title: Effects of Intraoperative Hemodynamics on Incidence of Postoperative Delirium in Elderly Patients: A Retrospective Study.
abstract: BACKGROUND
  Postoperative delirium (POD) is a common complication in the elderly. This retrospective study investigated the effect of intraoperative hemodynamics on the incidence of POD in elderly patients after major surgery to explore ways to reduce the incidence of POD.
  
  
  METHODS
  Based on the incidence of POD, elderly patients (81±6 y) were assigned to a POD (n=137) or non-POD group (n=343) after elective surgery with total intravenous anesthesia. POD was diagnosed based on the guidelines of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), using the confusion assessment method. The hemodynamic parameters, such as mean arterial pressure, were monitored 10 min before anesthesia (baseline) and intraoperatively. The incidence of intraoperative hypertension, hypotension, tachycardia, and bradycardia were calculated.
  
  
  RESULTS
  At 30 min and 60 min after the initiation of anesthesia and at the conclusion of surgery, the monitored hemodynamic parameter values of the POD group, but not those of the non-POD group, were significantly higher than at baseline. Multivariate logistic regression analysis showed that intraoperative hypertension and tachycardia were significantly associated with POD.
  
  
  CONCLUSIONS
  Intraoperative hypertension and tachycardia were significantly associated with POD. Maintaining intraoperative stable hemodynamics may reduce the incidence of POD in elderly patients undergoing surgery.
authors.affiliation: Department of Nerve Electroneurophysiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland).
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland).
authors.forename: De-feng
authors.initials: DF
authors.lastname: Sun
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland).
authors.forename: Jun
authors.initials: J
authors.lastname: Han
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland).
authors.forename: Ruochuan
authors.initials: R
authors.lastname: Liu
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland).
authors.forename: Li-jie
authors.initials: LJ
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland).
authors.forename: Zhen-zhen
authors.initials: ZZ
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000494:pharmacology; D000777:Anesthetics / Q000494:pharmacology; D003693:Delirium / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D003710:Demography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D015994:Incidence; D007430:Intraoperative Care; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000700:Analgesics; D000777:Anesthetics