Key result
A preoperative HDS-R score of 20 or lower was a strong independent predictor of postoperative delirium in elderly patients undergoing gastroenterological surgery (OR 18.516).
Why the study?
Does preoperative HDS-R score predict postoperative delirium in elderly patients undergoing gastroenterological surgery?
Observational (n=191)
Does preoperative HDS-R score predict postoperative delirium in elderly patients undergoing gastroenterological surgery?
Odds Ratio: 18.516 (95% CI 5.978–57.078)
Absolute Event Rate: 60% vs 2.4%
p-value: p=<0.001
Preoperative evaluation using the HDS-R is a strong independent predictor of postoperative delirium in elderly patients undergoing gastroenterological surgery.
目的:高齢者術後せん妄発生予測因子を明らかにする．方法:2006年1月からの2年間に当院で手術をした胃癌と大腸癌の症例で，改訂長谷川式簡易知能評価スケール（以下HDS-R）による評価を術前行った70歳以上の高齢者121例を対象とし，術前因子（年齢，性別，既往歴，ASA分類，PNI，PS，術前在院期間，HDS-R）と手術因子（病変部位，手術時間，出血量，アプローチ，手術難易度，ICU入室，白血球数，CRP，術後合併症，食事開始時期）を検討した1)．結果:術後せん妄発生率は19.0％（23/121）だった．単変量解析では，術後せん妄発生とPNI（p=0.007），HDS-R（p=0.001），CRP（p<0.001），食事開始時期（p=0.004）に有意の関連を認め，多変量解析ではHDS-Rのみが選択された（OR13.514，95％CI4.878-37.037，p<0.001）．結論:HDS-Rは術後せん妄発生予測に有用であると考えられた．
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Yamada et al. (2009) conducted an observational in Gastric or colorectal cancer requiring elective surgery (n=191). HDS-R score ≤ 20 vs. HDS-R score > 20 was evaluated on Occurrence of postoperative delirium (OR 18.516, 95% CI 5.978-57.078, p=<0.001). A preoperative HDS-R score of 20 or lower was a strong independent predictor of postoperative delirium in elderly patients undergoing gastroenterological surgery (OR 18.516).
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