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Predictive Factors of Postoperative Delirium in Patients After Pancreaticoduodenectomy

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Postoperative delirium is a common serious complication after various types of surgery. However, the incidence and predictive factors associated with delirium after pancreaticoduodenectomy (PD) have not been investigated. Thus, this study aimed to investigate the incidence and predictive factors of postoperative delirium in patients who underwent PD.

Methods

This study included 155 consecutive patients who underwent PD. Patients with and without postoperative delirium were compared to identify differential patient characteristics. Multivariate regression analysis was used to statistically identify independent predictive factors significantly associated with the development of postoperative delirium.

Results

Postoperative delirium developed in 27 (22.4%) of 155 patients. The majority of incidents occurred on postoperative day 2, and the mean delirium duration was 4.6 ± 4.8 days. Patients with postoperative delirium had an older age and a previous history of benzodiazepine use. A multivariate analysis revealed that the development of delirium was significantly correlated with these two factors. Receiver-operator characteristics (ROC) curve analysis of the two factors yielded an area under the ROC curve of 0.823 (0.750–0.896), suggesting good discrimination power.

Conclusions

This study reports on the incidence of postoperative delirium after PD. Furthermore, we identified age and use of benzodiazepines as significant predictive factors for developing delirium after PD. These results contribute to the prediction and treatment of postoperative delirium.

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Authors and Affiliations

  1. Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara, Toyonaka, Osaka, 560-8565, Japan

    Yoshito Tomimaru, Sung Ae Park, Kozo Noguchi, Shingo Noura, Hiroshi Imamura & Keizo Dono

  2. Department of Psychiatry, Toyonaka Municipal Hospital, Toyonaka, Japan

    Asuka Shibata & Shinichi Miyagawa

  3. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

    Toru Shirakawa

Authors
  1. Yoshito Tomimaru
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  2. Sung Ae Park
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  3. Asuka Shibata
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  4. Shinichi Miyagawa
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  5. Kozo Noguchi
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  6. Shingo Noura
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  7. Hiroshi Imamura
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  8. Toru Shirakawa
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  9. Keizo Dono
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Contributions

Study design: Y Tomimaru and SA Park.

Acquisition of data: Y Tomimaru, SA Park, A Shibata, S Miyagawa, and K Noguchi.

Analysis and interpretation: Y Tomimaru, SA Park, A Shibata, S Miyagawa, and T Shirakawa.

Manuscript preparation: Y Tomimaru and SA Park.

Assistance with data interpretation: S Noura, H Imamura, T Iwazawa, and K Dono.

Corresponding author

Correspondence to Yoshito Tomimaru.

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Tomimaru, Y., Park, S.A., Shibata, A. et al. Predictive Factors of Postoperative Delirium in Patients After Pancreaticoduodenectomy. J Gastrointest Surg 24, 849–854 (2020). https://doi.org/10.1007/s11605-019-04212-1

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  • DOI: https://doi.org/10.1007/s11605-019-04212-1

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