Association of sleep quality on the night of operative day with postoperative delirium in elderly patients: A prospective cohort study.
Eur J Anaesthesiol
; 41(3): 226-233, 2024 Mar 01.
Article
in En
| MEDLINE
| ID: mdl-38230449
ABSTRACT
BACKGROUND:
Sleep disturbances in the peri-operative period have been associated with adverse outcomes, including postoperative delirium (POD). However, research on sleep quality during the immediate postoperative period is limited.OBJECTIVES:
This study aimed to investigate the association between sleep quality on the night of the operative day assessed using the Sleep Quality Numeric Rating Scale (SQ-NRS), and the incidence of POD in a large cohort of surgical patients.DESIGN:
A prospective cohort study.SETTING:
A tertiary hospital in China. PATIENTS This study enrolled patients aged 65âyears or older undergoing elective surgery under general anaesthesia. The participants were categorised into the sleep disturbance and no sleep disturbance groups according to their operative night SQ-NRS. MAIN OUTCOMEMEASURES:
The primary outcome was delirium incidence, whereas the secondary outcomes included acute kidney injury, stroke, pulmonary infection, cardiovascular complications and all-cause mortality within 1 year postoperatively.RESULTS:
In total, 3072 patients were included in the analysis of this study. Among them, 791 (25.72%) experienced sleep disturbances on the night of operative day. Patients in the sleep disturbance group had a significantly higher risk of developing POD (adjusted OR 1.43, 95% CI 1.11 to 1.82, P â=â0.005). Subgroup analysis revealed that age 65-75âyears; male sex; ASA III and IV; haemoglobin more than 12âgâl -1 ; intra-operative hypotension; surgical duration more than 120âmin; and education 9âyears or less were significantly associated with POD. No interaction was observed between the subgroups. No significant differences were observed in the secondary outcomes, such as acute kidney injury, stroke, pulmonary infection, cardiovascular complications and all-cause mortality within 1 year postoperatively.CONCLUSIONS:
The poor subjective sleep quality on the night of operative day was independently associated with increased POD risk, especially in certain subpopulations. Optimising peri-operative sleep may reduce POD. Further research should investigate potential mechanisms and causal relationships. TRIAL REGISTRY chictr.org.cn ChiCTR1900028545.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Stroke
/
Delirium
/
Cardiovascular Infections
/
Acute Kidney Injury
/
Emergence Delirium
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
Eur J Anaesthesiol
Journal subject:
ANESTESIOLOGIA
Year:
2024
Document type:
Article
Country of publication: