New aspects of delirium in elderly patients with critical limb ischemia

Willem A van Eijsden,1 Jelle W Raats,1 Paul GH Mulder,2 Lijckle van der Laan1 1Department of Surgery, 2Amphia Academy, Amphia Hospital, Breda, the Netherlands Objective: The primary objective was to identify possible risk factors for delirium in patients with critical limb ischemia undergoing surg...

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Autores principales:	van Eijsden WA, Raats JW, Mulder PGH, van der Laan L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	critical limb ischemia delirium elderly surgery Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/75cf514f961346518faea0d4b9152100
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spelling	oai:doaj.org-article:75cf514f961346518faea0d4b91521002021-12-02T07:08:59ZNew aspects of delirium in elderly patients with critical limb ischemia1178-1998https://doaj.org/article/75cf514f961346518faea0d4b91521002015-09-01T00:00:00Zhttps://www.dovepress.com/new-aspects-of-delirium-in-elderly-patients-with-critical-limb-ischemi-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Willem A van Eijsden,1 Jelle W Raats,1 Paul GH Mulder,2 Lijckle van der Laan1 1Department of Surgery, 2Amphia Academy, Amphia Hospital, Breda, the Netherlands Objective: The primary objective was to identify possible risk factors for delirium in patients with critical limb ischemia undergoing surgery. The secondary objective was to study the effect of delirium on complications, the length of hospital stay, health care costs, and mortality. Methods: All patients 65 years or older with critical limb ischemia undergoing surgery from February 2013 to July 2014 at Amphia Hospital, were included and followed up until December 31, 2014. Delirium was scored using the Delirium Observation Screening Scale (DOSS). Perioperative risk factors (age, comorbidity, factors of frailty, operation type, hemoglobulin, and transfusion) were collected and analyzed using logistic regression. Secondary outcomes were the number of complications, total hospital stay, extra health care costs per delirium, and mortality within 3 months and 6 months of surgery Results: We included 92 patients with critical limb ischemia undergoing surgery. Twenty-nine (32%) patients developed a delirium during admission, of whom 17 (59%) developed delirium preoperatively. After multivariable analysis, only diabetes mellitus (odds ratio [OR] =6.23; 95% confidence interval [CI]: 1.11–52.2; P=0.035) and Short Nutritional Assessment Questionnaire for Residential Care (SNAQ-RC) ≥3 (OR =5.55; 95% CI: 1.07–42.0; P=0.039) was significantly associated with the onset of delirium. Delirium was associated with longer hospital stay (P=0.001), increased health care costs, and higher mortality after 6 months (P<0.001). Conclusion: Delirium is a common adverse event in patients with critical limb ischemia undergoing surgery with devastating outcome in the long term. Most patients developed delirium preoperatively, which indicates the need for early recognition and preventive strategies in the preoperative period. This study identified undernourishment and diabetes mellitus as independent risk factors for delirium. Keywords: confusion, frailty, vascular surgery, bypass surgery, amputation, risk factors, costsvan Eijsden WARaats JWMulder PGHvan der Laan LDove Medical Pressarticlecritical limb ischemiadeliriumelderlysurgeryGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 1537-1546 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	critical limb ischemia delirium elderly surgery Geriatrics RC952-954.6
spellingShingle	critical limb ischemia delirium elderly surgery Geriatrics RC952-954.6 van Eijsden WA Raats JW Mulder PGH van der Laan L New aspects of delirium in elderly patients with critical limb ischemia
description	Willem A van Eijsden,1 Jelle W Raats,1 Paul GH Mulder,2 Lijckle van der Laan1 1Department of Surgery, 2Amphia Academy, Amphia Hospital, Breda, the Netherlands Objective: The primary objective was to identify possible risk factors for delirium in patients with critical limb ischemia undergoing surgery. The secondary objective was to study the effect of delirium on complications, the length of hospital stay, health care costs, and mortality. Methods: All patients 65 years or older with critical limb ischemia undergoing surgery from February 2013 to July 2014 at Amphia Hospital, were included and followed up until December 31, 2014. Delirium was scored using the Delirium Observation Screening Scale (DOSS). Perioperative risk factors (age, comorbidity, factors of frailty, operation type, hemoglobulin, and transfusion) were collected and analyzed using logistic regression. Secondary outcomes were the number of complications, total hospital stay, extra health care costs per delirium, and mortality within 3 months and 6 months of surgery Results: We included 92 patients with critical limb ischemia undergoing surgery. Twenty-nine (32%) patients developed a delirium during admission, of whom 17 (59%) developed delirium preoperatively. After multivariable analysis, only diabetes mellitus (odds ratio [OR] =6.23; 95% confidence interval [CI]: 1.11–52.2; P=0.035) and Short Nutritional Assessment Questionnaire for Residential Care (SNAQ-RC) ≥3 (OR =5.55; 95% CI: 1.07–42.0; P=0.039) was significantly associated with the onset of delirium. Delirium was associated with longer hospital stay (P=0.001), increased health care costs, and higher mortality after 6 months (P<0.001). Conclusion: Delirium is a common adverse event in patients with critical limb ischemia undergoing surgery with devastating outcome in the long term. Most patients developed delirium preoperatively, which indicates the need for early recognition and preventive strategies in the preoperative period. This study identified undernourishment and diabetes mellitus as independent risk factors for delirium. Keywords: confusion, frailty, vascular surgery, bypass surgery, amputation, risk factors, costs
format	article
author	van Eijsden WA Raats JW Mulder PGH van der Laan L
author_facet	van Eijsden WA Raats JW Mulder PGH van der Laan L
author_sort	van Eijsden WA
title	New aspects of delirium in elderly patients with critical limb ischemia
title_short	New aspects of delirium in elderly patients with critical limb ischemia
title_full	New aspects of delirium in elderly patients with critical limb ischemia
title_fullStr	New aspects of delirium in elderly patients with critical limb ischemia
title_full_unstemmed	New aspects of delirium in elderly patients with critical limb ischemia
title_sort	new aspects of delirium in elderly patients with critical limb ischemia
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/75cf514f961346518faea0d4b9152100
work_keys_str_mv	AT vaneijsdenwa newaspectsofdeliriuminelderlypatientswithcriticallimbischemia AT raatsjw newaspectsofdeliriuminelderlypatientswithcriticallimbischemia AT mulderpgh newaspectsofdeliriuminelderlypatientswithcriticallimbischemia AT vanderlaanl newaspectsofdeliriuminelderlypatientswithcriticallimbischemia
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New aspects of delirium in elderly patients with critical limb ischemia

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