Preoperative Acute Pain Is Associated with Postoperative Delirium
Abstract Background Studies have provided some evidence that pain is a risk factor for postoperative delirium (POD). Therefore, we investigated the relationship between preoperative pain and POD after noncardiac surgery. Methods POD was assessed with the Montreal Cognitive Assessment, and preoperati...
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| Veröffentlicht in: | Pain medicine (Malden, Mass.) Mass.), 2021-01, Vol.22 (1), p.15-21 |
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| creator | Ding, Xian Gao, Xiang Chen, Qizhong Jiang, Xuliang Li, Yi Xu, Jingjing Qin, Guowei Lu, Shunmei Huang, Dongxiao |
| description | Abstract
Background
Studies have provided some evidence that pain is a risk factor for postoperative delirium (POD). Therefore, we investigated the relationship between preoperative pain and POD after noncardiac surgery.
Methods
POD was assessed with the Montreal Cognitive Assessment, and preoperative cognition was assessed with the Mini-Mental State Examination. Plasma C-reactive protein (CRP) was detected by enzyme-linked immunosorbent assay before surgery. Preoperative pain was classified by its duration before surgery as chronic pain (lasting more than 1 month), acute pain (lasting less than 1 month), or no pain (no obvious pain). Multiple linear regression was used to adjust for confounding.
Results
From October 15, 2018, through August 12, 2019, a total of 67 patients were randomized; 7 were excluded because they were discharged before the seventh postoperative day. The prevalence of POD was significantly higher in the acute pain group (13 of 20; 65%) than in the chronic pain group (5 of 20; 25%) or the no pain group (6 of 20; 30%) (P = 0.019), indicating that delirium is associated with preoperative acute pain. The plasma level of preoperative CRP was also higher in the acute pain group than in the other two groups (mean [interquartile range]: 10.7 [3.3, 29.3] vs 1 [0.5, 3.8]mg/l; P |
| doi_str_mv | 10.1093/pm/pnaa314 |
| format | Article |
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Background
Studies have provided some evidence that pain is a risk factor for postoperative delirium (POD). Therefore, we investigated the relationship between preoperative pain and POD after noncardiac surgery.
Methods
POD was assessed with the Montreal Cognitive Assessment, and preoperative cognition was assessed with the Mini-Mental State Examination. Plasma C-reactive protein (CRP) was detected by enzyme-linked immunosorbent assay before surgery. Preoperative pain was classified by its duration before surgery as chronic pain (lasting more than 1 month), acute pain (lasting less than 1 month), or no pain (no obvious pain). Multiple linear regression was used to adjust for confounding.
Results
From October 15, 2018, through August 12, 2019, a total of 67 patients were randomized; 7 were excluded because they were discharged before the seventh postoperative day. The prevalence of POD was significantly higher in the acute pain group (13 of 20; 65%) than in the chronic pain group (5 of 20; 25%) or the no pain group (6 of 20; 30%) (P = 0.019), indicating that delirium is associated with preoperative acute pain. The plasma level of preoperative CRP was also higher in the acute pain group than in the other two groups (mean [interquartile range]: 10.7 [3.3, 29.3] vs 1 [0.5, 3.8]mg/l; P < 0.001), suggesting that elevated preoperative plasma levels of CRP were associated with delirium.
Conclusions
Preoperative acute pain was associated with POD, and increased plasma levels of CRP provide a marker. In addition, we found that illiteracy and advanced age were risk factors for POD.</description><identifier>ISSN: 1526-2375</identifier><identifier>EISSN: 1526-4637</identifier><identifier>DOI: 10.1093/pm/pnaa314</identifier><identifier>PMID: 33040141</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Acute pain ; Acute Pain - diagnosis ; Acute Pain - epidemiology ; C-Reactive Protein ; Chronic pain ; Cognitive ability ; Complications ; Complications and side effects ; Delirium ; Delirium - diagnosis ; Delirium - epidemiology ; Delirium - etiology ; Enzyme-linked immunosorbent assay ; Health aspects ; Humans ; Pain ; Pain management ; Plasma ; Plasma levels ; Postoperative Complications ; Risk Factors ; Surgery</subject><ispartof>Pain medicine (Malden, Mass.), 2021-01, Vol.22 (1), p.15-21</ispartof><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2020</rights><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>COPYRIGHT 2021 Oxford University Press</rights><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c412t-f803cad535cb020cc610bda245ace9f95ed74f977520dfd7ba5ebc2f5e3ae5ac3</citedby><cites>FETCH-LOGICAL-c412t-f803cad535cb020cc610bda245ace9f95ed74f977520dfd7ba5ebc2f5e3ae5ac3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33040141$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ding, Xian</creatorcontrib><creatorcontrib>Gao, Xiang</creatorcontrib><creatorcontrib>Chen, Qizhong</creatorcontrib><creatorcontrib>Jiang, Xuliang</creatorcontrib><creatorcontrib>Li, Yi</creatorcontrib><creatorcontrib>Xu, Jingjing</creatorcontrib><creatorcontrib>Qin, Guowei</creatorcontrib><creatorcontrib>Lu, Shunmei</creatorcontrib><creatorcontrib>Huang, Dongxiao</creatorcontrib><title>Preoperative Acute Pain Is Associated with Postoperative Delirium</title><title>Pain medicine (Malden, Mass.)</title><addtitle>Pain Med</addtitle><description>Abstract
Background
Studies have provided some evidence that pain is a risk factor for postoperative delirium (POD). Therefore, we investigated the relationship between preoperative pain and POD after noncardiac surgery.
