title: Pre- and Intraoperative Predictors of Delirium after Open Abdominal Aortic Aneurysm Repair.
abstract: OBJECTIVE
  We reviewed our series of patients who underwent open abdominal aortic aneurysm (AAA) repair and constructed a prediction model for postoperative delirium.
  
  
  METHODS
  397 patients who underwent open AAA repair at our institution between April 2005 and June 2013 were retrospectively reviewed. Postoperative delirium was diagnosed from the patients' medical records according to the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) criteria. Mental alterations resulting from postoperative cerebrovascular events or preexisting mental disorders were excluded. Parameters with significant differences on univariate analysis were subjected to a logistic regression analysis.
  
  
  RESULTS
  There were 46 patients (11.5%) diagnosed with postoperative delirium. The following parameters were significant in the univariate analysis: age, history of stroke, hyperlipidemia, forced expiratory volume in 1 s (FEV1), percent vital capacity (%VC), and blood urea nitrogen (BUN) level. A logistic regression analysis revealed that an age ≥70 years (odds ratio [95% confidence interval], 3.342 [1.437-7.774]), blood loss ≥1517 mL (2.707 [1.359-5.391]), and the absence of hyperlipidemia (2.154 [1.060-4.374]) were significant risk factors.
  
  
  CONCLUSIONS
  Older patients with substantial intraoperative blood loss require highly vigilant postoperative care. Further studies are necessary to elucidate the relationship between cholesterol and delirium.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sugimoto
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Kodama
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Narita
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Banno
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Komori
keywords: abdominal aortic aneurysm; delirium; open repair