Low skeletal muscle mass as a risk factor for postoperative delirium in elderly patients undergoing colorectal cancer surgery

Christina Alexa Mosk,1 Jeroen LA van Vugt,2 Huub de Jonge,1 Carlijn DM Witjes,2 Stefan Buettner,2 Jan NM Ijzermans,2 Lijckle van der Laan11Department of Surgery, Amphia Hospital, Breda, the Netherlands; 2Department of Surgery, Erasmus MC University Medical Center, Rotterdam, the NetherlandsBackgroun...

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Autores principales:	Mosk CA, van Vugt JLA, de Jonge H, Witjes CDM, Buettner S, Ijzermans JNM, van der Laan L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	skeletal muscle mass sarcopenia colorectal surgery postoperative delirium elderly nomogram. Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/93b791c3b5a04984ab41e0ddc3441aeb
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spelling	oai:doaj.org-article:93b791c3b5a04984ab41e0ddc3441aeb2021-12-02T08:45:54ZLow skeletal muscle mass as a risk factor for postoperative delirium in elderly patients undergoing colorectal cancer surgery1178-1998https://doaj.org/article/93b791c3b5a04984ab41e0ddc3441aeb2018-10-01T00:00:00Zhttps://www.dovepress.com/low-skeletal-muscle-mass-as-a-risk-factor-for-postoperative-delirium-i-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Christina Alexa Mosk,1 Jeroen LA van Vugt,2 Huub de Jonge,1 Carlijn DM Witjes,2 Stefan Buettner,2 Jan NM Ijzermans,2 Lijckle van der Laan11Department of Surgery, Amphia Hospital, Breda, the Netherlands; 2Department of Surgery, Erasmus MC University Medical Center, Rotterdam, the NetherlandsBackground: Both low skeletal muscle mass (LSMM) and delirium are frequently seen in elderly patients. This study aimed to investigate the association between preoperative LSMM and postoperative delirium (POD) in elderly patients undergoing colorectal cancer (CRC) surgery and to design a model to predict POD. Patients and methods: This is a retrospective observational cohort study. Patients aged 70 years or older undergoing CRC surgery from January 2013 to October 2015 were included in this study. The cross-sectional skeletal muscle area at the level of the third lumbar vertebra using computed tomography was adjusted for patients’ height, resulting in the skeletal muscle index. The lowest quartile per sex was defined as LSMM. Short Nutritional Assessment Questionnaire for Residential Care and KATZ-Activities of Daily Living were used to define malnourishment and physical dependency, respectively. POD was diagnosed using the Delirium Observational Screening Scale and geriatricians’ notes. Results: Median age of the 251 included patients was 76 years (IQR, 73–80 years), of whom 56% of patients were males, 24% malnourished, and 15% physically impaired. LSMM and POD were diagnosed in 65 and 33 (13%) patients, respectively. POD occurred significantly more in patients with LSMM (25%) compared with patients without LSMM (10%), P=0.006. In the multivariate analysis, age, history of delirium, and LSMM were significantly associated with POD. In addition, this effect increased in patients with LSMM and malnourishment (P=0.019) or physical dependency (P=0.017). Conclusion: Age, history of delirium, LSMM, and malnourishment or physical dependency were independently associated with POD. Our nomogram could be used to identify patients at an increased risk for delirium. These patients may benefit from intensive monitoring to prevent POD.Keywords: skeletal muscle mass, sarcopenia, colorectal surgery, postoperative delirium, elderly, nomogramMosk CAvan Vugt JLAde Jonge HWitjes CDMBuettner SIjzermans JNMvan der Laan LDove Medical Pressarticleskeletal muscle masssarcopeniacolorectal surgerypostoperative deliriumelderlynomogram.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 2097-2106 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	skeletal muscle mass sarcopenia colorectal surgery postoperative delirium elderly nomogram. Geriatrics RC952-954.6
spellingShingle	skeletal muscle mass sarcopenia colorectal surgery postoperative delirium elderly nomogram. Geriatrics RC952-954.6 Mosk CA van Vugt JLA de Jonge H Witjes CDM Buettner S Ijzermans JNM van der Laan L Low skeletal muscle mass as a risk factor for postoperative delirium in elderly patients undergoing colorectal cancer surgery
description	Christina Alexa Mosk,1 Jeroen LA van Vugt,2 Huub de Jonge,1 Carlijn DM Witjes,2 Stefan Buettner,2 Jan NM Ijzermans,2 Lijckle van der Laan11Department of Surgery, Amphia Hospital, Breda, the Netherlands; 2Department of Surgery, Erasmus MC University Medical Center, Rotterdam, the NetherlandsBackground: Both low skeletal muscle mass (LSMM) and delirium are frequently seen in elderly patients. This study aimed to investigate the association between preoperative LSMM and postoperative delirium (POD) in elderly patients undergoing colorectal cancer (CRC) surgery and to design a model to predict POD. Patients and methods: This is a retrospective observational cohort study. Patients aged 70 years or older undergoing CRC surgery from January 2013 to October 2015 were included in this study. The cross-sectional skeletal muscle area at the level of the third lumbar vertebra using computed tomography was adjusted for patients’ height, resulting in the skeletal muscle index. The lowest quartile per sex was defined as LSMM. Short Nutritional Assessment Questionnaire for Residential Care and KATZ-Activities of Daily Living were used to define malnourishment and physical dependency, respectively. POD was diagnosed using the Delirium Observational Screening Scale and geriatricians’ notes. Results: Median age of the 251 included patients was 76 years (IQR, 73–80 years), of whom 56% of patients were males, 24% malnourished, and 15% physically impaired. LSMM and POD were diagnosed in 65 and 33 (13%) patients, respectively. POD occurred significantly more in patients with LSMM (25%) compared with patients without LSMM (10%), P=0.006. In the multivariate analysis, age, history of delirium, and LSMM were significantly associated with POD. In addition, this effect increased in patients with LSMM and malnourishment (P=0.019) or physical dependency (P=0.017). Conclusion: Age, history of delirium, LSMM, and malnourishment or physical dependency were independently associated with POD. Our nomogram could be used to identify patients at an increased risk for delirium. These patients may benefit from intensive monitoring to prevent POD.Keywords: skeletal muscle mass, sarcopenia, colorectal surgery, postoperative delirium, elderly, nomogram
format	article
author	Mosk CA van Vugt JLA de Jonge H Witjes CDM Buettner S Ijzermans JNM van der Laan L
author_facet	Mosk CA van Vugt JLA de Jonge H Witjes CDM Buettner S Ijzermans JNM van der Laan L
author_sort	Mosk CA
title	Low skeletal muscle mass as a risk factor for postoperative delirium in elderly patients undergoing colorectal cancer surgery
title_short	Low skeletal muscle mass as a risk factor for postoperative delirium in elderly patients undergoing colorectal cancer surgery
title_full	Low skeletal muscle mass as a risk factor for postoperative delirium in elderly patients undergoing colorectal cancer surgery
title_fullStr	Low skeletal muscle mass as a risk factor for postoperative delirium in elderly patients undergoing colorectal cancer surgery
title_full_unstemmed	Low skeletal muscle mass as a risk factor for postoperative delirium in elderly patients undergoing colorectal cancer surgery
title_sort	low skeletal muscle mass as a risk factor for postoperative delirium in elderly patients undergoing colorectal cancer surgery
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/93b791c3b5a04984ab41e0ddc3441aeb
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Low skeletal muscle mass as a risk factor for postoperative delirium in elderly patients undergoing colorectal cancer surgery

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