Preoperative physical performance-related postoperative delirium in patients after cardiovascular surgery. (November 2020)

• Record Type: Journal Article
• Authors: Otsuka, Ryohei; Oyanagi, Keiichi; Hokari, Misaki; Shinoda, Taku; Harada, Jumpei; Shimogai, Takayuki; Takahashi, Yusuke; Kitai, Takeshi; Iwata, Kentaro; Tsubaki, Atsuhiro
• Is Part Of: Archives of gerontology and geriatrics. Volume 91(2020)
• Publication Date: 2020-11
• Subjects: ADL activities of daily living -- CAM-ICU confusion assessment method for the ICU -- Kaigo-Yobo CL Kaigo-Yobo check list -- POD postoperative delirium -- SPPB short physical performance battery; Frailty -- Preoperative physical function -- Postoperative delirium -- Short physical performance battery; Aging -- Periodicals; Geriatrics -- Periodicals; Gerontology -- Periodicals; Electronic journals; 305.26
• DOI: 10.1016/j.archger.2020.104172
• Languages: English
• ISSNs: 0167-4943

Abstract

Highlights: Delirium is a poor prognostic factor. Several risk factors for delirium have been reported. Physical performance is a risk factor for delirium onset independent on age. Abstract: Objectives: This investigation clarified the relationship between a short physical performance battery (SPPB) that can comprehensively and safely evaluate balance function, walking ability, lower limb muscle strength, and postoperative delirium. Methods: This was a retrospective observational study performed at Kobe City Medical Center General Hospital. Patients who underwent surgery at the Kobe City Medical Center General Hospital Cardiovascular Surgery from August 1, 2016 to July 31, 2017 were included. Preoperative physical functions were obtained. Those showing positive results using the confusion assessment method for intensive care unit (ICU) during the ICU stay were considered as the delirium group, and the postoperative and non-postoperative delirium groups were compared. A multiple logistic regression analysis was performed with the presence or absence of onset of delirium as the dependent variable and the SPPB total score and age as dependent variables. Results: There were 193 subjects in this study (120 males and 73 females). Sixteen patients (8.4 %) had postoperative delirium. The age in the postoperative delirium group was significantly higher than in the postoperative delirium group (77.8 (7.0) years vs. 70.0 (11.1) years). BMI and SPPB total score were significantly lower in the postoperative delirium group. From the multiple logistic regression, the SPPB total score (OR: 0.754, 95 % CI: 0.643–0.883, p < 0.001) was extracted as a factor related to postoperative delirium onset. Conclusion: It was illuminated that in patients with cardiovascular surgery, preoperative low physical function was not affected by age and became a risk factor of postoperative delirium onset.