Delirium Bibliography

The searchable delirium bibliography page is one of our most popular features, allowing you to quickly gain access to the literature on delirium and acute care of older persons.  The HELP team keeps it updated for you on a monthly basis!  Feel free to search by author, title, keywords. It is primarily intended for clinicians and researchers interested in exploring these topics.

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Total Results: 2941

  • Sedation Variability Increases Incidence of Delirium in Adult Medical Intensive Care Unit Patients at a Tertiary Academic Medical Center. 2019 Ritchie, B. M. Torbic, H. DeGrado, J. R. Reardon, D. P.. Am J Ther, 26:1 (e92-e95)
    • Title

      Sedation Variability Increases Incidence of Delirium in Adult Medical Intensive Care Unit Patients at a Tertiary Academic Medical Center.

    • Authors
      Ritchie, B. M. Torbic, H. DeGrado, J. R. Reardon, D. P.
    • Year
      2019
    • Journal
      Am J Ther
    • URL
    • Abstract
      BACKGROUND: Variability in sedation may increase the incidence of delirium and mortality, as well as increased intensive care unit (ICU) and hospital lengths of stay (LOS), despite mean Richmond Agitation Sedation Scale (RASS) scores at goal. Coefficient of variation (CV) can be used to represent variability with a higher ratio indicating increased variability. STUDY QUESTION: Do patients with an increased variability in sedation, as evaluated by CV in RASS, have an increased incidence of delirium? METHODS: We conducted a retrospective chart review of adult medical ICU patients requiring mechanical ventilation (MV) for >/=24 hours between January and April 2013. Patients were excluded if intubated at an outside hospital, neuromuscularly blocked, suffering from anoxic brain injury, or had a goal RASS of -4 or -5. Outcomes assessed included the presence of delirium, as evaluated by the Confusion Assessment Method, RASS, CV in RASS, duration of MV, ICU, and hospital LOS, and survival. RESULTS: Of 45 included patients, 32 experienced delirium during their ICU admission and 13 did not. The groups were similar at baseline. There was no difference in mean RASS when comparing the delirium and nondelirium groups (-1.6 +/- 1.3 vs. -1.8 +/- 0.8, respectively; P = 0.61). Patients with delirium had a greater CV in RASS (0.3 +/- 0.135 vs. 0.2 +/- 0.105; P = 0.02), a longer MV duration [4 (2-8) vs. 3 (2-3) days; P = 0.045], and a trend toward increased ICU LOS [8 (5-12.25) vs. 4 (3-8) days; P = 0.096], but no difference in hospital LOS [13 (10-25) vs. 18 (9-39) days; P = 0.83] and survival (71.9% vs. 69.2%; P = 1.0). CONCLUSION: Medical ICU patients with delirium had a higher CV in RASS compared with patients without delirium, suggesting that greater variability in sedation may increase the incidence of delirium. Patients with delirium also had a greater duration of MV and a trend toward longer ICU LOS.
    • PubMed ID
  • Current Pharmacotherapy Does Not Improve Severity of Hypoactive Delirium in Patients with Advanced Cancer: Pharmacological Audit Study of Safety and Efficacy in Real World (Phase-R). 2019 Okuyama, T. Yoshiuchi, K. Ogawa, A. Iwase, S. Yokomichi, N. Sakashita, A. Tagami, K. Uemura, K. Nakahara, R. Akechi, T.. Oncologist,
    • Title

      Current Pharmacotherapy Does Not Improve Severity of Hypoactive Delirium in Patients with Advanced Cancer: Pharmacological Audit Study of Safety and Efficacy in Real World (Phase-R).

