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A clinical risk analysis of early post-operative delirium after laparoscopic colorectal cancer surgery in elderly patients: a retrospective study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Early post-operative delirium (EPOD) is a frequent complication following colorectal surgery. The present study investigated the risk factors for EPOD after laparoscopic colorectal surgery in elderly patients.

Methods

A retrospective study was conducted among 208 patients ≥70 years old who underwent laparoscopic colorectal surgery. Univariate and multivariate analyses were performed to determine the clinicopathological factors associated with the EPOD.

Results

The overall incidence of EPOD was 10.1% (21/208). The univariate analysis showed that an older age (≥80 years old; P=0.002), slee** pill medication before surgery (P=0.037), a history of dementia (P=0.030) and cerebrovascular disease (P=0.017), elevated levels of D-dimer (P=0.016), maximum intraoperative temperature ≥37 °C (P=0.036), and non-continuous usage of droperidol with analgesia (P=0.005) were associated with EPOD. The multivariate logistic regression analysis revealed an older age (≥80 years old; odds ratio [OR]: 6.26, 95% confidence interval [CI]: 1.94–20.15, P=0.002), slee** pill medication before surgery (OR: 5.39, 95% CI: 1.36–21.28, P=0.016), history of cerebrovascular disease (OR: 3.91, 95% CI: 1.12–13.66, P=0.033), and maximum intraoperative temperature ≥37 °C (OR: 5.10, 95% CI: 1.53–16.92, P=0.008) to be independent risk factors. When the patients were divided into groups according to the number of positive risk factors, the prevalence rate was 6.5%, 16.0%, and 63.6% for patients with 1, 2, and 3 positive risk factors, respectively.

Conclusion

Our findings suggest that an older age, slee** pill medication before surgery, history of cerebrovascular disease, and maximum intraoperative temperature ≥37 °C are independent risk factors of EPOD after laparoscopic colorectal surgery in elderly patients.

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Data availability

The data sets generated during the study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank Dr. Kumpei Yukimoto, Dr. Keiichiro Okuyama, Dr. Hiroshi Kubo, Dr. Osamu Ikeda, Dr. Atsushi Miyoshi, and Dr. Seiji Sato, who all belong to the Department of Surgery, Saga Medical Center Koseikan, Saga, Japan, for treating the patients and for useful discussions. We also thank Ms. Shiori Johjima, who belongs to the Medical Information Division, Life Science Research Institution, Saga Medical Center Koseikan, Saga, Japan, for the data collection.

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Authors and Affiliations

  1. Department of Surgery, Saga Medical Center Koseikan, 400 Nakabaru, Kasemachi, Saga City, Saga, 840-8571, Japan

    Masatsugu Hiraki, Toshiya Tanaka, Hirofumi Sato & Kenji Kitahara

  2. Department of Psychiatry, Saga Medical Center Koseikan, 400 Nakabaru, Kasemachi, Saga City, Saga, 840-8571, Japan

    Hironobu Ishii, Takashi Sunami & Kiyoji Hanafusa

  3. Life Science Research Institution, Saga Medical Center Koseikan, 400 Nakabaru, Kasemachi, Saga City, Saga, 840-8571, Japan

    Eiji Sadashima

  4. Department of Anesthesiology, Saga Medical Center Koseikan, 400 Nakabaru, Kasemachi, Saga City, Saga, 840-8571, Japan

    Daisuke Miura

Authors
  1. Masatsugu Hiraki
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  2. Toshiya Tanaka
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  3. Hironobu Ishii
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  4. Eiji Sadashima
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  5. Daisuke Miura
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  6. Takashi Sunami
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  7. Kiyoji Hanafusa
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  8. Hirofumi Sato
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  9. Kenji Kitahara
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Contributions

M Hiraki designed this study. M Hiraki, T Tanaka, H Ishii, D Miura, T Sunami, K Hanafusa, H Sato, and K Kitahara treated the patients. M Hiraki and E Sadashima (specialist in statistics) analyzed the data. M Hiraki and T Tanaka interpreted the results and wrote the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Masatsugu Hiraki.

Ethics declarations

Ethics approval

The medical ethics committee of Saga Medical Center Koseikan reviewed and approved this study design (permission number: 20-11-01-04).

Consent to participate

All patients and their families were informed about the surgical procedure and provided their written consent. Informed broad consent for this study was obtained.

Consent for publication

Informed broad consent for this study was obtained.

Conflict of interest

The authors declare no competing interests.

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Hiraki, M., Tanaka, T., Ishii, H. et al. A clinical risk analysis of early post-operative delirium after laparoscopic colorectal cancer surgery in elderly patients: a retrospective study. Int J Colorectal Dis 36, 1461–1468 (2021). https://doi.org/10.1007/s00384-021-03919-5

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  • DOI: https://doi.org/10.1007/s00384-021-03919-5

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