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World Journal of Surgery
Published in: World Journal of Surgery 1/2019

01-01-2019 | Original Scientific Report

Preoperative Anxiety as a Predictor of Delirium in Cancer Patients: A Prospective Observational Cohort Study

Authors: Saho Wada, Hironobu Inoguchi, Ryoichi Sadahiro, Yutaka J. Matsuoka, Yosuke Uchitomi, Tetsufumi Sato, Kazuaki Shimada, Seichi Yoshimoto, Hiroyuki Daiko, Ken Shimizu

Published in: World Journal of Surgery | Issue 1/2019

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Abstract

Background

Postoperative delirium is a common and important complication in cancer patients. We need to identify patients at high risk of postoperative delirium such that it can be prevented preoperatively or in early postoperative phase. The aim of this study was to investigate whether preoperative anxiety predicted onset of postoperative delirium in cancer patients, not only in order to identify high-risk groups but also to help develop new preventive approaches.

Methods

This was a prospective observational cohort study of cancer patients undergoing tumor resections. Postoperative delirium was assessed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Preoperative anxiety was evaluated with the Hospital Anxiety and Depression Scale-Anxiety (HADS-A), and we defined HADS-A > 7 as clinical anxiety. We conducted multivariate logistic regression to determine which factors were predictors of delirium.

Results

The final analysis included 91 patients, 29 of whom met the criteria for postoperative delirium. In multivariable logistic regression, age (5-year increments; odds ratio (OR) = 1.565, 95% confidence interval (CI) = 1.057–2.317, p = 0.025) and HADS-A > 7 (OR = 4.370, 95% CI = 1.051–18.178, p = 0.043) predicted delirium onset. These variables explained 74.2% of the variance.

Conclusions

Preoperative anxiety strongly predicted postoperative delirium in cancer patients. Our findings suggest that preoperative anxiety may be a new target for prevention of postoperative delirium.
Trial registration number This study was registered at UMIN000018980
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Metadata
Title
Preoperative Anxiety as a Predictor of Delirium in Cancer Patients: A Prospective Observational Cohort Study
Authors
Saho Wada
Hironobu Inoguchi
Ryoichi Sadahiro
Yutaka J. Matsuoka
Yosuke Uchitomi
Tetsufumi Sato
Kazuaki Shimada
Seichi Yoshimoto
Hiroyuki Daiko
Ken Shimizu
Publication date
01-01-2019
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 1/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-018-4761-0

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