Delirium Clinical Trial
Official title:
The Comparison of Sugammadex and Conventional Cholinesterase Inhibitor on the Aspect of Postoperative Delirium in the Elderly Patients Undergoing Hip Surgery
This study evaluated the effect of sugammadex on postoperative delirium in elderly patients
undergoing hip fracture surgery.
Medical records from 235 consecutive patients undergoing hip fracture surgery were
retrospectively reviewed and total 61 patients were excluded for age under 60 years,
preoperative neurologic problem. Finally total 174 patients aged over 60 years undergoing
hip fracture surgery with general anaesthesia using a neuromuscular blocking agent from 2012
to 2014 at a university hospital were analyzed to compare perioperative incidence of
postoperative delirium, pulmonary complications, intensive care unit (ICU) admission, and
ICU and hospital stay duration and laboratory findings between patients treated with
sugammadex (S group) and conventional cholinesterase inhibitors (C group).
Study population The medical records of patients undergoing hip surgery under general
anaesthesia with neuromuscular blocking agents at Konkuk University Medical Center from
February 2012 to August 2014 review.
The patients were divided according to use (S group) or not (C group) of sugammadex for
recovery from neuromuscular blocking agent.
exclusion criteria
1. age < 60 years
2. preoperative neurologic or psychological problem including dementia, Parkinson's
disease or delirium
3. other concurrent surgery.
Assessment of postoperative delirium Evaluation of postoperative delirium was done in the
general ward or in the ICU by the responsible surgeon using commonly accepted delirium
symptoms in addition to the confusion assessment method (CAM) rating for delirium. Delirium
symptoms were defined as the presence of any of the following: acute onset and fluctuating
symptoms; inattention; speech disorganization; level of consciousness change;
disorientation; memory impairment; perceptual disturbance; abnormal psychomotor activity;
and altered sleep wake cycle. Incidence of postoperative delirium assess by medical records
review.
Postoperative clinical follow-up
By medical records review, the following clinical data were obtained:
transfusion amount of packed red blood cell during intraoperative period and up to
postoperative 24 hours postoperative visual analogue scale (VAS, ranging from 0 [no pain] to
100 [worst pain imaginable]) up to postoperative day 1; delayed extubation events up to
postoperative day 7; postoperative pulmonary complication [new onset abnormal findings in
postoperative chest radiography with pulmonary symptoms such as cough, sputum, dyspnea] up
to postoperative day 7; postoperative hypoxia [oxygen saturation on pulse oximeter < 95%] up
to postoperative 24 hours; the event of admission to ICU; duration of ICU stay; duration of
hospital stay. Perioperative laboratory findings, Haemoglobin (Hb), haematocrit (Hct), and
serum levels of total protein, albumin, aspartate aminotransferase (AST), alanine
aminotransferase (ALT), creatinine and high sensitivity C reactive protein (HS-CRP) during
intraoperative period and up to postoperative 24 hours were assessed by medical records
review.
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Observational Model: Cohort, Time Perspective: Retrospective
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