標題: Pre-surgical Geriatric Syndromes, Frailty, and Risks for Postoperative Delirium in Older Patients Undergoing Gastrointestinal Surgery: Prevalence and Red Flags
作者: Chen, Cheryl Chia-Hui
Lin, Ming-Tsan
Liang, Jin-Tung
Chen, Chun-Min
Yen, Chung-Jen
Huang, Guan-Hua
統計學研究所
Institute of Statistics
關鍵字: Geriatric syndromes;Frailty;Delirium;Screening;Preoperative risk assessment
公開日期: 1-May-2015
摘要: We sought to identify and evaluate red flags for pre-surgical geriatric conditions (geriatric syndromes, frailty, and risks for postoperative delirium) in older patients undergoing gastrointestinal surgery. Older individuals (a parts per thousand yen65 years) undergoing major elective gastrointestinal surgery from 2009 to 2012 were enrolled and assessed preoperatively. Participants (N = 379; mean age = 74.5 +/- 5.9 years) primarily underwent colorectal (54.3 %), gastric (21.9 %), and pancreatobiliary (12.6 %) surgery. Overall, 30.9 % had existing geriatric syndromes, 26.7 % were frail, and 22.8 % had > 3 risk factors for postoperative delirium. The largest proportion (45.7 %) presented with at least one geriatric condition. Patients with or without geriatric conditions were discriminated with adequate sensitivity (67 %), specificity (84 %), and positive predictive value (77 %) by eight red flags: age a parts per thousand yen75 years (OR, 2.86; P < 0.001), eating soft food (OR, 3.63; P = 0.001), reported hypertension (OR, 2.8; P = 0.001), weight loss > 3 kg (OR, 4.79; P < 0.001), fair-to-weak grip strength (OR, 2.53; P = 0.001), sleeplessness (OR, 2.57; P = 0.001), no-better-than-peer perceived health (OR, 1.88; P = 0.022), and short-term inability to recall two of three common words (OR, 1.81; P = 0.025). Eight red flags covered as part of history and physical examination are well suited to screen patients for geriatric conditions indicating the need for preoperative geriatric assessments and optimization.
URI: http://dx.doi.org/10.1007/s11605-015-2760-0
http://hdl.handle.net/11536/124661
ISSN: 1091-255X
DOI: 10.1007/s11605-015-2760-0
期刊: JOURNAL OF GASTROINTESTINAL SURGERY
Volume: 19
起始頁: 927
結束頁: 934
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