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Why should you stay one night? Prospective observational study of enhanced recovery in elderly patients

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Abstract

Background

Delirium is a severe condition that can arise in many contexts during hospitalization. The aim of this research was to measure the incidence of postoperative delirium in patients aged 75 years or older, with the exclusion of those with preexisting neurocognitive disorders (NCD), who underwent fast-track, moderate surgery.

Methods

We conducted a prospective cohort study with patients ≥ 75 years of age who were eligible for fast-track, moderate surgery, without severe dementia, with a planned hospitalization of 24 h and with a physical status varying from very fit to vulnerable. The 4-item confusion assessment method (CAM4) was used to measure delirium.

Results

Of the 209 eligible patients, 195 subjects were enrolled in the study. The percentage of the population with a CAM4 score above 0 before surgery was 2.56%; after surgery, the percentage was 10.25%; and on the following day, the percentage was 4.61%. There was a statistically significant difference in the CAM4 scores between immediately after surgery and at 24 h after surgery (p = 0.0172).

Conclusion

The data from this study support an enhanced recovery approach for elderly patients, in which after a minor surgical procedure with anaesthesia, a recovery period of one night in the hospital can contribute to normalizing the CAM4 score and reducing the incidence of delirium.

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Funding

The study was funded by institutional funds for ad hoc research from the University of Modena and Reggio Emilia, Italy.

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Authors and Affiliations

  1. Anaesthesia and Intensive Care, Policlinico Teaching Hospital, Azienda Ospedaliero-Universitaria di Modena, via del Pozzo 71, 41124, Modena, MO, Italy

    Gabriele Melegari, Giovanna Albertini & Elisabetta Bertellini

  2. MD Lt, Italian Army, Rome, Italy

    Andrea Romani & Francesca Traccitto

  3. School of Anaesthesia and Intensive Care, University of Modena and Reggio Emilia, Modena, Italy

    Silvio Malaguti & Alberto Barbieri

  4. Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy

    Enrico Giuliani

  5. Department of Head-Neck Surgery, Policlinico Teaching Hospital, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy

    Gian Maria Cavallini

Authors
  1. Gabriele Melegari
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  2. Giovanna Albertini
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  3. Andrea Romani
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  4. Silvio Malaguti
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  5. Francesca Traccitto
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  6. Enrico Giuliani
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  7. Gian Maria Cavallini
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  8. Elisabetta Bertellini
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  9. Alberto Barbieri
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Contributions

G.M.: study conception and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript. G.A.: acquisition of data. A.R.: acquisition of data. S.M.: acquisition of data. F.T.: acquisition of data. E.G.: drafting of themanuscript. E.B.: drafting and critical revision of the manuscript. G.M.C.: drafting and critical revision of the manuscript. A.B.: study concept and design, analysis and interpretation of data, drafting and critical revision of the manuscript.

Corresponding author

Correspondence to Gabriele Melegari.

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Conflict of interest

The authors report no conflicts of interest.

Ethics approval, consent to participate and for publication

Clinical trial registration. Local approval of the Institutional Ethics Committee (Comitato Etico Provinciale di Modena, July 29, 2015, procedure 119/15).

Informed consent

All participants provided informed consent prior their participation.

Availability of data and material

The dataset is available upon request.

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Melegari, G., Albertini, G., Romani, A. et al. Why should you stay one night? Prospective observational study of enhanced recovery in elderly patients. Aging Clin Exp Res 33, 1955–1961 (2021). https://doi.org/10.1007/s40520-020-01690-1

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  • DOI: https://doi.org/10.1007/s40520-020-01690-1

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