Methods
POD was assessed with the Montreal Cognitive Assessment, and preoperative cognition was assessed with the Mini-Mental State Examination. Plasma C-reactive protein (CRP) was detected by enzyme-linked immunosorbent assay before surgery. Preoperative pain was classified by its duration before surgery as chronic pain (lasting more than 1 month), acute pain (lasting less than 1 month), or no pain (no obvious pain). Multiple linear regression was used to adjust for confounding.
Results
From October 15, 2018, through August 12, 2019, a total of 67 patients were randomized; 7 were excluded because they were discharged before the seventh postoperative day. The prevalence of POD was significantly higher in the acute pain group (13 of 20; 65%) than in the chronic pain group (5 of 20; 25%) or the no pain group (6 of 20; 30%) (P = 0.019), indicating that delirium is associated with preoperative acute pain. The plasma level of preoperative CRP was also higher in the acute pain group than in the other two groups (mean [interquartile range]: 10.7 [3.3, 29.3] vs 1 [0.5, 3.8]mg/l; P < 0.001), suggesting that elevated preoperative plasma levels of CRP were associated with delirium.
Conclusions
Preoperative acute pain was associated with POD, and increased plasma levels of CRP provide a marker. In addition, we found that illiteracy and advanced age were risk factors for POD.</description><subject>Acute pain</subject><subject>Acute Pain - diagnosis</subject><subject>Acute Pain - epidemiology</subject><subject>C-Reactive Protein</subject><subject>Chronic pain</subject><subject>Cognitive ability</subject><subject>Complications</subject><subject>Complications and side effects</subject><subject>Delirium</subject><subject>Delirium - diagnosis</subject><subject>Delirium - epidemiology</subject><subject>Delirium - etiology</subject><subject>Enzyme-linked immunosorbent assay</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Pain</subject><subject>Pain management</subject><subject>Plasma</subject><subject>Plasma levels</subject><subject>Postoperative Complications</subject><subject>Risk Factors</subject><subject>Surgery</subject><issn>1526-2375</issn><issn>1526-4637</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</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><recordid>eNp90UtLxDAQB_Agiu-LH0AKIoiwmmezPZb1CYJ70HNI04lG2qYmreK3N7KroojkkBB-MwzzR2iP4BOCC3bat6d9pzUjfAVtEkHzCc-ZXF2-KZNiA23F-IQxyfmUraMNxjDHhJNNVM4D-B6CHtwLZKUZB8jm2nXZdczKGL1xeoA6e3XDYzb3cfi2Z9C44MZ2B61Z3UTYXd7b6P7i_G52Nbm5vbyelTcTwwkdJnaKmdG1YMJUmGJjcoKrWlMutIHCFgJqyW0hpaC4trWstIDKUCuAaUiGbaOjRd8--OcR4qBaFw00je7Aj1FRzouiYJyxRA9-0Sc_hi5Np6iQMhdpJ_JbPegGlOusH4I2H01VKTGeFpRinNTJHyqdGlpnfAfWpf8fBceLAhN8jAGs6oNrdXhTBKuPvFTfqmVeCe8vJx2rFuov-hlQAocL4Mf-v0bvak2cNQ</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Ding, Xian</creator><creator>Gao, Xiang</creator><creator>Chen, Qizhong</creator><creator>Jiang, Xuliang</creator><creator>Li, Yi</creator><creator>Xu, Jingjing</creator><creator>Qin, Guowei</creator><creator>Lu, Shunmei</creator><creator>Huang, Dongxiao</creator><general>Oxford University Press</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>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20210101</creationdate><title>Preoperative Acute Pain Is Associated with Postoperative Delirium</title><author>Ding, Xian ; Gao, Xiang ; Chen, Qizhong ; Jiang, Xuliang ; Li, Yi ; Xu, Jingjing ; Qin, Guowei ; Lu, Shunmei ; Huang, Dongxiao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-f803cad535cb020cc610bda245ace9f95ed74f977520dfd7ba5ebc2f5e3ae5ac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute pain</topic><topic>Acute Pain - diagnosis</topic><topic>Acute Pain - epidemiology</topic><topic>C-Reactive Protein</topic><topic>Chronic pain</topic><topic>Cognitive ability</topic><topic>Complications</topic><topic>Complications