title: Postoperative Delirium in Patients after Pancreaticoduodenectomy.
abstract: OBJECTIVE
  Postoperative delirium (POD) is one of the most common complications after various types of surgery. The aim of this study was to investigate the incidence and risk factors for delirium after pancreaticoduodenectomy (PD).
  
  
  METHODS
  This was a retrospective study of 146 consecutive patients who underwent PD between April 2007 and June 2015 at Saiseikai Yokohamashi Tobu Hospital.
  
  
  RESULTS
  Twenty-nine patients (19.9%) were diagnosed with delirium. Patients who were >70 years were divided into a delirium group (n = 24) and a non-delirium group (n = 41). Multivariate analysis showed that only the Charlson Age Comorbidity Index (CACI) (OR 1.8; 95% CI 1.067-3.036; p = 0.028) was an independent risk factor of delirium for patients >70 years. The receiver operating characteristic curve revealed an optimal cutoff value of 4.5 for the CACI score in all patients (sensitivity 62.1%; specificity 82.9%; area under the curve 0.782). The higher CACI score (≥5) is significantly different from the lower CACI score (p < 0.0001) with respect to POD occurrence.
  
  
  CONCLUSIONS
  The CACI, especially in elderly patients, was associated with the incidence of POD. Therefore, utilizing this validated and practical tool preoperatively might be useful for POD.
authors.affiliation: Department of Surgery, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ito
authors.forename: Yuta
authors.initials: Y
authors.lastname: Abe
authors.forename: Kan
authors.initials: K
authors.lastname: Handa
authors.forename: Shintaro
authors.initials: S
authors.lastname: Shibutani
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Egawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nagashima
authors.forename: Minoru
authors.initials: M
authors.lastname: Kitago
authors.forename: Osamu
authors.initials: O
authors.lastname: Itano
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001661:Biliary Tract Neoplasms / Q000601:surgery*; D015897:Comorbidity; D003693:Delirium / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology*; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors