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KMID : 1143920230270030301
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Annals of Hepato-Biliary-Pancreatic Surgery
2023 Volume.27 No. 3 p.301 ~ p.306
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Postoperative delirium after cholecystectomy in older patients: A retrospective study
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Park Young-Mok
Seo Hyung-Il
Noh Byeong-Gwan
Kim Suk
Hong Seung-Baek
Lee Nam-Kyung
Kim Dong-Uk
Han Sung-Yong
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Abstract
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Backgrounds/Aims: Postoperative delirium (POD) is a common complication that increases mortality and morbidity in older patients. This study aimed to evaluate the clinical significance of post-cholecystectomy delirium in older patients.
Methods: This retrospective study included 201 patients aged > 75 years who underwent cholecystectomy for acute or chronic cholecystitis between January 2016 and December 2019. Patients were divided into the POD (n = 21) and non-POD (n = 180) groups, and their demographic features and clinical results were compared.
Results: The mean patient age was 78.88 years; the female/male ratio was 44.8%/55.2%. Laparoscopic surgery was performed in 93.5% of patients. The univariate analysis showed that lower body mass index (BMI), immobilized admission status, neuropsychiatric disease history, preoperative intervention (percutaneous drainage), high C-reactive protein, hypoalbuminemia, neutrophilia, hypo-/hyperkalemia, and longer operative time were more frequently observed in the POD group. The multivariate analysis showed that lower BMI (odds ratio [OR], 2.796; p = 0.024), neuropsychiatric disease history (OR, 3.019; p = 0.049), hyperkalemia (OR, 5.972; p = 0.007), and longer operative time (OR, 1.011; p = 0.013) were significant risk factors for POD.
Conclusions: POD was associated with inflammation degree, general condition, poor nutritional status, electrolyte imbalance, and stressful conditions. Recognizing risk factors requiring multidisciplinary team approaches is important to prevent and treat POD.
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KEYWORD
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Delirium, Cholecystectomy, Body mass index, Nutrition, Older patients
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