Helmholtz Gemeinschaft

Search
Browse
Statistics
Feeds

Preoperative medication use and development of postoperative delirium and cognitive dysfunction

[img]
Preview
PDF (Original Article) - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
287kB
[img] Other (Supplementary Material)
43kB

Item Type:Article
Title:Preoperative medication use and development of postoperative delirium and cognitive dysfunction
Creators Name:Heinrich, M. and Nottbrock, A. and Borchers, F. and Mörgeli, R. and Kruppa, J. and Winterer, G. and Slooter, A.J.C. and Spies, C.
Abstract:Postoperative delirium (POD) and postoperative (neuro-)cognitive disorder (POCD) are frequent and serious complications after operations. We aim to investigate the association between pre-operative polypharmacy and potentially inappropriate medications and the development of POD/POCD in elderly patients. This investigation is part of the European BioCog project (www.biocog.eu), a prospective multicenter observational study with elderly surgical patients. Patients with a Mini-Mental State Examination score less than or equal to 23 points were excluded. POD was assessed up to 7 days after surgery using the Nursing Delirium Screening Scale, Confusion Assessment Method (for the intensive care unit [ICU]), and a patient chart review. POCD was assessed 3 months after surgery with a neuropsychological test battery. Pre-operative long-term medication was evaluated in terms of polypharmacy (≥5 agents) and potentially inappropriate medication (defined by the PRISCUS and European list of potentially inappropriate medications [EU(7)-PIM] lists), and associations with POD and POCD were analyzed using logistic regression analysis. Eight hundred thirty-seven participants were included for analysis of POD and 562 participants for POCD. Of these, 165 patients (19.7%) fulfilled the criteria of POD and 60 (10.7%) for POCD. After adjusting for confounders, pre-operative polypharmacy and intake of potentially inappropriate medications could not be shown to be associated with the development of POD nor POCD. We found no associations between pre-operative polypharmacy and potentially inappropriate medications and development of POD and POCD. Future studies should focus on the evaluation of drug interactions to determine whether patients benefit from a pre-operative adjustment.
Keywords:Emergence Delirium, Mental Status and Dementia Tests, Polypharmacy, Postoperative Cognitive Complications, Potentially Inappropriate Medication List, Preoperative Period, Prospective Studies
Source:Clinical and Translational Science
ISSN:1752-8054
Publisher:Wiley
Volume:14
Number:5
Page Range:1830-1840
Date:September 2021
Official Publication:https://doi.org/10.1111/cts.13031
PubMed:View item in PubMed

Repository Staff Only: item control page

Downloads

Downloads per month over past year

Open Access
MDC Library