and side effects</topic><topic>Delirium</topic><topic>Delirium - diagnosis</topic><topic>Delirium - epidemiology</topic><topic>Delirium - etiology</topic><topic>Enzyme-linked immunosorbent assay</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Pain</topic><topic>Pain management</topic><topic>Plasma</topic><topic>Plasma levels</topic><topic>Postoperative Complications</topic><topic>Risk Factors</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ding, Xian</creatorcontrib><creatorcontrib>Gao, Xiang</creatorcontrib><creatorcontrib>Chen, Qizhong</creatorcontrib><creatorcontrib>Jiang, Xuliang</creatorcontrib><creatorcontrib>Li, Yi</creatorcontrib><creatorcontrib>Xu, Jingjing</creatorcontrib><creatorcontrib>Qin, Guowei</creatorcontrib><creatorcontrib>Lu, Shunmei</creatorcontrib><creatorcontrib>Huang, Dongxiao</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Pain medicine (Malden, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ding, Xian</au><au>Gao, Xiang</au><au>Chen, Qizhong</au><au>Jiang, Xuliang</au><au>Li, Yi</au><au>Xu, Jingjing</au><au>Qin, Guowei</au><au>Lu, Shunmei</au><au>Huang, Dongxiao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative Acute Pain Is Associated with Postoperative Delirium</atitle><jtitle>Pain medicine (Malden, Mass.)</jtitle><addtitle>Pain Med</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>22</volume><issue>1</issue><spage>15</spage><epage>21</epage><pages>15-21</pages><issn>1526-2375</issn><eissn>1526-4637</eissn><abstract>Abstract
Background
Studies have provided some evidence that pain is a risk factor for postoperative delirium (POD). Therefore, we investigated the relationship between preoperative pain and POD after noncardiac surgery.
Methods
POD was assessed with the Montreal Cognitive Assessment, and preoperative cognition was assessed with the Mini-Mental State Examination. Plasma C-reactive protein (CRP) was detected by enzyme-linked immunosorbent assay before surgery. Preoperative pain was classified by its duration before surgery as chronic pain (lasting more than 1 month), acute pain (lasting less than 1 month), or no pain (no obvious pain). Multiple linear regression was used to adjust for confounding.
Results
From October 15, 2018, through August 12, 2019, a total of 67 patients were randomized; 7 were excluded because they were discharged before the seventh postoperative day. The prevalence of POD was significantly higher in the acute pain group (13 of 20; 65%) than in the chronic pain group (5 of 20; 25%) or the no pain group (6 of 20; 30%) (P = 0.019), indicating that delirium is associated with preoperative acute pain. The plasma level of preoperative CRP was also higher in the acute pain group than in the other two groups (mean [interquartile range]: 10.7 [3.3, 29.3] vs 1 [0.5, 3.8]mg/l; P < 0.001), suggesting that elevated preoperative plasma levels of CRP were associated with delirium.
Conclusions
Preoperative acute pain was associated with POD, and increased plasma levels of CRP provide a marker. In addition, we found that illiteracy and advanced age were risk factors for POD.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>33040141</pmid><doi>10.1093/pm/pnaa314</doi><tpages>7</tpages></addata></record> |
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| subjects | Acute pain Acute Pain - diagnosis Acute Pain - epidemiology C-Reactive Protein Chronic pain Cognitive ability Complications Complications and side effects Delirium Delirium - diagnosis Delirium - epidemiology Delirium - etiology Enzyme-linked immunosorbent assay Health aspects Humans Pain Pain management Plasma Plasma levels Postoperative Complications Risk Factors Surgery |
| title | Preoperative Acute Pain Is Associated with Postoperative Delirium |
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