title: Risk Factors for Postoperative Delirium in Abdominal Surgery: A Proposal of a Postoperative Delirium Risk Score in Abdominal Surgery.
abstract: OBJECTIVE
  Despite the presence of several diagnosis scales for delirium, no prediction scale that is specific for postoperative delirium after abdominal surgery is available. We sought to create a novel delirium prediction system that is specific for abdominal surgery.
  
  
  METHODS
  This study included 213 consecutive patients who required management in the surgical ICU following abdominal surgery. The Neelon and Champagne (NEECHAM) Confusion score was monitored throughout the postoperative course and patients with low NEECHAM score (≤26) were diagnosed as having delirium.
  
  
  RESULTS
  Seventy-three patients (34%) were categorized in the delirium group. Multivariate analyses indicated that an age >70 years, hypertension, those undergoing hepatopancreatobiliary or upper gastrointestinal surgeries, a serum albumin level <2.5 g/dl on postoperative day (POD) 3 or 5 and a ≥6 mEq/l gap in the serum sodium level between the preoperative value and that on POD 3 were independently associated with a low NEECHAM score (≤26). When the presence of each risk was counted as 1 point, 21 patients had ≥4 points and 15 of them (71%) had low NEECHAM score.
  
  
  CONCLUSIONS
  The scoring system combining multiple risk factors may be useful for predicting patients with an elevated risk for postoperative delirium after abdominal surgery.
authors: Department of Hospital Pharmacy, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Yasuhiro
authors: Y
authors: Miyagawa
authors: Yukihiro
authors: Y
authors: Yokoyama
authors: Shota
authors: S
authors: Fukuzawa
authors: Shinji
authors: S
authors: Fukata
authors: Masahiko
authors: M
authors: Ando
authors: Takashi
authors: T
authors: Kawamura
authors: Kiyofumi
authors: K
authors: Yamada
authors: Masato
authors: M
authors: Nagino
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D003693:Delirium / Q000453:epidemiology* / Q000209:etiology; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012964:Sodium / Q000097:blood; D055815:Young Adult
chemical_list: D012709:Serum Albumin; D012964:Sodium