De voorspellende waarde van de mini-mental state examination voor postoperatief delier bij ouderen.

Boks, M.N. (2013) De voorspellende waarde van de mini-mental state examination voor postoperatief delier bij ouderen. thesis, Medicine.

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Abstract

Delirium is a common postoperative complication in elderly patients. Since cognitive dysfunction is a known predisposing factor for delirium, we hypothesized that a low score on the Mini-Mental State Examination would be a predictor for delirium symptoms in frail cancer patients over 65 who underwent a surgical procedure. Also, we expected the risk to be higher with decreasing scores. For this prospective cohort study, frail patients have been selected using the Groningen Frailty Indicator. The MMSE was applied at least 24 hours prior to surgery. Symptoms of delirium were registered using the Delirium Observation Scale up to seven days after the surgical procedure. Symptoms of delirium, defined as having a mean DOS-score of 3 or higher during at least one day, were the outcome variable in a multivariate logistic regression. Dependent variables were age, gender, type of surgery (intracavitary or superficial) and MMSE-score. A total of 20.5% (n=45) developed symptoms of delirium. The MMSE-score was the only significant predictor of delirium (p < 0.001). Compared to patients with a high score on the MMSE (29 or 30 points), patients with a score ranging from 25 to 28 had a 3.7 times higher risk for developing delirium symptoms, those with a score of 21 to 24 a 4.3 times higher risk and those patients with a score of 20 or lower an 8.1 times higher risk. Using a score of 27 as cut-off-point for preventive measures, the sensitivity of the MMSE is 71.1%, the specificity 59.4%. The MMSE has a predictive value for symptoms of postoperative delirium in frail elderly cancer patients. A lower score leads to an up to eightfold increased risk for developing symptoms of delirium compared to a high score. Although the sensitivity and specificity of the test with a cut-off-point of 27 is low, the MMSE could be useful as a screening instrument for the allocation of preventive measures.

Item Type:	Thesis (Thesis)
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:05
Last Modified:	25 Jun 2020 11:05
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2541

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