Confusion Postoperative, Delirium, Gastrointestinal Cancer, Nutritional Deficiency
Conditions
Keywords
confusion, delirium, gastrointestinal cancer, prognostic nutritional index
Brief summary
Aim: We aimed to show the relationship between preoperative prognostic nutritional index and postoperative delirium in patients who had undergone gastrointestinal cancer surgery. Materials and Methods: Our study is a single-center, prospective, observational study. Routine preoperative anesthesia evaluation of all patients was performed and patient's age, sex, ASA physical score, body mass index (BMI), existing comorbid diseases, level of education, smoking status, cancer diagnosis, chemotherapy and radiotherapy history, type of surgery, past invasive interventions, concentration of hemoglobin and albumin, lymphocyte count, liver and kidney function tests were recorded. PNI score was calculated with the preoperative measurements. With the calculated PNI score, nutritional status was defined as normal (PNI ≥50), mild malnutrition (PNI 45-50), moderate-severe malnutrition (PNI 40-45), and severe (PNI \<40) accordingly. The patients were then evaluated for the presence of delirium using the Confusion Assessment Method (CAM) for 3 days postoperatively.
Detailed description
Aim: Malnutrition, common among gastrointestinal cancer patients, affects morbidity and mortality. Prognostic nutritional index (PNI) is an inflammation-based scoring that measures the nutritional and immunological status of patients and has been used to determine prognosis and predict postoperative complications. Postoperative delirium (POD) describes a neurocognitive complication that may occur after surgery and anesthesia. Most of the studies examining the relationship between PNI and POD are retrospective and the number of prospective large case series are insufficient. In this study, we aimed to show the relationship between preoperative prognostic nutritional index and postoperative delirium in patients who had undergone gastrointestinal cancer surgery. Materials and Methods: Our study is a single-center, prospective, observational study. Routine preoperative anesthesia evaluation of all patients was performed and patient's age, sex, ASA physical score, body mass index (BMI), existing comorbid diseases, level of education, smoking status, cancer diagnosis, chemotherapy and radiotherapy history, type of surgery, past invasive interventions, concentration of hemoglobin and albumin, lymphocyte count, liver and kidney function tests were recorded. PNI score was calculated with the preoperative measurements. With the calculated PNI score, nutritional status was defined as normal (PNI ≥50), mild malnutrition (PNI 45-50), moderate-severe malnutrition (PNI 40-45), and severe (PNI \<40) accordingly. The patients were then evaluated for the presence of delirium using the Confusion Assessment Method (CAM) for 3 days postoperatively.
Interventions
DIAGNOSTIC_TESTprognostic nutritional index
Prognostic nutritional index is an inflammation-based scoring that measures the nutritional and immunological status of patients and has been used to determine prognosis and predict postoperative complications.
Sponsors
Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital
Study design
Observational model
CASE_CROSSOVER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients aged 18 and over * Patients who will undergo gastrointestinal cancer surgery * Able to give voluntary consent * ASA I-IV patients
Exclusion criteria
* Under 18 years old * Those who do not agree to be included in the study * Unconscious * Hearing, sight and speech impaired * Chronic alcohol user * Patients with cognitive or psychiatric disorders such as known dementia, Parkinson's, Alzheimer's * Patients who need postoperative mechanical ventilation support
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of the development of delirium | 15 October 2021-20 May 2022 | Evaluation of whether delirium develops in postoperative patients within the first 3 days using the Confusion Assessment Method (CAM) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| demographic characteristics | 15 October 2021-15 June 2022 | Evaluation of patients' age, gender, education level and their relationship with delirium |
| amount of bleeding | 15 October 2021-15 June 2022 | The relationship between the amount of bleeding and delirium |
| biochemical parameters | 15 October 2021-15 June 2022 | Evaluation of the patients' lymphocyte count, hemoglobin, albumin, urea, creatinine, AST, ALT concentrations and their relationship with delirium |
Countries
Turkey (Türkiye)
Outcome results
None listed