Abstract:
BACKGROUND:Postoperative delirium is one of the most common complications in the elderly surgical population. However, its long-term outcomes remain largely to be determined. Therefore a prospective cohort study was conducted to determine the association between postoperative delirium and long-term decline in activities of daily living and postoperative mortality. The hypothesis in the present study was that postoperative delirium was associated with a greater decline in activities of daily living and higher mortality within 24 to 36 months after anesthesia and surgery. METHODS:The participants (at least 65 yr old) having the surgeries of (1) proximal femoral nail, (2) hip replacement, or (3) open reduction and internal fixation under general anesthesia were enrolled. The Confusion Assessment Method algorithm was administered to diagnose delirium before and on the first, second, and fourth days after the surgery. Activities of daily living were evaluated by using the Chinese version of the activities of daily living scale (range, 14 to 56 points), and preoperative cognitive function was assessed by using the Chinese Mini-Mental State Examination (range, 0 to 30 points). The follow-up assessments, including activities of daily living and mortality, were conducted between 24 and 36 months after anesthesia and surgery. RESULTS:Of 130 participants (80 ± 6 yr, 24% male), 34 (26%) developed postoperative delirium during the hospitalization. There were 32% of the participants who were lost to follow-up, resulting in 88 participants who were finally included in the data analysis. The participants with postoperative delirium had a greater decline in activities of daily living (16 ± 15 vs. 9 ± 15, P = 0.037) and higher 36-month mortality (8 of 28, 29% vs. 7 of 75, 9%; P = 0.009) as compared with the participants without postoperative delirium. CONCLUSIONS:Postoperative delirium was associated with long-term detrimental outcomes, including greater decline in activities of daily living and a higher rate of postoperative mortality.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Shi Z,Mei X,Li C,Chen Y,Zheng H,Wu Y,Zheng H,Liu L,Marcantonio ER,Xie Z,Shen Ydoi
10.1097/ALN.0000000000002849subject
Has Abstractpub_date
2019-09-01 00:00:00pages
492-500issue
3eissn
0003-3022issn
1528-1175journal_volume
131pub_type
杂志文章相关文献
ANESTHESIOLOGY文献大全abstract::The goal of this randomized study of high-risk surgical patients was to determine whether intraoperative thoracic epidural anesthesia in combination with light general anesthesia alters postoperative morbidity when compared to a standard technique of "balanced" general anesthesia. A total of 173 patients scheduled for...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199110000-00010
更新日期:1991-10-01 00:00:00
abstract:AIMS:Helium protects myocardium by inducing preconditioning in animals. We investigated whether human endothelium is preconditioned by helium inhalation in vivo. METHODS AND RESULTS:Forearm ischemia-reperfusion (I/R) in healthy volunteers (each group n = 10) was performed by inflating a blood pressure cuff for 20 min....
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3182751300
更新日期:2013-01-01 00:00:00
abstract::Perioperative myocardial ischemia is associated with an increased risk of perioperative myocardial infarction (PMI). Several attempts have been made to define intraoperative hemodynamic predictors of myocardial ischemia. In a canine preparation with coronary stenosis, a pressure rate quotient (PRQ = mean arterial pres...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199105000-00008
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:High-fidelity simulation is known to improve participant learning and behavioral performance. Simulation scenarios generate stress that affects memory retention and may impact future performance. The authors hypothesized that more participants would recall three or more critical key messages at three months ...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0000000000002045
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Approximate entropy, a measure of signal complexity and regularity, quantifies electroencephalogram changes during anesthesia. With increasing doses of anesthetics, burst-suppression patterns occur. Because of the high-frequency bursts, spectrally based parameters such as median electroencephalogram frequenc...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-200010000-00018
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Identifying functionally relevant anesthetic-binding sites in pentameric ligand-gated ion channels (pLGICs) is an important step toward understanding the molecular mechanisms underlying anesthetic action. The anesthetic propofol is known to inhibit cation-conducting pLGICs, including a prokaryotic pLGIC from...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000001005
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Neuroligin-1 (NL1) forms a complex with the presynaptic neurexin-1β (Nrx1b), regulating clustering of N-methyl-D-aspartate receptors with postsynaptic density-95 (PSD-95) to underlie learning-/memory-associated plasticity. Pain-related spinal neuroplasticity shares several common features with learning-/memo...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000809
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Ventilator-associated pneumonia (VAP) requires early diagnosis and adequate antibiotic therapy. The aim of this prospective postmortem study was to assess the accuracy of direct examination and quantification of intracellular organisms (ICO) for the diagnosis of VAP. METHODS:Total and differential cell coun...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199708000-00013
更新日期:1997-08-01 00:00:00
abstract::To determine whether administration of nitrous oxide, 50% and 70%, could provide analgesia and anxiolysis during venous cannulation in pediatric patients, 165 ASA Physical Status 1 patients scheduled for elective surgery were studied. Children, 3 weeks to 18 yr of age, were randomly assigned either to receive nitrous ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199002000-00010
更新日期:1990-02-01 00:00:00
abstract:BACKGROUND:Recent studies have questioned the importance of the gravitational model of pulmonary perfusion. Because low levels of positive end-expiratory pressure (PEEP) are commonly used during anesthesia, the authors studied the distribution of pulmonary blood flow with low levels of PEEP using a high spatial resolut...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199805000-00021
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Initial anesthetic-induced hypothermia results largely from core-to-peripheral redistribution of heat. Nifedipine administration may minimize hypothermia by inducing vasodilation well before induction of anesthesia. Although vasodilation would redistribute heat to peripheral tissues, thermoregulatory respons...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199401000-00019
更新日期:1994-01-01 00:00:00
abstract::Neurophysiologic and local cerebral metabolic mapping techniques indicate that seizures associated with lidocaine toxicity originate in subcortical brain structures. Normally local cerebral blood flow (l-CBF) is quantitatively coupled to local cerebral metabolic rate for glucose (l-CMRg). In the present study the resp...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198606000-00016
更新日期:1986-06-01 00:00:00