    • Authors
      Okuyama, T. Yoshiuchi, K. Ogawa, A. Iwase, S. Yokomichi, N. Sakashita, A. Tagami, K. Uemura, K. Nakahara, R. Akechi, T.
    • Year
      2019
    • Journal
      Oncologist
    • URL
    • Abstract
      BACKGROUND: Pharmacotherapy is generally recommended to treat patients with delirium. We sought to describe the current practice, effectiveness, and adverse effects of pharmacotherapy for hypoactive delirium in patients with advanced cancer, and to explore predictors of the deterioration of delirium symptoms after starting pharmacotherapy. SUBJECTS, MATERIALS, AND METHODS: We included data of patients with advanced cancer who were diagnosed with hypoactive delirium and received pharmacotherapy for treatment of delirium. This was a pharmacovigilance study characterized by prospective registries and systematic data-recording using internet technology, conducted among 38 palliative care teams and/or units. The severity of delirium and other outcomes were assessed using established measures at days 0 (T0), 3 (T1), and 7 (T2). RESULTS: Available data were obtained from 218 patients. The most frequently used agent was haloperidol (37%). A total of 67 and 42 patients (31% and 19%) had died or discontinued pharmacotherapy by T1 and T2, respectively. Delirium symptoms deteriorated between T0 and T1, but this trend did not reach statistical significance. The most prevalent adverse event was sedation (9%). Delirium severity worsened after starting pharmacotherapy in 121 patients (56%) at T1. In patients whose death was expected within a few days and those with delirium caused by organ failure, symptoms of delirium were significantly more likely to deteriorate after starting pharmacotherapy. CONCLUSION: Current pharmacotherapy for hypoactive delirium in patients with advanced cancer is not recommended, especially in those whose death is expected within a few days and in those with delirium caused by organ failure. IMPLICATIONS FOR PRACTICE: Delirium is common among patients with advanced cancer, and hypoactive delirium is the dominant motor subtype in the palliative care setting. Pharmacotherapy is recommended and regularly used to treat delirium. This article describes the effectiveness and adverse effects of pharmacotherapy for hypoactive delirium in patients with advanced cancer. The findings of this study do not support the use of pharmacotherapy for treatment of hypoactive delirium in the palliative care setting. Pharmacotherapy should especially be avoided in patients whose death is expected within a few days and in those with delirium caused by organ failure.
    • PubMed ID
  • Quality of care in hospitalized cancer patients before and after implementation of a systematic prevention program for delirium: the DELTA exploratory trial. 2019 Ogawa, A. Okumura, Y. Fujisawa, D. Takei, H. Sasaki, C. Hirai, K. Kanno, Y. Higa, K. Ichida, Y. Sekimoto, A. Asanuma, C.. Supportive Care in Cancer, 27:2 (557-565)
    • Title

      Quality of care in hospitalized cancer patients before and after implementation of a systematic prevention program for delirium: the DELTA exploratory trial.

    • Authors
      Ogawa, A. Okumura, Y. Fujisawa, D. Takei, H. Sasaki, C. Hirai, K. Kanno, Y. Higa, K. Ichida, Y. Sekimoto, A. Asanuma, C.
    • Year
      2019
    • Journal
      Supportive Care in Cancer
    • URL
    • Abstract
      Background: We evaluated whether the DELirium Team Approach (DELTA) program—a systematic management program aimed at screening high-risk groups and preventing delirium—would improve quality of care in patients hospitalized with cancer. Methods: A retrospective before–after study was conducted during a pre-intervention period (between October 2012 and March 2013) and a post-intervention period (between October 2013 and March 2014) at a Japanese hospital providing specialized treatments for cancer. A total of 4180 inpatients were evaluated before the implementation of the DELTA program and 3797 inpatients were evaluated after implementation. Results: After program implementation, the incidence of delirium decreased from 7.1 to 4.3% (odds ratio [OR], 0.52; 95% CI, 0.42–0.64). The incidence of adverse events, including falls or self-extubation, also decreased, from 3.5 to 2.6% (OR, 0.71; 95% CI, 0.54–0.92). There was a significant decrease in the prescription of benzodiazepines (OR, 0.79; 95% CI, 0.71–0.87), increase in the level of independence in activities of daily living at discharge (OR, 1.94; 95% CI, 1.11–3.38), and decrease in the length of stay (risk ratio 0.90; 95% CI, 0.90–0.90). Conclusions: The systematic management program for delirium decreased the incidence of delirium and improved several clinical outcomes. These data suggest that this simple cost-effective program is feasible and implementable as routine care in busy wards.
    • PubMed ID
  • Relevance of peripheral cholinesterase activity on postoperative delirium in adult surgical patients (CESARO): A prospective observational cohort study. 2019 Müller, A. Olbert, M. Heymann, A. Zahn, P. K. Plaschke, K. von Dossow, V. Bitzinger, D. Barth, E. Meister, M. Kranke, P. Herrmann, C. Wernecke, K. D. Spies, C. D.. European Journal of Anaesthesiology, 36:2 (114-122)
    • Title

      Relevance of peripheral cholinesterase activity on postoperative delirium in adult surgical patients (CESARO): A prospective observational cohort study.

