Incidence and Risk Factors of Postoperative Delirium following Pancreatic Surgery: Does the Administration of TJ-54 Reduce the Incidence of Delirium.
OBJECTIVE
To clarify the incidence and risk factors of postoperative delirium in patients following pancreatic surgery, and the impact of yokukansan (TJ-54) administered to reduce delirium.


METHODS
Fifty-nine consecutive patients who underwent pancreatic surgery (2012.4-2013.5) were divided into 2 groups: TJ-54 group: patients who received TJ-54 (n = 21) due to insomnia and the No-TJ-54 group: patients who did not receive TJ-54 (n = 38), and the medical records including the delirium rating scale - Japanese version (DRS-J) were retrospectively reviewed.


RESULTS
Postoperative delirium occurred in 2 patients (9.5%) in the TJ-54 group and in 4 (10.5%) patients in the No-TJ-54 group (p = 0.90). The DRS-J on 5 days after surgery was lower in the TJ-54 group than in the No-TJ-54 group (rough p = 0.006), however, without any statistically significant differences with the Bonferroni correction. As for the hospital cost, there was no difference between the TJ-54 and the No-TJ-54 groups (p = 0.78). History of delirium was identified as an independent risk factor of postoperative delirium.


CONCLUSIONS
The patients with preoperative insomnia, who were treated with TJ-54, did not have a higher incidence of postoperative delirium, compared to those without preoperative insomnia. The patients who had a history of delirium have an increased risk of postoperative delirium and should be cared for and treated prophylactically to prevent it.
Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University School of Medicine, Tsu, Japan.
Shugo
S
Mizuno
Sachie
S
Takeuchi
Masashi
M
Kishiwada
Noriko
N
Mizutani
Mikiko
M
Matsuda
Noriko
N
Sekoguchi
Yusuke
Y
Iizawa
Yoshinori
Y
Azumi
Naohisa
N
Kuriyama
Masanobu
M
Usui
Hiroyuki
H
Sakurai
Kazuo
K
Maruyama
Masahiro
M
Okuda
Motohiro
M
Okada
Shuji
S
Isaji
D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002491:Central Nervous System Agents / Q000627:therapeutic use*; D003693:Delirium / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D002491:Central Nervous System Agents; D004365:Drugs, Chinese Herbal; C524644:Yi-Gan San
Delirium rating scale – Japanese version; Pancreatic surgery; Postoperative delirium; Yokukansan (TJ-54)