ISSN:
1525-1438
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
The purpose of this study was to determine the incidence and possible predisposing factors for the development of postoperative delirum following radical gynecologic oncology surgery. A retrospective chart review was performed on 153 consecutive patients undergoing radical gynecologic oncology surgery. Preoperative variables assessed included: age, sepsis, decreased vision, decreased hearing, psychiatric history and abnormal mental status. Operative variables assess included: anesthesia time, estimated blood loss, hypotension, arrhythmia and transfusions. Preoperative medications, postoperative pain medication and abnormal perioperative laboratory values were also assessed. Sixteen of 150 patients (11%) developed postoperative delirium. Age was a significant predictor of postoperative delirium (median age 69 years vs 53 years, P = 0.006). Preoperative abnormal mental status examination was a significant predictor (P = 0.27). Use of chronic narcotic pain medication was significant (P = 0.008). All three patients who were septic at the time of emergency surgery developed postoperative delirum (P = 0.001). No other variables could be identified. When reviewing the date using any high risk factor as a positive test (advanced age, sepsis, abnormal mental status exam or chronic narcotic pain medication), sensitivity was 88%, specificity 76%, positive predictive value 35% and negative predictive value 77%. Delirium occurred most frequently on the second post-operative day (range 1–4 days) and lasted for a median of 2 days (range 1–5 days). Delirium resolved completely in all 16 patients. In conclusion, 11% of women undergoing radical gynecologic oncology surgery developed postoperative delirium. Advanced age, preoperative abnormal mental status, chronic narcotic pain medication and preoperative sepsis were all predisposing risk factors.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1046/j.1525-1438.1996.06020094.x
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