    • Authors
      Müller, A. Olbert, M. Heymann, A. Zahn, P. K. Plaschke, K. von Dossow, V. Bitzinger, D. Barth, E. Meister, M. Kranke, P. Herrmann, C. Wernecke, K. D. Spies, C. D.
    • Year
      2019
    • Journal
      European Journal of Anaesthesiology
    • URL
    • Abstract
      BACKGROUND: The cholinergic system is considered to play a key role in the development of postoperative delirium (POD), which is a common complication after surgery. OBJECTIVES: To determine whether peri-operative acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities are associated with the development of POD in in-hospital surgical patients, and raise hypotheses on cholinergic regulatory mechanisms in POD. DESIGN: A prospective multicentre observational study by the Peripheral Cholinesterase-activity on Neurocognitive Dysfunctions in Surgical Patients (CESARO) study group. SETTING: Nine German hospitals. PATIENTS: Patients of at least 18 years of age scheduled for inpatient elective surgery for a variety of surgical procedures. A total of 650 patients (mean age 61.5 years, 52.8% male) were included. METHODS: Clinical variables, and peripheral AChE and BuChE activities, were assessed throughout the peri-operative period using bedside point-of-care measurements (one pre-operative and two postoperative measurements). POD screening was conducted postoperatively for at least 24 h and up to the third postoperative day using a validated screening tool (nursing delirium screening scale). RESULTS: In all, 179 patients (27.5%) developed POD within the early postoperative phase. There was a lower BuChE activity in patients with delirium compared with patients without delirium pre-operatively (Cohen's r = 0.07, P = 0.091), on postoperative day 1 (Cohen's r = 0.12, P = 0.003) and on postoperative day 2 (Cohen's r = 0.12, P = 0.002). In contrast, there was a significantly higher AChE activity in patients with delirium compared with patients without delirium pre-operatively (Cohen's r = 0.10, P = 0.012), on postoperative day 1 (Cohen's r = 0.11, P = 0.004) and on postoperative day 2 (Cohen's r = 0.13, P = 0.002). After adjusting for covariates in multiple logistic regression, a significant association between both BuChE and AChE activities and POD was not found. However, in the multivariable analysis using the Generalized Estimating Equation, cholinesterase activities showed that a decrease of BuChE activity by 100 U L increased the risk of a delirium by approximately 2.1% (95% CI 1.6 to 2.8%) and for each 1 U g of haemoglobin increase in AChE activity, there was a 1.4% (95% CI 0.6 to 2.2%) increased risk of POD. CONCLUSION: Peri-operative peripheral cholinesterase activities may be related to the development of POD, but the clinical implications remain unclear. Further studies, in homogeneous patient groups with a strict protocol for measurement time points, are needed to investigate the relationship between cholinesterase activities and POD. TRIAL REGISTRATION: www.clinicaltrials.gov. Identifier NCT01964274.
    • PubMed ID
  • Predicting postoperative delirium and postoperative cognitive decline with combined intraoperative electroencephalogram monitoring and cerebral near-infrared spectroscopy in patients undergoing cardiac interventions. 2019 Momeni, M. Meyer, S. Docquier, M. A. Lemaire, G. Kahn, D. Khalifa, C. Rosal Martins, M. Van Dyck, M. Jacquet, L. M. Peeters, A. Watremez, C.. J Clin Monit Comput,
    • Title

      Predicting postoperative delirium and postoperative cognitive decline with combined intraoperative electroencephalogram monitoring and cerebral near-infrared spectroscopy in patients undergoing cardiac interventions.

    • Authors
      Momeni, M. Meyer, S. Docquier, M. A. Lemaire, G. Kahn, D. Khalifa, C. Rosal Martins, M. Van Dyck, M. Jacquet, L. M. Peeters, A. Watremez, C.
    • Year
      2019
    • Journal
      J Clin Monit Comput
    • URL
    • Abstract
      Studies have associated electroencephalogram (EEG) suppression with postoperative delirium (POD) and postoperative cognitive decline (POCD). Otherwise, improving cerebral tissue oxygen saturation (rScO2) seems beneficial. No study has evaluated the impact of EEG suppression and decreased rScO2 on the incidence of POD and POCD when the intraoperative management of patients is performed with a depth-of-anesthesia (DOA) monitor and a cerebral oximetry. In this prospective study patients undergoing cardiac interventions were monitored with the NeuroSENSE((R)) DOA monitor and bilateral cerebral oximetry. An algorithm was used to optimize cerebral oxygenation. EEG suppression was presented as total area under the curve (AUC) of suppression ratio (SR) > 0 s (AUCEEGSR>0s). Cerebral desaturation was defined as AUC of 25% drop of oximetry values as compared to baseline. POD was evaluated by the chart review method. POCD was defined as a Z-score 0s) was significantly associated with POD (OR = 2.247; 95% CI = 1.414-3.571; P = 0.001). Low rScO2 at the end of surgery was statistically associated with POCD (OR = 0.981; 95% CI = 0.965-0.997; P = 0.018). The results of our study show that the degree of intraoperative EEG suppression on one hand, and low rScO2 at the end of procedure on the other hand, are associated with respectively POD and POCD in patients undergoing cardiac interventions.
    • PubMed ID
  • Early Postoperative Actigraphy Poorly Predicts Hypoactive Delirium. 2019 Maybrier, H. R. King, C. R. Crawford, A. E. Mickle, A. M. Emmert, D. A. Wildes, T. S. Avidan, M. S. Palanca, B. J. A.. J Clin Sleep Med, 15:1 (79-87)
    • Title

