Acute postoperative confusion and hallucinations in Parkinson disease.
OBJECTIVE
To determine whether patients with Parkinson disease are at an increased risk for postoperative confusion.


METHODS
Retrospective chart review of patients with Parkinson disease who remained in the hospital at least 48 hours after their surgery. Current data were compared with published historical controls.


METHODS
Recent medical records of a university-affiliated hospital, Veterans Administration hospital, and community hospital.


METHODS
Available charts of patients with Parkinson disease who had had surgery in the last 2 years. Patients were excluded if they were disoriented at admission or had serious metabolic disturbances.


RESULTS
Fifteen of twenty-five postoperative patients with Parkinson disease (60%; CI, 39% to 78%) suffered significant acute confusion, and 9 of these patients had documented hallucinations. Neuropsychiatric changes were frequently delayed after surgery. The acute confusional state lasted an average 2.5 days; several patients, however, were discharged before resolution. These disturbances did not appear to be related to type of anti-parkinsonian medication or anesthetic.


CONCLUSIONS
In comparison with historical controls, the relative risk of patients with Parkinson disease having an acute postoperative confusional state is between 2.8 and 8.1. These patients may need environmental supports during the postoperative period.
Golden
W E
WE
University of Arkansas for Medical Sciences, Little Rock.
Lavender
R C
RC
Metzer
W S
WS
D000368:Aged; D000369:Aged, 80 and over; D002230:Carbidopa / Q000627:therapeutic use; D003072:Cognition Disorders / Q000209:etiology*; D003221:Confusion / Q000209:etiology*; D004338:Drug Combinations; D005260:Female; D006212:Hallucinations / Q000209:etiology*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology*; D011183:Postoperative Complications / Q000523:psychology*; D012189:Retrospective Studies; D012306:Risk
D004338:Drug Combinations; D007980:Levodopa; D002230:Carbidopa