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Predictors of postoperative delirium among patients undergoing total knee arthroplasty: a literature review

Kapur, Anshika (2018) Predictors of postoperative delirium among patients undergoing total knee arthroplasty: a literature review. Master Essay, University of Pittsburgh.

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Delirium is a neurocognitive disorder characterized by the presence of disturbance in attention that develops over a short period of time, which is not explained by another preexisting neurocognitive disorder and it is the physiological consequence of another medical condition. Although there are no known causes of delirium, multiple factors are thought to play a role in the development of the disorder. Postoperative delirium is common in hospitalized patients undergoing surgery. Studies have indicated that postoperative delirium incidence varies depending on the type of surgery performed, the criteria used to diagnose delirium, and the population that is being studied. Consequences of postoperative delirium include prolonged hospitalization, decline in cognitive function, and an increase in mortality rate. The purpose of the study was to review the literature on the risk factors of delirium incidence postoperatively among patients undergoing total knee arthroplasty. A literature review on postoperative delirium in total knee arthroplasty patients and its risk factors was conducted using the PubMed database from January 2011 to March 2018, yielding 15 articles that met inclusion criteria. Articles were reviewed for patient demographic characteristics, postoperative delirium diagnosis methods, findings, strengths, and limitations. There was little consistency on the diagnostic measures of postoperative delirium, where nine of the studies used the same standardized tool, but there was still variation in the frequency of the use of the tool. Among patients undergoing total knee arthroplasty (age range: 60 to >80 years), postoperative delirium incidence ranged from 0.6% to 62.5%. Incidence of postoperative delirium was determined by the following risk factors: older age and/or history of psychiatric disorders and/or ethnicity, electrolyte disorders, preoperative cerebrospinal fluid β-amyloid/tau ratio, preexisting obstructive sleep apnea, use of preventative screening measures, vigorous physiotherapy, and type of pain medication prescribed. In conclusion, accurate prediction of risk factors associated with postoperative delirium incidence may help patients, providers, payers, and health systems with decision-making and opportunities for intervention(s) early in the disease course, therefore prioritizing the public health implications associated with postoperative delirium.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Kapur, Anshikaank191@pitt.eduank1910000-0001-8785-257X
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairGlynn, Nancyglynnn@edc.pitt.eduglynnnUNSPECIFIED
Committee MemberTrauth, Jeanettetrauth@pitt.edutrauthUNSPECIFIED
Committee MemberCipkala-Gaffin, Janetcipkalaj@upmc.eduUNSPECIFIEDUNSPECIFIED
Date: April 2018
Date Type: Completion
Number of Pages: 54
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 31 May 2019 17:48
Last Modified: 01 May 2021 05:15


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