      Early Postoperative Actigraphy Poorly Predicts Hypoactive Delirium.

    • Authors
      Maybrier, H. R. King, C. R. Crawford, A. E. Mickle, A. M. Emmert, D. A. Wildes, T. S. Avidan, M. S. Palanca, B. J. A.
    • Year
      2019
    • Journal
      J Clin Sleep Med
    • URL
    • Abstract
      STUDY OBJECTIVES: Delirium is a postoperative complication accompanied by disturbances in attention, cognition, arousal, and psychomotor activity. Wrist actigraphy has been advocated to study inactivity and inferred sleep patterns during delirium. We hypothesized that altered patterns of motor activity or immobility, reflective of disordered sleep and wakefulness patterns, would serve as predictive markers of hypoactive postoperative delirium. METHODS: Eighty-four elderly surgical patients were classified into three groups based on the timing of hypoactive delirium following surgery: intact with no delirium throughout postoperative days (POD) 0-5 (n = 51), delirium during POD 0-1 (n = 24), and delirium during POD 2-5 (n = 13). Delirium was detected on daily Confusion Assessment Method evaluations and chart review. Actigraphy measures were calculated from accelerometry signals acquired on the first postoperative day (POD 0, 16:00-23:00) and night (POD 0, 23:00-POD 1, 06:00). RESULTS: Actigraphy metrics showed substantial interpatient variability. Among the three patient groups, only those without delirium showed greater movement during the day compared to night and also fewer minutes of night immobility (P = .03 and P = .02, Wilcoxon rank-sum tests). These patients were poorly discriminated from those with delirium during either POD 0-1 or POD 2-5, using differences in day and night activity (C-statistic, 95% confidence interval [CI]: 0.66 [0.53-0.79] and C-statistic, 95% CI: 0.71 [0.55-0.87], respectively). Inclusion of low-frequency signals improved performance of immobility measures without affecting those based on activity. Cognitively intact patients during POD 0-5 were distinguished from those with delirium during POD 0-1, based on differences in the number of day and night immobile minutes (C-statistic 0.65, 95% CI: [0.53-0.78]). Actigraphy metrics with the strongest association to delirium incidence were not reliably correlated with an increased risk during POD 0-5, when accounting for patient age, sex, intensive care unit admission, and Charlson Comorbidity Index (adjusted odds ratio of 1.7, 95% CI: [1.0-3.0], P = .09, likelihood ratio test). CONCLUSIONS: Early postoperative wrist actigraphy metrics that serve as markers of sleep and wakefulness offer limited capacity as sole predictors or markers of hypoactive delirium. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Title: Electroencephalography Guidance of Anesthesia to Alleviate Geriatric Syndromes (ENGAGES) Study; Identifier: NCT02241655; URL: https://clinicaltrials.gov/ct2/show/NCT02241655.
    • PubMed ID
  • Subsyndromal delirium is associated with poor functional outcome after ischemic stroke. 2019 Klimiec, E. Lis, A. Pera, J. Slowik, A. Dziedzic, T.. Eur J Neurol,
    • Title

      Subsyndromal delirium is associated with poor functional outcome after ischemic stroke.

