Obstructive Sleep Apnea and Incidence of Postoperative Delirium after Elective Knee Replacement in the Nondemented Elderly

• DOI: 10.1097/aln.0b013e31824b94fc
• Publication Date: 2012-02-15T09:45:31Z
• Authors: Benjamin J. Flink; Sarah K. Rivelli; Elizabeth A. Cox; William D. White; Grace Falcone; Thomas P. Vail; Christopher C. Young; Michael P. Bolognesi; Andrew D. Krystal; Paula T. Trzepacz; Richard E. Moon; Madan M. Kwatra
• Keywords: Aged, 80 and over; Male; Sleep Apnea, Obstructive; Incidence; Delirium; 3. Good health; 03 medical and health sciences; Postoperative Complications; 0302 clinical medicine; Elective Surgical Procedures; Surveys and Questionnaires; Humans; Female; Prospective Studies; Arthroplasty, Replacement, Knee; Aged

Postoperative delirium, a common complication in the elderly, can occur following any type of surgery and is associated with increased morbidity mortality; it may also be subsequent cognitive problems. Effective therapy for postoperative delirium remains elusive because causative factors are likely multiple varied.Patients 65 yr or older undergoing elective knee arthroplasty were prospectively evaluated Diagnostic Statistical Manual Mental Disorders-IV delirium. Exclusion criteria included dementia, mini-mental state exam score less than 24, clinically significant central nervous system/neurologic disorder, current alcoholism, serious psychiatric disorder. Delirium was assessed on days 2 3 using standardized scales. Patients' preexisting medical conditions obtained from charts. The occurrence obstructive sleep apnea confirmed by contacting patients to check their polysomnography records. Data analyzed Pearson chi-square Wilcoxon rank sum tests logistic regressions adjusted effects covariates.Of 106 enrolled patients, 27 (25%) developed Of 15 apnea, eight (53%) experienced compared 19 (20%) without (P = 0.0123, odds ratio: 4.3). Obstructive only statistically predictor multivariate analyses.This first prospective study employing validated measures identify an association between