지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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초록· 키워드
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Objective : Postoperative delirium is a common complication in the elderly after surgery but few papers have reported after spinal surgery. We analyzed various risk factors for postoperative delirium after spine surgery. Methods : Between May 2012 and September 2013, 70 patients over 60 years of age were examined. The patients were divided into two groups : Group A with delirium and Group B without delirium. Cognitive function was examined with the Mini-Mental State Examination-Korea (MMSE-K), Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Information was also obtained on the patients' education level, underlying diseases, duration of hospital stay and laboratory findings. Intraoperative assessment included Bispectral index (BIS), type of surgery or anesthesia, blood pressure, fluid balance, estimated blood loss and duration of surgery. Results : Postoperative delirium developed in 17 patients. The preoperative scores for the MMSE, CDR, and GDS in Group A were $19.1{\pm}5.4$, $0.9{\pm}0.6$, and $3.3{\pm}1.1$. These were significantly lower than those of Group B ($25.6{\pm}3.4$, $0.5{\pm}0.2$, and $2.1{\pm}0.7$) (p<0.05). BIS was lower in Group A ($30.2{\pm}6.8$ compared to $35.4{\pm}5.6$ in group B) (p<0.05). The number of BIS <40 were $5.1{\pm}3.1$ times in Group A, $2.5{\pm}2.2$ times in Group B (p<0.01). In addition, longer operation time and longer hospital stay were risk factors. Conclusion : Precise analysis of risk factors for postoperative delirium seems to be more important in spinal surgery because the surgery is not usually expected to have an effect on brain function. Although no risk factors specific to spinal surgery were identified, the BIS may represent a valuable new intraoperative predictor of the risk of delirium.
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참고문헌 (34)
참고문헌 신청
American Psychiatric Association / 2013 / Diagnostic and Statistical Manual of Mental Disorders / American Psychiatric Association
Boos GL / 2005 / Postoperative cognitive dysfunction : prevalence and associated factors / Rev Bras Anestesiol 55:517~524
Cerejeira J / 2010 / The neuroinflammatory hypothesis of delirium / Acta Neuropathol 119:737~754
Chan MT / 2013 / CODA Trial Group : BIS-guided anesthesia decreases postoperative delirium and cognitive decline / J Neurosurg Anesthesiol 25:33~42
Deiner S / 2009 / Postoperative delirium and cognitive dysfunction. / Br J Anaesth 103(Suppl 1):i41~i46
Boos GL / 2005 / Postoperative cognitive dysfunction : prevalence and associated factors / Rev Bras Anestesiol 55:517~524
Cerejeira J / 2010 / The neuroinflammatory hypothesis of delirium / Acta Neuropathol 119:737~754
Chan MT / 2013 / CODA Trial Group : BIS-guided anesthesia decreases postoperative delirium and cognitive decline / J Neurosurg Anesthesiol 25:33~42
Deiner S / 2009 / Postoperative delirium and cognitive dysfunction. / Br J Anaesth 103(Suppl 1):i41~i46
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