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- Title
Rivastigmine patch reduces the incidence of postoperative delirium in older patients with cognitive impairment.
- Authors
Youn, Young Chul; Shin, Hae‐Won; Choi, Byung‐Sun; Kim, SangYun; Lee, Jung‐Yeop; Ha, Yong‐Chan; Shin, Hae-Won; Choi, Byung-Sun; Lee, Jung-Yeop; Ha, Yong-Chan
- Abstract
<bold>Objective: </bold>To date, data regarding the efficacy of acetylcholinesterase inhibitors in preventing postoperative delirium (POD) are inconsistent and conflicting. Older individuals with cognitive dysfunction are thought to show POD more frequently. Our aim was to study the effectiveness of rivastigmine prophylaxis on the incidence, severity, and risk factors for POD in older patients with cognitive impairment undergoing hip fracture surgery.<bold>Methods: </bold>Of 62 older patients with cognitive impairment about to undergo surgery after a hip fracture, 31 were randomly assigned to receive a rivastigmine patch from 3 days before to 7 days after the operation (Group I), and the other 31 did not receive a rivastigmine patch (Group II). The two groups were compared with regard to incidence and severity of delirium on postoperative days 2 or 3 and 7. Multivariate logistic regression analysis was performed to assess factors associated with POD.<bold>Results: </bold>Postoperative delirium occurred in five Group I patients and 14 Group II patients (p = 0.013). The mean severity of delirium in the two groups as determined by the Delirium Rating Scale was 2.2 and 6.2 respectively (p = 0.033). The odds ratio for POD was 0.259 (95% CI: 0.074-0.905, p = 0.034) after adjusting for American Society of Anesthesiologists score (p = 0.058), age (p = 0.203), and gender (p = 0.560). There were no rivastigmine-related perioperative complications.<bold>Conclusion: </bold>Perioperative rivastigmine patch application could reduce the occurrence of POD in older patients with low cognitive status. Copyright © 2016 John Wiley & Sons, Ltd.
- Subjects
ACETYLCHOLINESTERASE; ACETYLCHOLINESTERASE inhibitors; DELIRIUM; POSTOPERATIVE care; COGNITION disorders; PREVENTION of surgical complications; RIVASTIGMINE; COMPARATIVE studies; DRUG administration; BONE fractures; HIP joint injuries; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MULTIVARIATE analysis; RESEARCH; SURGICAL complications; TRANSDERMAL medication; EVALUATION research; RANDOMIZED controlled trials; DISEASE incidence; ODDS ratio; PREVENTION
- Publication
International Journal of Geriatric Psychiatry, 2017, Vol 32, Issue 10, p1079
- ISSN
0885-6230
- Publication type
journal article
- DOI
10.1002/gps.4569