    • Authors
      Klimiec, E. Lis, A. Pera, J. Slowik, A. Dziedzic, T.
    • Year
      2019
    • Journal
      Eur J Neurol
    • URL
    • Abstract
      BACKGROUND: Subsyndromal delirium (SSD) refers to patients with delirious symptoms who do not meet criteria for delirium. We aimed to determine the prognostic significance of SSD in stroke patients. METHODS: We included 564 patients with ischemic stroke (median age: 71, 50.5% female). We used Confusion Assessment Method to assess symptoms of delirium and DSM-5 criteria to diagnose delirium. We defined SSD as one or more core features of delirium without fulfilling diagnostic criteria. We assessed functional outcome using the modified Rankin Scale at 3 and 12 months after stroke. RESULTS: We diagnosed delirium in 23.4% of patients and SSD in 10.3% of patients. SSD was associated with the increased risk of poor functional outcome. The adjusted odds ratios for unfavorable outcome at 3 and 12 months were 2.88 (95%CI: 1.43-5.79, p <0.01) and 2.93 (95%CI: 1.39-6.22, p<0.01), respectively. In the multivariate analysis, delirium was an independent predictor of poor functional outcome at 3 months (OR: 6.41, 95%CI: 3.36-12.21, p<0.01) and 12 months (OR: 6.11, 95%CI: 3.05-12.27, p<0.01) after stroke. Delirium was also independently associated with the increased risk of death within 3 months (HR: 3.68, 95%CI: 1.69-8.02, p<0.01) and 12 months (HR: 3.76, 95%CI 2.05-6.90, p<0.01). SSD was not associated with the increased risk of death. CONCLUSIONS: In SSD patients the risk of poor functional outcome after stroke is increased and intermediate between patients with and patients without delirium. This article is protected by copyright. All rights reserved.
    • PubMed ID
  • Pharmacological Management of Delirium in the Intensive Care Unit: A Randomized Pragmatic Clinical Trial. 2019 Khan, B. A. Perkins, A. J. Campbell, N. L. Gao, S. Farber, M. O. Wang, S. Khan, S. H. Zarzaur, B. L. Boustani, M. A.. J Am Geriatr Soc,
    • Title

      Pharmacological Management of Delirium in the Intensive Care Unit: A Randomized Pragmatic Clinical Trial.

    • Authors
      Khan, B. A. Perkins, A. J. Campbell, N. L. Gao, S. Farber, M. O. Wang, S. Khan, S. H. Zarzaur, B. L. Boustani, M. A.
    • Year
      2019
    • Journal
      J Am Geriatr Soc
    • URL
    • Abstract
      BACKGROUND/OBJECTIVE: Delirium in the intensive care units (ICUs) is prevalent, with both delirium duration and delirium severity associated with adverse outcomes. We designed a pragmatic trial to test the efficacy of a pharmacological management of delirium (PMD) bundle in improving delirium/coma-free days and reducing delirium severity among ICU patients. DESIGN: A randomized pragmatic clinical trial. SETTING: Medical, surgical, and progressive ICUs of three tertiary care hospitals. PARTICIPANTS: A total of 351 critically ill patients. INTERVENTION: A multicomponent PMD bundle consisting of reducing the exposure to 20 definite anticholinergic medications and benzodiazepines and prescribing low-dose haloperidol. MEASUREMENTS: The primary outcomes were delirium/coma-free days, measured through the Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the ICU (CAM-ICU), and delirium severity, measured through Delirium Rating Scale-Revised-98 and the CAM-ICU-7. Secondary outcomes were in-hospital and posthospital discharge 30-day mortality, ICU and hospital lengths of stay, and delirium-related hospital complications. RESULTS: We randomized 351 critically ill delirious patients (mean age = 59.3 years [SD = 16.9 years]; 52% female, 42% African Americans) to receive the PMD bundle or usual care. There were no significant differences in median delirium/coma-free days at day 8 (PMD vs usual care = 4 [interquartile range {IQR} = 2-7] days vs 5 [IQR = 1-7] days; P = .888) or at day 30 (PMD vs usual care = 26 [IQR 19-29] days vs 26 [IQR, 14-29] days; P = .991). There were no significant differences for decrease in delirium severity at day 8, but at hospital discharge, the intervention group showed a greater reduction in delirium severity (mean decrease in CAM-ICU-7 score for PMD vs usual care = 3.2 [SD = 3.3] vs 2.5 [SD = 3.2]; P = .046). No differences were observed between groups for ICU and hospital lengths of stay, mortality, and delirium-related hospital complications. Similar results were observed when analyses were limited to patients 65 years or older and 75 years or older. CONCLUSION AND RELEVANCE: Implementing the PMD bundle in the ICU did not reduce delirium duration or severity among critically ill patients. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00842608.
    • PubMed ID
  • Use of medicines that may precipitate delirium prior to hospitalisation in older Australians with delirium: An observational study. 2019 Kassie, G. M. Kalisch Ellett, L. M. Nguyen, T. A. Roughead, E. E.. Australas J Ageing,
    • Title

      Use of medicines that may precipitate delirium prior to hospitalisation in older Australians with delirium: An observational study.

