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Incidence and Risk Factors of Postoperative Delirium in Patients with Esophageal Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Postoperative delirium is a common complication after major surgery and is characterized by acute confusion with fluctuating consciousness. The aim of this study was to investigate the incidence and risk factors of postoperative delirium in patients with esophageal cancer.

Methods

We conducted a retrospective cohort analysis of 306 consecutive patients who had undergone an esophagectomy at Keio University Hospital from January 1998 to December 2009. All data were assessed by psychiatrists, and delirium was diagnosed according to criteria of the Diagnostic and Statistical Manual Disorder, fourth edition. Univariate and multivariate analyses were performed.

Results

Postoperative delirium developed in 153 (50.0 %) of 306 patients. One hundred fourteen (37.3 %) of the 306 patients required psychoactive medication for symptoms associated with delirium. Univariate analyses showed that older age, male gender, additional flunitrazepam for sedation in intensive care unit (ICU) after surgery, longer periods of time under mechanical ventilation after surgery, longer ICU stays, occurrence of postoperative complications, and longer hospital stays were significantly associated with postoperative delirium. Multivariate analysis revealed that development of delirium was linked to older age, additional flunitrazepam in ICU, and occurrence of postoperative complication.

Conclusions

The development of postoperative delirium in patients with esophageal cancer is a problem that cannot be ignored. Our results suggest that the risk of developing delirium is associated with older age, use of flunitrazepam in ICU, and postoperative complications.

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Authors and Affiliations

  1. Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan

    Mari Takeuchi MD, Daisuke Fujisawa MD, Kaya Miyajima MD, Joichiro Shirahase MD & Masaru Mimura MD

  2. Department of Surgery, Keio University School of Medicine, Tokyo, Japan

    Hiroya Takeuchi MD & Yuko Kitagawa MD

  3. Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan

    Daisuke Fujisawa MD

  4. Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan

    Kimio Yoshimura MD

  5. Department of Anesthesia, Keio University School of Medicine, Tokyo, Japan

    Saori Hashiguchi MD

  6. Department of Gastroenterological Surgery, Tokai University School of Medicine, Kanagawa, Japan

    Soji Ozawa MD

  7. Department of Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan

    Nobutoshi Ando MD

Authors
  1. Mari Takeuchi MD
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  2. Hiroya Takeuchi MD
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  3. Daisuke Fujisawa MD
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  4. Kaya Miyajima MD
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  5. Kimio Yoshimura MD
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  6. Saori Hashiguchi MD
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  7. Soji Ozawa MD
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  8. Nobutoshi Ando MD
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  9. Joichiro Shirahase MD
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  10. Yuko Kitagawa MD
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  11. Masaru Mimura MD
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Corresponding author

Correspondence to Hiroya Takeuchi MD.

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Takeuchi, M., Takeuchi, H., Fujisawa, D. et al. Incidence and Risk Factors of Postoperative Delirium in Patients with Esophageal Cancer. Ann Surg Oncol 19, 3963–3970 (2012). https://doi.org/10.1245/s10434-012-2432-1

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  • DOI: https://doi.org/10.1245/s10434-012-2432-1

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