{"title":"Prediction of Postoperative Delirium after Gastrointestinal Surgery Using the Mie Constructional Apraxia Scale.","authors":"Yosuke Tenpaku, Masayuki Satoh, Kenji Kato, Kazuhisa Fujinaga, Yuji Haruki, Hiroki Nakahashi, Keisuke Morikawa, Yasunori Imaoka, Hiroyuki Takemura, Hiroshi Tatsumi","doi":"10.1159/000520249","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium (POD) is a transient postoperative complication that occurs after surgical procedures. Risk factors reported for POD include dementia and cognitive decline. The purpose of this study was to identify predictors of POD by examining the use of preoperative neuropsychological tests, including the Mie Constructional Apraxia Scale (MCAS), and patient background factors.</p><p><strong>Method: </strong>The study was performed as a retrospective cohort study. The subjects were 33 patients (mean age, 75.8 ± 10.9 years; male:female ratio, 26:7) who underwent gastrointestinal surgery at Matsusaka City Hospital between December 2019 and April 2021. Data were collected retrospectively from medical records. The study was started after receiving approval from the institution's ethics committee. The survey items included general patient information, nutritional assessment, surgical information, and neuropsychological tests. Subjects were classified into 2 groups according to the presence or absence of POD. If a significant difference was observed between the 2 groups, the sensitivity, specificity, and area under the curve were calculated using a receiver operating characteristic (ROC) curve.</p><p><strong>Result: </strong>There were 10 patients in the POD group (male:female ratio, 6:4) and 23 patients in the non-POD group (20:3). The POD group had a shorter education history (<i>p</i> = 0.047) and significantly higher MCAS scores (<i>p</i> = 0.007) than the non-POD group. The ROC curve showed a sensitivity of 90%, a specificity of 69%, and an area under the curve of 0.798 when the MCAS cutoff value was set at 3 points.</p><p><strong>Conclusion: </strong>Preoperative MCAS results were capable of predicting the occurrence of POD after gastrointestinal surgery. In addition, a relatively short education background was also considered a risk factor for POD.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"11 3","pages":"306-313"},"PeriodicalIF":1.4000,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/12/dee-0011-0306.PMC8740234.pdf","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Dementia and Geriatric Cognitive Disorders Extra","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000520249","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/9/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 1
Abstract
Background: Postoperative delirium (POD) is a transient postoperative complication that occurs after surgical procedures. Risk factors reported for POD include dementia and cognitive decline. The purpose of this study was to identify predictors of POD by examining the use of preoperative neuropsychological tests, including the Mie Constructional Apraxia Scale (MCAS), and patient background factors.
Method: The study was performed as a retrospective cohort study. The subjects were 33 patients (mean age, 75.8 ± 10.9 years; male:female ratio, 26:7) who underwent gastrointestinal surgery at Matsusaka City Hospital between December 2019 and April 2021. Data were collected retrospectively from medical records. The study was started after receiving approval from the institution's ethics committee. The survey items included general patient information, nutritional assessment, surgical information, and neuropsychological tests. Subjects were classified into 2 groups according to the presence or absence of POD. If a significant difference was observed between the 2 groups, the sensitivity, specificity, and area under the curve were calculated using a receiver operating characteristic (ROC) curve.
Result: There were 10 patients in the POD group (male:female ratio, 6:4) and 23 patients in the non-POD group (20:3). The POD group had a shorter education history (p = 0.047) and significantly higher MCAS scores (p = 0.007) than the non-POD group. The ROC curve showed a sensitivity of 90%, a specificity of 69%, and an area under the curve of 0.798 when the MCAS cutoff value was set at 3 points.
Conclusion: Preoperative MCAS results were capable of predicting the occurrence of POD after gastrointestinal surgery. In addition, a relatively short education background was also considered a risk factor for POD.
期刊介绍:
This open access and online-only journal publishes original articles covering the entire spectrum of cognitive dysfunction such as Alzheimer’s and Parkinson’s disease, Huntington’s chorea and other neurodegenerative diseases. The journal draws from diverse related research disciplines such as psychogeriatrics, neuropsychology, clinical neurology, morphology, physiology, genetic molecular biology, pathology, biochemistry, immunology, pharmacology and pharmaceutics. Strong emphasis is placed on the publication of research findings from animal studies which are complemented by clinical and therapeutic experience to give an overall appreciation of the field. Dementia and Geriatric Cognitive Disorders Extra provides additional contents based on reviewed and accepted submissions to the main journal Dementia and Geriatric Cognitive Disorders Extra .