Postoperative delirium after lung resection for primary lung cancer: Risk factors, risk scoring system, and prognosis
Delirium is a common post-surgical complication, but few studies have examined postoperative delirium following lung cancer surgery. The purpose of this study was to clarify the risk factors of postoperative delirium, to construct a useful scoring system, and to clarify the relationship between deli...
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| creator | Hayashi, Kazuki Motoishi, Makoto Sawai, Satoru Horimoto, Kanna Hanaoka, Jun |
| description | Delirium is a common post-surgical complication, but few studies have examined postoperative delirium following lung cancer surgery. The purpose of this study was to clarify the risk factors of postoperative delirium, to construct a useful scoring system, and to clarify the relationship between delirium and prognosis after lung cancer surgery. We retrospectively analyzed data from 570 patients who underwent surgery for primary lung cancer. Logistic regression analysis was used to determine the effects of various factors on the onset of delirium. Kaplan-Meier analysis was performed to determine the relationship between delirium and prognosis. Postoperative delirium occurred in 6.7% of the patients. Three risk factors were identified, and the risk scores were determined as follows: 2×(cerebrovascular disease history) + 1×(squamous cell carcinoma) + 1×(age older than 75 years). Scores 0-1 denoted low risk, 2 denoted intermediate risk, and 3-4 denoted high risk. Additionally, we found that patients who developed delirium had significantly shorter overall survival. However, there was no difference in the frequency between cancer-related death and non-cancer related death when comparing the delirium and non-delirium groups. We identified the risk factors, i.e., cerebrovascular disease history, squamous cell carcinoma, and age older than 75 years, that determine the onset of delirium after lung cancer surgery and constructed a useful scoring system. In addition, although the prognosis of the delirium group was poor, the factor that determines prognosis may not be cancer per se but vulnerability in the patient background. |
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The purpose of this study was to clarify the risk factors of postoperative delirium, to construct a useful scoring system, and to clarify the relationship between delirium and prognosis after lung cancer surgery. We retrospectively analyzed data from 570 patients who underwent surgery for primary lung cancer. Logistic regression analysis was used to determine the effects of various factors on the onset of delirium. Kaplan-Meier analysis was performed to determine the relationship between delirium and prognosis. Postoperative delirium occurred in 6.7% of the patients. Three risk factors were identified, and the risk scores were determined as follows: 2×(cerebrovascular disease history) + 1×(squamous cell carcinoma) + 1×(age older than 75 years). Scores 0-1 denoted low risk, 2 denoted intermediate risk, and 3-4 denoted high risk. Additionally, we found that patients who developed delirium had significantly shorter overall survival. However, there was no difference in the frequency between cancer-related death and non-cancer related death when comparing the delirium and non-delirium groups. We identified the risk factors, i.e., cerebrovascular disease history, squamous cell carcinoma, and age older than 75 years, that determine the onset of delirium after lung cancer surgery and constructed a useful scoring system. In addition, although the prognosis of the delirium group was poor, the factor that determines prognosis may not be cancer per se but vulnerability in the patient background.