Background: Postoperative delirium (POD) is a transient postoperative complication that occurs after surgical procedures. Risk factors reported for POD include dementia and cognitive decline. The purpose of this study was to identify predictors of POD by examining the use of preoperative neuropsychological tests, including the Mie Constructional Apraxia Scale (MCAS), and patient background factors. Method: The study was performed as a retrospective cohort study. The subjects were 33 patients (mean age, 75.8 ± 10.9 years; male:female ratio, 26:7) who underwent gastrointestinal surgery at Matsusaka City Hospital between December 2019 and April 2021. Data were collected retrospectively from medical records. The study was started after receiving approval from the institution’s ethics committee. The survey items included general patient information, nutritional assessment, surgical information, and neuropsychological tests. Subjects were classified into 2 groups according to the presence or absence of POD. If a significant difference was observed between the 2 groups, the sensitivity, specificity, and area under the curve were calculated using a receiver operating characteristic (ROC) curve. Result: There were 10 patients in the POD group (male:female ratio, 6:4) and 23 patients in the non-POD group (20:3). The POD group had a shorter education history (p = 0.047) and significantly higher MCAS scores (p = 0.007) than the non-POD group. The ROC curve showed a sensitivity of 90%, a specificity of 69%, and an area under the curve of 0.798 when the MCAS cutoff value was set at 3 points. Conclusion: Preoperative MCAS results were capable of predicting the occurrence of POD after gastrointestinal surgery. In addition, a relatively short education background was also considered a risk factor for POD.
Dement Geriatr Cogn Disord Extra 2021;11:306–313

中文翻译：

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使用 Mie 构造性失用量表预测胃肠手术后谵妄

背景：术后谵妄（POD）是外科手术后发生的一过性术后并发症。报告的 POD 风险因素包括痴呆和认知能力下降。本研究的目的是通过检查术前神经心理学测试的使用来确定 POD 的预测因素，包括 Mie 构造性失用量表 (MCAS) 和患者背景因素。方法：该研究作为回顾性队列研究进行。受试者为 2019 年 12 月至 2021 年 4 月期间在松阪市立医院接受胃肠道手术的 33 名患者（平均年龄 75.8 ± 10.9 岁；男女比例为 26:7）。数据是从病历中回顾性收集的。该研究在获得该机构伦理委员会的批准后开始。调查项目包括一般患者信息、营养评估、手术信息和神经心理学测试。根据是否存在 POD 将受试者分为 2 组。如果观察到两组之间存在显着差异，则使用受试者工作特征（ROC）曲线计算灵敏度、特异性和曲线下面积。结果：POD组10例（男女比例6:4），非POD组23例（20:3）。与非 POD 组相比，POD 组的教育历史更短（p = 0.047），MCAS 分数显着更高（p = 0.007）。ROC曲线的灵敏度为90%，特异性为69%，MCAS截止值为3点时的曲线下面积为0.798。结论：术前MCAS结果能够预测胃肠道手术后POD的发生。此外，相对较短的教育背景也被认为是 POD 的危险因素。
Dement Geriatr Cogn Disord Extra 2021;11:306–313