Association between remimazolam and postoperative delirium in older adults undergoing elective cardiovascular surgery : a prospective cohort study
© 2022. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists..
PURPOSE: Postoperative delirium is one of the most common complications after cardiovascular surgery in older adults. Benzodiazepines are a reported risk factor for delirium; however, there are no studies investigating remimazolam, a novel anesthetic agent. Therefore, we prospectively investigated the effect of remimazolam on postoperative delirium.
METHODS: We included elective cardiovascular surgery patients aged ≥ 65 years at Hamamatsu University Hospital between August 2020 and February 2022. Patients who received general anesthesia with remimazolam were compared with those who received other anesthetics (control group). The primary outcome was delirium within 5 days after surgery. Secondary outcomes were delirium during intensive care unit stay and hospitalization, total duration of delirium, subsyndromal delirium, and differences in the Mini-Mental State Examination scores from preoperative to postoperative days 2 and 5. To adjust for differences in the groups' baseline covariates, we used stabilized inverse probability weighting as the primary analysis and propensity score matching as the sensitivity analysis.
RESULTS: We enrolled 200 patients; 78 in the remimazolam group and 122 in the control group. After stabilized inverse probability weighting, 30.3% of the remimazolam group patients and 26.6% of the control group patients developed delirium within 5 days (risk difference, 3.8%; 95% confidence interval -11.5% to 19.1%; p = 0.63). The secondary outcomes did not differ significantly between the groups, and the sensitivity analysis results were similar to those for the primary analysis.
CONCLUSION: Remimazolam was not significantly associated with postoperative delirium when compared with other anesthetic agents.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
Journal of anesthesia - 37(2023), 1 vom: 11. Feb., Seite 13-22 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Aoki, Yoshitaka [VerfasserIn] |
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| Links: |
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| Themen: |
12794-10-4 |
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| Anmerkungen: |
Date Completed 25.01.2023 Date Revised 01.02.2023 published: Print-Electronic CommentIn: J Anesth. 2022 Nov 21;:. - PMID 36409331 Citation Status MEDLINE |
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| doi: |
10.1007/s00540-022-03119-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM347361234 |
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| 100 | 1 | |a Aoki, Yoshitaka |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association between remimazolam and postoperative delirium in older adults undergoing elective cardiovascular surgery |b a prospective cohort study |
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| 500 | |a Date Revised 01.02.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Anesth. 2022 Nov 21;:. - PMID 36409331 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists. | ||
| 520 | |a PURPOSE: Postoperative delirium is one of the most common complications after cardiovascular surgery in older adults. Benzodiazepines are a reported risk factor for delirium; however, there are no studies investigating remimazolam, a novel anesthetic agent. Therefore, we prospectively investigated the effect of remimazolam on postoperative delirium | ||
| 520 | |a METHODS: We included elective cardiovascular surgery patients aged ≥ 65 years at Hamamatsu University Hospital between August 2020 and February 2022. Patients who received general anesthesia with remimazolam were compared with those who received other anesthetics (control group). The primary outcome was delirium within 5 days after surgery. Secondary outcomes were delirium during intensive care unit stay and hospitalization, total duration of delirium, subsyndromal delirium, and differences in the Mini-Mental State Examination scores from preoperative to postoperative days 2 and 5. To adjust for differences in the groups' baseline covariates, we used stabilized inverse probability weighting as the primary analysis and propensity score matching as the sensitivity analysis | ||
| 520 | |a RESULTS: We enrolled 200 patients; 78 in the remimazolam group and 122 in the control group. After stabilized inverse probability weighting, 30.3% of the remimazolam group patients and 26.6% of the control group patients developed delirium within 5 days (risk difference, 3.8%; 95% confidence interval -11.5% to 19.1%; p = 0.63). The secondary outcomes did not differ significantly between the groups, and the sensitivity analysis results were similar to those for the primary analysis | ||
| 520 | |a CONCLUSION: Remimazolam was not significantly associated with postoperative delirium when compared with other anesthetic agents | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cardiovascular surgical procedures | |
| 650 | 4 | |a Cognitive dysfunction | |
| 650 | 4 | |a Mental status and dementia tests | |
| 650 | 4 | |a Postintensive care unit delirium | |
| 650 | 4 | |a Remimazolam sedation | |
| 650 | 7 | |a Anesthetics |2 NLM | |
| 650 | 7 | |a Benzodiazepines |2 NLM | |
| 650 | 7 | |a 12794-10-4 |2 NLM | |
| 700 | 1 | |a Kurita, Tadayoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Nakajima, Mikio |e verfasserin |4 aut | |
| 700 | 1 | |a Imai, Ryo |e verfasserin |4 aut | |
| 700 | 1 | |a Suzuki, Yuji |e verfasserin |4 aut | |
| 700 | 1 | |a Makino, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Kinoshita, Hiroyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Doi, Matsuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Nakajima, Yoshiki |e verfasserin |4 aut | |
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