https://scholars.lib.ntu.edu.tw/handle/123456789/477423
標題: | Pre-surgical Geriatric Syndromes, Frailty, and Risks for Postoperative Delirium in Older Patients Undergoing Gastrointestinal Surgery: Prevalence and Red Flags | 作者: | CHERYL CHIA-HUI CHEN MING-TSAN LIN JIN-TUNG LIANG Chen C.-M. CHUNG-JEN YEN Huang G.-H. |
公開日期: | 2015 | 出版社: | Springer New York LLC | 卷: | 19 | 期: | 5 | 起(迄)頁: | 927-934 | 來源出版物: | Journal of Gastrointestinal Surgery | 摘要: | Objective: We sought to identify and evaluate red flags for pre-surgical geriatric conditions (geriatric syndromes, frailty, and risks for postoperative delirium) in older patients undergoing gastrointestinal surgery. Methods: Older individuals (?65?years) undergoing major elective gastrointestinal surgery from 2009 to 2012 were enrolled and assessed preoperatively. Results: Participants (N = 379; mean age = 74.5 ± 5.9?years) primarily underwent colorectal (54.3?%), gastric (21.9?%), and pancreatobiliary (12.6?%) surgery. Overall, 30.9?% had existing geriatric syndromes, 26.7?% were frail, and 22.8?% had >3 risk factors for postoperative delirium. The largest proportion (45.7?%) presented with at least one geriatric condition. Patients with or without geriatric conditions were discriminated with adequate sensitivity (67?%), specificity (84?%), and positive predictive value (77?%) by eight red flags: age ?75?years (OR, 2.86; P < 0.001), eating soft food (OR, 3.63; P = 0.001), reported hypertension (OR, 2.8; P = 0.001), weight loss >3?kg (OR, 4.79; P < 0.001), fair-to-weak grip strength (OR, 2.53; P = 0.001), sleeplessness (OR, 2.57; P = 0.001), no-better-than-peer perceived health (OR, 1.88; P = 0.022), and short-term inability to recall two of three common words (OR, 1.81; P = 0.025). Conclusions: Eight red flags covered as part of history and physical examination are well suited to screen patients for geriatric conditions indicating the need for preoperative geriatric assessments and optimization. ? 2015, The Society for Surgery of the Alimentary Tract. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84928668953&doi=10.1007%2fs11605-015-2760-0&partnerID=40&md5=06515f624c19bd9e7f26942ccef0c216 https://scholars.lib.ntu.edu.tw/handle/123456789/477423 |
ISSN: | 1091-255X | DOI: | 10.1007/s11605-015-2760-0 | SDG/關鍵字: | abdominal surgery; adverse effects; aged; delirium; elective surgery; female; frail elderly; geriatric assessment; human; male; Postoperative Complications; prevalence; risk assessment; syndrome; Aged; Delirium; Digestive System Surgical Procedures; Elective Surgical Procedures; Female; Frail Elderly; Geriatric Assessment; Humans; Male; Postoperative Complications; Prevalence; Risk Assessment; Syndrome |
顯示於: | 醫學系 |
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