Ramelteon and suvorexant for postoperative delirium in elderly patients with esophageal cancer.

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Esophagus Pub Date : 2023-10-01 Epub Date: 2023-08-10 DOI:10.1007/s10388-023-01019-7

Shuhei Mayanagi, Ryoma Haneda, Masazumi Inoue, Kenjiro Ishii, Yasuhiro Tsubosa

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引用次数: 0

Abstract

Background: There is no clear evidence on the prevention of postoperative delirium with pharmacotherapy in elderly patients with esophageal cancer. This retrospective study aimed to evaluate the efficacy of ramelteon and suvorexant in preventing postoperative delirium in this patient group.

Methods: Data on 251 patients who received radical esophagectomy for thoracic esophageal cancer were collected from January 2010 to September 2021. In total, 74 patients did not receive preventive intervention, and 177 received ramelteon and suvorexant. After propensity score matching, the rate of postoperative delirium was compared between the two groups.

Results: Seventy-two well-balanced patients in each group demonstrated similar clinical and pathological characteristics. The mean ages of the intervention and control groups were 70.8 and 70.3 years, respectively. All the patients underwent McKeown esophagectomy, and in the volume of intraoperative blood loss or operative time did not significantly differ between the two groups. The incidence rates of postoperative hyperactive delirium were 7% (5/72) in the intervention group and 32% (23/72) in the control group (p < 0.001). No severe adverse event potentially attributable to the intervention drug was observed. The multivariate analysis showed that the use of ramelteon and suvorexant was the only independent protective factor against postoperative delirium (hazard ratio 0.157, 95% CI 0.055-0.448, p < 0.001).

Conclusions: Ramelteon and suvorexant may play an important role in reducing postoperative delirium in elderly patients with esophageal cancer.

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Ramelteon和suvorexant治疗老年癌症患者术后谵妄。

背景：没有明确的证据表明药物治疗可以预防老年癌症患者术后谵妄。这项回顾性研究旨在评估拉梅尔顿和舒己酮预防该患者组术后谵妄的疗效。方法：收集2010年1月至2021年9月收治的251例癌症胸段食管癌根治术患者的资料。总的来说，74名患者没有接受预防性干预，177名患者接受了拉美顿和舒福来。在倾向评分匹配后，比较两组患者术后谵妄的发生率。结果：每组72名平衡良好的患者表现出相似的临床和病理特征。干预组和对照组的平均年龄分别为70.8岁和70.3岁。所有患者均接受了麦基翁食管切除术，两组在术中失血量或手术时间方面没有显著差异。干预组术后过度活动性谵妄的发生率为7%（5/72），对照组为32%（23/72）（p 结论：Ramelteon和suvorexant可能在减少老年癌症患者术后谵妄中发挥重要作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Esophagus GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.90

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.