Incidence and risk factors of subsyndromal delirium after curative resection of gastric cancer

Heesung Hwang, Kwang Min Lee, Kyung Lak Son, Dooyoung Jung, Won Hyoung Kim, Joo Young Lee, Seong Ho Kong, Yun Suhk Suh, Hyuk-Joon Lee, Han-Kwang Yang, Bong-Jin Hahm

Research output: Contribution to journalArticle

Abstract

Background: Subsyndromal delirium, a condition in which patients exhibit some, but not all, of the symptoms of delirium, can negatively affect the outcomes of patients with cancer. However, the incidence of subsyndromal delirium in patients with gastric cancer is unknown. Here, we investigated the incidence and risk factors of subsyndromal delirium after curative resection of gastric cancer. Methods: We recruited consecutive patients with gastric cancer who were scheduled for curative resection at a tertiary hospital. Patients' subsyndromal delirium symptoms were serially assessed preoperatively and 1, 2, 3, and 7days postoperatively using the Delirium Rating Scale-Revised-98 (DRS-R-98). A DRS-R-98 score of 8-14 at any postoperative assessment was considered to indicate subsyndromal delirium. Sociodemographic and pre-/intra-operative clinical data were also assessed. Logistic regression analyses were used to determine the associated risk factors. Results: Data were analysed from 163 out of 217 eligible patients. Postoperative delirium occurred in one patient (0.6%) and subsyndromal delirium occurred in 19 patients (11.7%). Age≥70years (odds ratio, [OR] 3.85; 95% confidence interval [CI], 1.36-10.92; p=0.011) and education level≤9years (OR, 3.98; 95% CI, 1.39-11.41; p=0.010) were independent risk factors of subsyndromal delirium after adjusting for preoperative cognitive function. Other pre-/intra-operative variables including anxiety/depression, poor sleep quality, and anaesthesia duration were not associated with subsyndromal delirium. Conclusions: In contrast to the low incidence of delirium among patients undergoing curative resection of gastric cancer, a substantial proportion of such patients experienced subsyndromal delirium. Considering the prognostic implications, more careful detection and management of subsyndromal delirium may be warranted in patients with gastric cancer.

Original languageEnglish
Article number765
JournalBMC Cancer
Volume18
Issue number1
DOIs
StatePublished - 27 Jul 2018

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Delirium
Stomach Neoplasms
Incidence
Odds Ratio
Confidence Intervals
Tertiary Care Centers
Cognition

Keywords

  • Gastrectomy
  • Incidence
  • Risk factor
  • Stomach neoplasm
  • Subsyndromal delirium

Cite this

@article{ee5956a1428c46b4897a3a2929af325c,
title = "Incidence and risk factors of subsyndromal delirium after curative resection of gastric cancer",
abstract = "Background: Subsyndromal delirium, a condition in which patients exhibit some, but not all, of the symptoms of delirium, can negatively affect the outcomes of patients with cancer. However, the incidence of subsyndromal delirium in patients with gastric cancer is unknown. Here, we investigated the incidence and risk factors of subsyndromal delirium after curative resection of gastric cancer. Methods: We recruited consecutive patients with gastric cancer who were scheduled for curative resection at a tertiary hospital. Patients' subsyndromal delirium symptoms were serially assessed preoperatively and 1, 2, 3, and 7days postoperatively using the Delirium Rating Scale-Revised-98 (DRS-R-98). A DRS-R-98 score of 8-14 at any postoperative assessment was considered to indicate subsyndromal delirium. Sociodemographic and pre-/intra-operative clinical data were also assessed. Logistic regression analyses were used to determine the associated risk factors. Results: Data were analysed from 163 out of 217 eligible patients. Postoperative delirium occurred in one patient (0.6{\%}) and subsyndromal delirium occurred in 19 patients (11.7{\%}). Age≥70years (odds ratio, [OR] 3.85; 95{\%} confidence interval [CI], 1.36-10.92; p=0.011) and education level≤9years (OR, 3.98; 95{\%} CI, 1.39-11.41; p=0.010) were independent risk factors of subsyndromal delirium after adjusting for preoperative cognitive function. Other pre-/intra-operative variables including anxiety/depression, poor sleep quality, and anaesthesia duration were not associated with subsyndromal delirium. Conclusions: In contrast to the low incidence of delirium among patients undergoing curative resection of gastric cancer, a substantial proportion of such patients experienced subsyndromal delirium. Considering the prognostic implications, more careful detection and management of subsyndromal delirium may be warranted in patients with gastric cancer.",
keywords = "Gastrectomy, Incidence, Risk factor, Stomach neoplasm, Subsyndromal delirium",
author = "Heesung Hwang and Lee, {Kwang Min} and Son, {Kyung Lak} and Dooyoung Jung and Kim, {Won Hyoung} and Lee, {Joo Young} and Kong, {Seong Ho} and Suh, {Yun Suhk} and Hyuk-Joon Lee and Han-Kwang Yang and Bong-Jin Hahm",
year = "2018",
month = "7",
day = "27",
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language = "English",
volume = "18",
journal = "BMC cancer",
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Incidence and risk factors of subsyndromal delirium after curative resection of gastric cancer. / Hwang, Heesung; Lee, Kwang Min; Son, Kyung Lak; Jung, Dooyoung; Kim, Won Hyoung; Lee, Joo Young; Kong, Seong Ho; Suh, Yun Suhk; Lee, Hyuk-Joon; Yang, Han-Kwang; Hahm, Bong-Jin.

