Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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Postoperative delirium after cholecystectomy in older patients: A retrospective study

  • Young Mok Park (Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Hyung Il Seo (Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Byeong Gwan Noh (Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Suk Kim (Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Seung Baek Hong (Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Nam Kyung Lee (Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Dong Uk Kim (Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Sung Yong Han (Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine)
  • Received : 2023.01.26
  • Accepted : 2023.04.05
  • Published : 2023.08.31
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Abstract

Backgrounds/Aims: Postoperative delirium (POD) is a common complication that increases mortality and morbidity in older patients. This study aimed to evaluate the clinical significance of post-cholecystectomy delirium in older patients. Methods: This retrospective study included 201 patients aged > 75 years who underwent cholecystectomy for acute or chronic cholecystitis between January 2016 and December 2019. Patients were divided into the POD (n = 21) and non-POD (n = 180) groups, and their demographic features and clinical results were compared. Results: The mean patient age was 78.88 years; the female/male ratio was 44.8%/55.2%. Laparoscopic surgery was performed in 93.5% of patients. The univariate analysis showed that lower body mass index (BMI), immobilized admission status, neuropsychiatric disease history, preoperative intervention (percutaneous drainage), high C-reactive protein, hypoalbuminemia, neutrophilia, hypo-/hyperkalemia, and longer operative time were more frequently observed in the POD group. The multivariate analysis showed that lower BMI (odds ratio [OR], 2.796; p = 0.024), neuropsychiatric disease history (OR, 3.019; p = 0.049), hyperkalemia (OR, 5.972; p = 0.007), and longer operative time (OR, 1.011; p = 0.013) were significant risk factors for POD. Conclusions: POD was associated with inflammation degree, general condition, poor nutritional status, electrolyte imbalance, and stressful conditions. Recognizing risk factors requiring multidisciplinary team approaches is important to prevent and treat POD.

Keywords

Acknowledgement

This work was supported by clinical research grant from Pusan National University Hospital in 2022.

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