abstract::The aim of the study was to establish whether there exists a relationship between blood methadone concentration and analgesic response and the intrasubject and intersubject variability in this relationship. Sixteen general surgical (upper abdominal) and orthopedic (spinal fusion) patients were administered methadone (...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:The chemokine family has been revealed to be involved in the pathogenesis of neuropathic pain. In this study, the authors investigated the role of chemokine (C-C motif) ligand 3 and its receptors chemokine (C-C motif) receptor 1 and chemokine (C-C motif) receptor (CCR) 5 in neuropathic pain. METHODS:A spina...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000190
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:The most sensitive diagnostic criterion of myasthenia gravis is a decrement in the muscular response to repetitive stimulation. The authors hypothesized that myasthenia gravis patients who show a train-of-four ratio (T4/T1) < 0.9 in the preanesthetic period will have increased sensitivity to nondepolarizing ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200008000-00011
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Single lung transplantation has become a viable therapy for treatment of end-stage pulmonary disease. We previously observed that left lung autotransplantation (LLA) results in a chronic increase in pulmonary vascular resistance and enhanced pulmonary vascular reactivity to sympathetic alpha adrenoreceptor a...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199609000-00019
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:The authors report on the appearance of misleading square wave "phantom" capnograph tracings for approximately 3 min after disconnection from the Siemens Servo 900c ventilator. A series of experiments are described to examine the mechanism of this phenomenon. METHODS:Patients were ventilated using the Sieme...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199703000-00026
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Previous studies integrated opioid benefit and harm into one single function-the utility function-to determine the drug toxicity (respiratory depression) in light of its wanted effect (analgesia). This study further refined the concept of the utility function using the respiratory and analgesic effects of th...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002138
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Acid aspiration into one lung causes contralateral lung injury and systemic organ injury; this injury is thought to be mediated by the sequestration of activated neutrophils. Recombinant human soluble complement receptor 1 (sCR1) inhibits both the classical and alternative complement pathways; this study inv...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199611000-00021
更新日期:1996-11-01 00:00:00
abstract::Cognitive performance in postsurgical patients may be impaired by disturbances of normal circadian rhythm analogous to those produced by rapid transmeridian travel ("jet lag"). We therefore tested the hypothesis that isoflurane anesthesia alone produces a phase-delay in the human circadian temperature rhythm. We monit...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199112000-00010
更新日期:1991-12-01 00:00:00
abstract::The pattern of breathing and lung mechanics were evaluated during the first 7 h of life in full-term healthy newborns delivered by cesarean section with bupivacaine epidural anesthesia, without (group 1) or with the addition of 100 micrograms of fentanyl (group 2). Respiration and oxyhemoglobin saturation (SpO2) were ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-199012000-00007
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:Days alive and out of hospital is a potentially useful patient-centered quality measure for perioperative care in adult surgical patients. However, there has been very limited prior validation of this endpoint with respect to its ability to capture differences in patient-level risk factor profiles and longer...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002701
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Although the use of an anesthesiology "airway" rotation to train the nonanesthesiologist is commonly employed, little data exist on the utility, clinical exposure, and outcomes of these programs. METHODS:A prospectively collected observational dataset of airway procedures completed by trainees in a 4-week, ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000064
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Neural glial signaling in the spinal cord may underlie pain and sensitization after peripheral injury. The authors test the role of a glial activator, the chemokine (C-C motif) ligand 2 (CCL2), on mechanical hypersensitivity after plantar incision in a rat model of postoperative pain. METHODS:Twenty-four ho...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181d3d978
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:The dose-dependent myocardial depression of volatile general anesthetics such as isoflurane has been linked to blockade of L-type Ca2+ channels. The effects of (+)- and (-)-isoflurane on the inhibition of [3H]isradipine binding to L-type Ca2+ channels in membranes prepared from mouse heart were examined. In ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199407000-00018
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Clinically used general anesthetics, alone or in combination, are damaging to the developing mammalian brain. In addition to causing widespread apoptotic neurodegeneration in vulnerable brain regions, exposure to general anesthesia at the peak of synaptogenesis causes learning and memory deficiencies later i...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3182303a63
更新日期:2011-11-01 00:00:00
abstract::Measurement of serum fentanyl and alfentanil concentrations by radioimmunoassay (RIA) may result in significant errors and high variability when the technique described in the available fentanyl and alfentanil RIA kits is used. The authors found a 29-94% overestimation of measured fentanyl and alfentanil serum levels ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198409000-00010
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:A relatively small number of inhibitory interneurons can control the excitability and synchronization of large numbers of pyramidal cells in hippocampus and other cortical regions. Thus, anesthetic modulation of interneurons could play an important role for the maintenance of anesthesia. The aim of this stud...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200102000-00025
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:Initial postoperative core temperature is a physician and hospital performance measure. However, the extent to which core temperature changes during emergence from anesthesia and transport from the operating room to the postanesthesia care unit (PACU) remains unknown. Similarly, the accuracy of many noninvas...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181a864ca
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Volatile anesthetics such as isoflurane are widely used in clinical and research contexts. Concerns have been raised that the effects of these drugs on the central nervous system may result in long-term impairment after surgery or general anesthesia. Hence, this study aimed to detect how different isoflurane...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181f79c7c
更新日期:2010-11-01 00:00:00