Association between post-operative delirium and use of volatile anesthetics in the elderly: A real-world big data approach - 05/11/22
, Lena Hubig, [PhD] b, 1, Heidi Seibold, [PhD] b, Zoé Schroeder, [MD] a, Baocheng Wang, [MD] a, Philipp Groene, [PhD] a, Robert Perneczky, [Professor] d, e, f, g, h, Vera von Dossow, [Professor] c, i, Ludwig C. Hinske, [Professor] a, b, jAbstract |
Study objective |
Early post-operative delirium is a common perioperative complication in the post anesthesia care unit. To date it is unknown if a specific anesthetic regime can affect the incidence of delirium after surgery. Our objective was to examine the effect of volatile anesthetics on post-operative delirium.
Design |
Single Center Observational Study.
Setting |
Post Anesthesia Care Units at a German tertiary medical center.
Patients |
30,075 patients receiving general anesthesia for surgery.
Measurements |
Delirium was assessed with the Nursing Delirium Screening Scale at the end of the recovery period. Subgroup-specific effects of volatile anesthetics on post-operative delirium were estimated using generalized-linear-model trees with inverse probability of treatment weighting. We further assessed the age-specific effect of volatiles using logistic regression models.
Main results |
Out of 30,075 records, 956 patients (3.2%) developed delirium in the post anesthesia care unit. On average, patients who developed delirium were older than patients without delirium. We found volatile anesthetics to increase the risk (Odds exp. (B) for delirium in the elderly 1.8-fold compared to total intravenous anesthesia. Odds increases with unplanned surgery 3.0-fold. In the very old (87 years or older), the increase in delirium is 6.2-fold. This result was confirmed with internal validation and in a logistic regression model.
Conclusions |
Our exploratory study indicates that early postoperative delirium is associated with the use of volatile anesthetics especially in the sub-cohort of patients aged 75 years and above. Further studies should include both volatile and intravenous anesthetics to find the ideal anesthetic in elderly patients.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Early post-operative delirium is a common perioperative complication. |
• | Though many risk factors are known, the ideal anesthetic regime is unknown. |
• | In a big data approach, the association of volatiles with delirium was examined. |
• | Use of volatile anesthetics in the very old is associated with delirium. |
Keywords : Delirium [D003693], General Anesthesia [D000768], Post anesthesia nursing [D016528], Volatile Anesthetics [D018685], Aged [D000368], Machine Learning [D000069550], Linear Models [D016014]
Plan
Vol 83
Article 110957- décembre 2022 Retour au numéro
Article précédent
- Predicting the needle in the haystack: Considerations for modeling low-frequency events
- Dmitry Tumin, Terrie Vasilopoulos
- Clinical agreement of a novel algorithm to estimate radial artery blood pressure from the non-invasive finger blood pressure
- Eline Kho, Björn J.P. van der Ster, Ward H. van der Ven, Alexander P.J. Vlaar, Rogier V. Immink, Denise P. Veelo
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?