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0223917</identifier><identifier>PMID: 31738751</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Age Factors ; Aged ; Aged, 80 and over ; Angina pectoris ; Cancer research ; Cancer surgery ; Carcinoma ; Carcinoma, Squamous Cell - complications ; Carcinoma, Squamous Cell - surgery ; Cerebrovascular diseases ; Cerebrovascular Disorders - complications ; Cerebrovascular Disorders - epidemiology ; Comorbidity ; Delirium ; Dexmedetomidine ; Emergence Delirium - epidemiology ; Emergence Delirium - etiology ; Esophageal cancer ; Female ; Health aspects ; Health risk assessment ; Health risks ; Hospitals ; Humans ; Intensive care ; Japan - epidemiology ; Kaplan-Meier Estimate ; Logistic Models ; Lung cancer ; Lung diseases ; Lung Neoplasms - complications ; Lung Neoplasms - surgery ; Male ; Medical prognosis ; Medical research ; Medicine and Health Sciences ; Mental disorders ; Middle Aged ; Neurophysiology ; Ostomy ; Patients ; Prognosis ; Pulmonary Surgical Procedures - adverse effects ; Regression analysis ; Retrospective Studies ; Risk analysis ; Risk Factors ; Scoring ; Squamous cell carcinoma ; Studies ; Surgery ; Systematic review ; Thoracic surgery ; Time Factors</subject><ispartof>PloS one, 2019-11, Vol.14 (11), p.e0223917-e0223917</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Hayashi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Hayashi et al 2019 Hayashi et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c736t-454190dc15a0ec5083ba5cb7a96b159a4d8b7ee17f69d3cd49d696d2352497103</citedby><cites>FETCH-LOGICAL-c736t-454190dc15a0ec5083ba5cb7a96b159a4d8b7ee17f69d3cd49d696d2352497103</cites><orcidid>0000-0002-2393-1233</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6860435/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6860435/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31738751$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Lee, Hyun-Sung</contributor><creatorcontrib>Hayashi, Kazuki</creatorcontrib><creatorcontrib>Motoishi, Makoto</creatorcontrib><creatorcontrib>Sawai, Satoru</creatorcontrib><creatorcontrib>Horimoto, Kanna</creatorcontrib><creatorcontrib>Hanaoka, Jun</creatorcontrib><title>Postoperative delirium after lung resection for primary lung cancer: Risk factors, risk scoring system, and prognosis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Delirium is a common post-surgical complication, but few studies have examined postoperative delirium following lung cancer surgery. 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epidemiology</subject><subject>Kaplan-Meier Estimate</subject><subject>Logistic Models</subject><subject>Lung cancer</subject><subject>Lung diseases</subject><subject>Lung Neoplasms - complications</subject><subject>Lung Neoplasms - surgery</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Mental disorders</subject><subject>Middle Aged</subject><subject>Neurophysiology</subject><subject>Ostomy</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Pulmonary Surgical Procedures - adverse effects</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Scoring</subject><subject>Squamous cell carcinoma</subject><subject>Studies</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Thoracic surgery</subject><subject>Time Factors</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk91r1TAYxosobk7_A9HCQBR2jkmTJo0Xwhh-HBhM5sdtSJO3PZltc0zS4f57U083zpFdSC_SJr_nSd8nebPsOUZLTDh-e-VGP6huuXEDLFFREIH5g-wQC1IsWIHIw533g-xJCFcIlaRi7HF2QDAnFS_xYTZ-cSG6DXgV7TXkBjrr7djnqong824c2txDAB2tG_LG-Xzjba_8zXZJq0GDf5df2vAzb5SOzoeT3E9fQTtvExJuQoT-JFeDSVrXDi7Y8DR71KguwLN5PMq-f_zw7ezz4vzi0-rs9HyhOWFxQUuKBTIalwqBLlFFalXqmivBalwKRU1VcwDMGyYM0YYKwwQzBSkLKjhG5Ch7ufXddC7IObEgC4LLEomCFYlYbQnj1JWci5NOWfl3wvlWKh-t7kAiwDUyoqlTcrRiuEKVUAVXvDKgoNbJ6_2821j3YDQM0atuz3R_ZbBr2bprySqGKCmTwevZwLtfI4Qoexs0dJ0awI3b_xYcUcoSevwPen91M9WqVIAdGpf21ZOpPGWIYYoomlJa3kOlx0BvdbpejU3ze4I3e4LERPgdWzWGIFdfL_-fvfixz77aYdegurgOrhunyxf2QboFtXcheGjuQsZITt1xm4acukPO3ZFkL3YP6E502w7kD_SPCtQ</recordid><startdate>20191118</startdate><enddate>20191118</enddate><creator>Hayashi, Kazuki</creator><creator>Motoishi, Makoto</creator><creator>Sawai, Satoru</creator><creator>Horimoto, Kanna</creator><creator>Hanaoka, Jun</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-2393-1233</orcidid></search><sort><creationdate>20191118</creationdate><title>Postoperative delirium after lung resection for primary lung cancer: Risk factors, risk scoring system, and prognosis</title><author>Hayashi, Kazuki ; Motoishi, Makoto ; Sawai, Satoru ; Horimoto, Kanna ; Hanaoka, Jun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c736t-454190dc15a0ec5083ba5cb7a96b159a4d8b7ee17f69d3cd49d696d2352497103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angina pectoris</topic><topic>Cancer research</topic><topic>Cancer surgery</topic><topic>Carcinoma</topic><topic>Carcinoma, Squamous Cell - complications</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Cerebrovascular diseases</topic><topic>Cerebrovascular Disorders - complications</topic><topic>Cerebrovascular Disorders - epidemiology</topic><topic>Comorbidity</topic><topic>Delirium</topic><topic>Dexmedetomidine</topic><topic>Emergence Delirium - epidemiology</topic><topic>Emergence Delirium - etiology</topic><topic>Esophageal cancer</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intensive care</topic><topic>Japan - epidemiology</topic><topic>Kaplan-Meier Estimate</topic><topic>Logistic Models</topic><topic>Lung cancer</topic><topic>Lung diseases</topic><topic>Lung Neoplasms - complications</topic><topic>Lung Neoplasms - surgery</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Mental disorders</topic><topic>Middle Aged</topic><topic>Neurophysiology</topic><topic>Ostomy</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Pulmonary Surgical Procedures - 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The purpose of this study was to clarify the risk factors of postoperative delirium, to construct a useful scoring system, and to clarify the relationship between delirium and prognosis after lung cancer surgery. We retrospectively analyzed data from 570 patients who underwent surgery for primary lung cancer. Logistic regression analysis was used to determine the effects of various factors on the onset of delirium. Kaplan-Meier analysis was performed to determine the relationship between delirium and prognosis. Postoperative delirium occurred in 6.7% of the patients. Three risk factors were identified, and the risk scores were determined as follows: 2×(cerebrovascular disease history) + 1×(squamous cell carcinoma) + 1×(age older than 75 years). Scores 0-1 denoted low risk, 2 denoted intermediate risk, and 3-4 denoted high risk. Additionally, we found that patients who developed delirium had significantly shorter overall survival. However, there was no difference in the frequency between cancer-related death and non-cancer related death when comparing the delirium and non-delirium groups. We identified the risk factors, i.e., cerebrovascular disease history, squamous cell carcinoma, and age older than 75 years, that determine the onset of delirium after lung cancer surgery and constructed a useful scoring system. In addition, although the prognosis of the delirium group was poor, the factor that determines prognosis may not be cancer per se but vulnerability in the patient background.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31738751</pmid><doi>10.1371/journal.pone.0223917</doi><tpages>e0223917</tpages><orcidid>https://orcid.org/0000-0002-2393-1233</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Age Factors Aged Aged, 80 and over Angina pectoris Cancer research Cancer surgery Carcinoma Carcinoma, Squamous Cell - complications Carcinoma, Squamous Cell - surgery Cerebrovascular diseases Cerebrovascular Disorders - complications Cerebrovascular Disorders - epidemiology Comorbidity Delirium Dexmedetomidine Emergence Delirium - epidemiology Emergence Delirium - etiology Esophageal cancer Female Health aspects Health risk assessment Health risks Hospitals Humans Intensive care Japan - epidemiology Kaplan-Meier Estimate Logistic Models Lung cancer Lung diseases Lung Neoplasms - complications Lung Neoplasms - surgery Male Medical prognosis Medical research Medicine and Health Sciences Mental disorders Middle Aged Neurophysiology Ostomy Patients Prognosis Pulmonary Surgical Procedures - adverse effects Regression analysis Retrospective Studies Risk analysis Risk Factors Scoring Squamous cell carcinoma Studies Surgery Systematic review Thoracic surgery Time Factors |
| title | Postoperative delirium after lung resection for primary lung cancer: Risk factors, risk scoring system, and prognosis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-24T00%3A23%3A17IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Postoperative%20delirium%20after%20lung%20resection%20for%20primary%20lung%20cancer:%20Risk%20factors,%20risk%20scoring%20system,%20and%20prognosis&rft.jtitle=PloS%20one&rft.au=Hayashi,%20Kazuki&rft.date=2019-11-18&rft.volume=14&rft.issue=11&rft.spage=e0223917&rft.epage=e0223917&rft.pages=e0223917-e0223917&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0223917&rft_dat=%3Cgale_plos_%3EA606140400%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2315509262&rft_id=info:pmid/31738751&rft_galeid=A606140400&rft_doaj_id=oai_doaj_org_article_0e1b0d9fb87548618089a27a78deaebc&rfr_iscdi=true |