In: BMC Cancer, Vol. 18, No. 1, 765, 27.07.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Incidence and risk factors of subsyndromal delirium after curative resection of gastric cancer

AU - Hwang, Heesung

AU - Lee, Kwang Min

AU - Son, Kyung Lak

AU - Jung, Dooyoung

AU - Kim, Won Hyoung

AU - Lee, Joo Young

AU - Kong, Seong Ho

AU - Suh, Yun Suhk

AU - Lee, Hyuk-Joon

AU - Yang, Han-Kwang

AU - Hahm, Bong-Jin

PY - 2018/7/27

Y1 - 2018/7/27

N2 - Background: Subsyndromal delirium, a condition in which patients exhibit some, but not all, of the symptoms of delirium, can negatively affect the outcomes of patients with cancer. However, the incidence of subsyndromal delirium in patients with gastric cancer is unknown. Here, we investigated the incidence and risk factors of subsyndromal delirium after curative resection of gastric cancer. Methods: We recruited consecutive patients with gastric cancer who were scheduled for curative resection at a tertiary hospital. Patients' subsyndromal delirium symptoms were serially assessed preoperatively and 1, 2, 3, and 7days postoperatively using the Delirium Rating Scale-Revised-98 (DRS-R-98). A DRS-R-98 score of 8-14 at any postoperative assessment was considered to indicate subsyndromal delirium. Sociodemographic and pre-/intra-operative clinical data were also assessed. Logistic regression analyses were used to determine the associated risk factors. Results: Data were analysed from 163 out of 217 eligible patients. Postoperative delirium occurred in one patient (0.6%) and subsyndromal delirium occurred in 19 patients (11.7%). Age≥70years (odds ratio, [OR] 3.85; 95% confidence interval [CI], 1.36-10.92; p=0.011) and education level≤9years (OR, 3.98; 95% CI, 1.39-11.41; p=0.010) were independent risk factors of subsyndromal delirium after adjusting for preoperative cognitive function. Other pre-/intra-operative variables including anxiety/depression, poor sleep quality, and anaesthesia duration were not associated with subsyndromal delirium. Conclusions: In contrast to the low incidence of delirium among patients undergoing curative resection of gastric cancer, a substantial proportion of such patients experienced subsyndromal delirium. Considering the prognostic implications, more careful detection and management of subsyndromal delirium may be warranted in patients with gastric cancer.

AB - Background: Subsyndromal delirium, a condition in which patients exhibit some, but not all, of the symptoms of delirium, can negatively affect the outcomes of patients with cancer. However, the incidence of subsyndromal delirium in patients with gastric cancer is unknown. Here, we investigated the incidence and risk factors of subsyndromal delirium after curative resection of gastric cancer. Methods: We recruited consecutive patients with gastric cancer who were scheduled for curative resection at a tertiary hospital. Patients' subsyndromal delirium symptoms were serially assessed preoperatively and 1, 2, 3, and 7days postoperatively using the Delirium Rating Scale-Revised-98 (DRS-R-98). A DRS-R-98 score of 8-14 at any postoperative assessment was considered to indicate subsyndromal delirium. Sociodemographic and pre-/intra-operative clinical data were also assessed. Logistic regression analyses were used to determine the associated risk factors. Results: Data were analysed from 163 out of 217 eligible patients. Postoperative delirium occurred in one patient (0.6%) and subsyndromal delirium occurred in 19 patients (11.7%). Age≥70years (odds ratio, [OR] 3.85; 95% confidence interval [CI], 1.36-10.92; p=0.011) and education level≤9years (OR, 3.98; 95% CI, 1.39-11.41; p=0.010) were independent risk factors of subsyndromal delirium after adjusting for preoperative cognitive function. Other pre-/intra-operative variables including anxiety/depression, poor sleep quality, and anaesthesia duration were not associated with subsyndromal delirium. Conclusions: In contrast to the low incidence of delirium among patients undergoing curative resection of gastric cancer, a substantial proportion of such patients experienced subsyndromal delirium. Considering the prognostic implications, more careful detection and management of subsyndromal delirium may be warranted in patients with gastric cancer.

KW - Gastrectomy

KW - Incidence

KW - Risk factor

KW - Stomach neoplasm

KW - Subsyndromal delirium

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U2 - 10.1186/s12885-018-4681-2

DO - 10.1186/s12885-018-4681-2

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AN - SCOPUS:85050659492

VL - 18

JO - BMC cancer

JF - BMC cancer

SN - 1471-2407

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ER -