputation: a retrospective study
title_full_unstemmed Postoperative delirium in elderly patients with critical limb ischemia undergoing major leg amputation: a retrospective study
title_short Postoperative delirium in elderly patients with critical limb ischemia undergoing major leg amputation: a retrospective study
title_sort postoperative delirium in elderly patients with critical limb ischemia undergoing major leg amputation a retrospective study
topic amputation
delirium
elderly patients
ischemia
leg
url http://ekja.org/upload/pdf/kja-d-18-27108.pdf
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