Incidence of postoperative delirium according to cognitive status, improved responsiveness and inflammatory response at elderly patients in urgent abdominal surgery

Demyter Inna, Gudz Dmytro, Vorotyntsev Sergii. Incidence of postoperative delirium according to cognitive status, improved responsiveness and inflammatory response at elderly patients in urgent abdominal surgery. Journal of Education, Health and Sport. 2019;9(11):163-173. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2019.09.11.013 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2019.09.11.013 https://zenodo.org/record/3551053 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2019; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 25.10.2019. Revised: 04.11.2019. Accepted: 17.11.2019. UDC 616.381-002-089.168-053.9-06:616.89-008.452 Incidence of postoperative delirium according to cognitive status, improved responsiveness and inflammatory response at elderly patients in urgent abdominal surgery Demyter Inna, Gudz Dmytro, Vorotyntsev Sergii Zaporizhzhya State Medical University, Ukraine Municipal non-profit enterprise «City hospital of emergency and ambulance» of Zaporizhzhia city council Background. Postoperative delirium (POD) is a clinical syndrome that is manifested in impaired consciousness and attention, perception, memory, thinking and psychomotor behavior after surgery. Methods. After passing the Bioethics Commission at Zaporizhzhya State Medical University and obtaining informed consent from patients, 30 elderly patients who underwent surgical interventions on the abdominal organs under urgent procedure were sequentially included in a single-center prospective study. Patients with a history of traumatic brain injury or stroke with neurological impairments in the form of sensory-motor aphasia and plegia were excluded from the study. Results .The study involved 30 patients (16 (53%) women and 14 (47%) men), aged 62 years to 92 years, grade III-IV ASA, who underwent urgent surgery for bowel tumors (n = 8), gallstone disease (n = 7), entrained inguinal and postoperative ventral hernias (n = 10), gastric or intestinal perforation (n = 5). Postoperative delirium occurred in 33% of patients. On the first day after surgery, the cognitive status of patients in the first group decreased by 1 point relative to the primary assessment (p = 0.88), when on the second postoperative day the indicator returned to baseline. Patients in the second group showed a sharp impairment of cognitive abilities in the postoperative period, associated with POD and a significant decrease in cognitive status at day 5 (p <0.05) compared with preoperative assessment. The level of inflammatory response of the body in the preoperative period is 1.5 times higher in patients with POD (p = 0.01). The correlation between leukocytosis level and POD revealed a moderately significant relationship between these indicators (rs = 0.45 at p