Clinical risk factors associated with postoperative delirium and evaluation of delirium management and assessment team in lung and esophageal cancer patients

Kiminaka Murakawa, Yoshihisa Kitamura, Saori Watanabe, Shiho Hongo, Kazuaki Shinomiya, Toshiaki Sendo

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Background: Delirium is an acute change in cognition and concentration that complicates the postoperative course. Patients who suffer delirium after surgery have an increased risk of persistent cognitive impairment, functional decline, and death. Postoperative delirium is also associated with an increased length of hospital stay and higher costs. With the goal of preventing delirium in postoperative patients, we organized a medical team from the Delirium Management and Assessment Center (D-mac) at Okayama University Hospital in January 2012. The team members consisted of physicians, pharmacists, nurses, and clinical psychologists. Methods: We retrospectively reviewed the medical records of patients with delirium to examine risk factors related to the patients' background. Results: Fifty-nine postoperative patients with lung or esophageal cancer were investigated; 25% exhibited delirium during hospitalization. Multiple logistic regression analysis showed significant associations between the presence of delirium and a past history of delirium (odds ratio, 4.22; 95% CI, 1.10-16.2; p = 0.09) and use of benzodiazepine receptor agonists (odds ratio, 3.97; 95% CI, 1.09-14.5; p = 0.03). Intervention by the D-mac significantly reduced the rate of delirium episodes in lung cancer patients (p =0.01). Notably, prior to intervention, the incidence of delirium was 100% when three high-risk factors for delirium were present. In contrast, the incidence of delirium in patients with three high-risk factors decreased following implementation of the D-mac intervention. Conclusions: These findings suggest that active participation by various staff in the medical team managing delirium had a marked therapeutic impact.

Original languageEnglish
Article number4
JournalJournal of Pharmaceutical Health Care and Sciences
Volume1
Issue number1
DOIs
Publication statusPublished - Jan 28 2015

Keywords

  • Delirium
  • Medical team
  • Postoperative patients
  • Risk factors

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology (nursing)

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