AAA, Aortic Aneurysm, Abdominal, Delirium, Intensive Care Unit Delirium, Surgery, Surgery--Complications
Conditions
Keywords
delirium, intensive care unit, surgical ward, abdominal aortic aneurysm surgery
Brief summary
The incidence of delirium following open abdominal aortic aneurysm (AAA) surgery is significant, with incidence rates ranging from 12 to 33%. The occurrence of delirium on the surgical ward after intensive care unit (ICU) dismissal in AAA patients remains unclear. Differences in outcomes between a delirium on the ICU and a delirium on the surgical ward have not been previously investigated. Delirium is a frequent complication in patients who underwent open AAA surgery. This study demonstrated that patients on the surgical ward remain at risk for developing a delirium after ICU dismissal. Physicians should therefore maintain a high level of awareness for delirium in AAA patients who return to the surgical ward after ICU dismissal. This simultaneously emphasises the necessity of delirium preventive measures and early recognition on the surgical ward in order to improve clinical outcomes.
Detailed description
The incidence of delirium following open abdominal aortic aneurysm (AAA) surgery is significant, with incidence rates ranging from 12 to 33%. The occurrence of delirium on the surgical ward after intensive care unit (ICU) dismissal in AAA patients remains unclear. Differences in outcomes between a delirium on the ICU and a delirium on the surgical ward have not been previously investigated. An observational cohort study was conducted that included all patients treated electively for an abdominal aortic aneurysm (AAA) by open repair and patients undergoing emergency treatment for a ruptured AAA between 2013 and 2018. The diagnosis of delirium was verified by a psychiatrist or geriatrician using the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria. Cox proportional hazards regression analysis was used to analyse 6- and 12-months survival rate.
Interventions
OTHERSurgery
All patients treated electively for an abdominal aortic aneurysm (AAA) by open repair and patients undergoing emergency treatment for a ruptured AAA between 2013 and 2018.
Sponsors
Amphia Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* All patients treated electively for an abdominal aortic aneurysm (AAA) by open repair and patients undergoing emergency treatment for a ruptured AAA between 2013 and 2018.
Exclusion criteria
* Patients that did not survive surgery * Patients that did not go to the intensive care unit postoperatively.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the incidence of delirium | between january 2013 and december 2018 | The incidence of delirium on the ICU and on the ward |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| mortality | 6 months and 12 months | mortality divided by ICU delirium and ward delirium |
Other
| Measure | Time frame | Description |
|---|---|---|
| Reoperations | Data on re-interventions, readmissions and survival were collected until February 2019. | Reoperations within 30 days after surgery |
| Length of hospital stay | Data on re-interventions, readmissions and survival were collected until February 2019. | Length of hospital stay in days |
| Discharge to a nursing home | Data on re-interventions, readmissions and survival were collected until February 2019. | Discharge to a nursing home |
| Complications | Data on re-interventions, readmissions and survival were collected until February 2019. | Complications within 30 days after surgery |
| Length of ICU stay | Data on re-interventions, readmissions and survival were collected until February 2019. | Length of ICU stay in days |
Countries
Netherlands
Outcome results
None listed