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| Item Type: | Article |
|---|---|
| Title: | Preoperative medication use and development of postoperative delirium and cognitive dysfunction |
| Creators Name: | Heinrich, M., Nottbrock, A., Borchers, F., Mörgeli, R., Kruppa, J., Winterer, G., 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 |
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