Utility of HDS-R and E-PASS for prediction of postoperative delirium in elderly patients undergoing gastroenterological surgery

Abstract

Purpose: We assessed the usefulness of the estimation of physiologic ability and surgical stress (E-PASS) and the revised version of Hasegawa's dementia scale; revised (HDS-R) for predictive value in occurrence of postoperative delirium for elderly patients who had digestive surgical operations. Methods: Seventy-two patients assessed by HDS-R before operation were evaluated by E-PASS. We assessed the preoperative risk score (PRS) before the operation, and surgical stress score (SSS) and comprehensive risk score (CRS) were assessed after the operation. Results: Of all patients, 19.4% (14 patients) developed postoperative delirium. Patients with postoperative delirium were significantly older, with poorer PS (≥2), ASA score (≥3), lower PNI, lower HDS-R score, and higher CRS. Multivariate analysis identified HDS-R and CRS as independent predictors of the occurrence of postoperative delirium (OR 0.77 and 30.3, 95% CI 0.648-0.915 and 1.58-582, P=0.0031 and 0.0237). Of the patients whose HDSR score was 23 or less and CRS score of 0.35 or more, 83.3% developed postoperative delirium. Conclusion: HDSR and E-PASS could be helpful for the prediction of postoperative delirium. © 2013 The Japanese Society of Gastroenterological Surgery.