    • Authors
      Kassie, G. M. Kalisch Ellett, L. M. Nguyen, T. A. Roughead, E. E.
    • Year
      2019
    • Journal
      Australas J Ageing
    • URL
    • Abstract
      OBJECTIVE: To assess the use of medicines associated with delirium prior to hospital admission in older Australian patients with a recorded diagnosis of delirium. METHODS: A retrospective observational study was conducted using de-identified data from the Australian Government Department of Veterans' Affairs Health Care Claims Database. The prevalence of use of medicines associated with delirium was determined in people 65 years or older with a delirium diagnosis. RESULTS: Three-quarters of the total 22 923 older patients included were taking at least one medicine associated with delirium, the median number of medications per patient was two (interquartile range, 1-3). The most frequently used medicines known to be associated with delirium were psycholeptics, opioids and tricyclic antidepressants. CONCLUSION: A substantial proportion of older hospitalised patients with a delirium diagnosis were taking medicines known or suspected to precipitate delirium prior to admission. There may be an opportunity to decrease medication-associated delirium by reducing use of risky medication.
    • PubMed ID
  • Comprehensive risk factor evaluation of postoperative delirium following major surgery: clinical data warehouse analysis. 2019 Kang, S. Y. Seo, S. W. Kim, J. Y.. Neurol Sci,
    • Title

      Comprehensive risk factor evaluation of postoperative delirium following major surgery: clinical data warehouse analysis.

    • Authors
      Kang, S. Y. Seo, S. W. Kim, J. Y.
    • Year
      2019
    • Journal
      Neurol Sci
    • URL
    • Abstract
      BACKGROUND: Postoperative delirium (POD) in older adults is a very serious complication. Due to the complexity of too many risk factors (RFs), an overall assessment of RFs may be needed. The aim of this study was to evaluate comprehensively the RFs of POD regardless of the organ undergoing operation, efficiently incorporating the concept of comprehensive big data using a smart clinical data warehouse (CDW). METHODS: We reviewed the electronic medical data of inpatients aged 65 years or older who underwent major surgery between January 2010 and June 2016 at Hallym University Sacred Heart Hospital. The following six major operation types were selected: cardiac, stomach, colorectal, hip, knee, and spine. Clinical features, laboratory findings, perioperative variables, and medication history were compared between patients without POD and with POD. RESULTS: Six hundred eighty-six of 3634 patients (18.9%) developed POD. In multivariate logistic regression analysis, common, independent RFs of POD were as follows (descending order of odds ratio): operation type ([hip] OR 8.858, 95%CI 3.432-22.863; p = 0.000; [knee] OR 7.492, 95%CI 2.739-20.487; p = 0.000; [spine] OR 6.919, 95%CI 2.687-17.815; p = 0.000; [colorectal] OR 2.037, 95%CI 0.784-5.291; p = 0.144; [stomach] OR 1.500, 95%CI 0.532-4.230; p = 0.443; [cardiac] reference), parkinsonism (OR 2.945, 95%CI 1.564-5.547; p = 0.001), intensive care unit stay (OR 1.675, 95%CI 1.354-2.072; p = 0.000), stroke history (OR 1.591, 95%CI 1.112-2.276; p = 0.011), use of hypnotics and sedatives (OR 1.307, 95%CI 1.072-1.594; p = 0.008), higher creatinine (OR 1.107, 95%CI 1.004-1.219; p = 0.040), lower hematocrit (OR 0.910, 95%CI 0.836-0.991; p = 0.031), older age (OR 1.053, 95%CI 1.037-1.069; p = 0.000), and lower body mass index (OR 0.967, 95%CI 0.942-0.993; p = 0.013). The use of analgesics (OR 0.644, 95%CI 0.467-0.887; p = 0.007) and antihistamines/antiallergics (OR 0.764, 95%CI 0.622-0.937; p = 0.010) were risk-reducing factors. Operation type with the highest odds ratio for POD was orthopedic surgery. CONCLUSIONS: Big data analytics could be applied to evaluate RFs in electronic medical records. We identified common RFs of POD, regardless of operation type. Big data analytics may be helpful for the comprehensive understanding of POD RFs, which can help physicians develop a general plan to prevent POD.
    • PubMed ID
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