William E. Golden, MD; Robert C. Lavender, MD; W. Steven Metzer, MD
Study Objective: To determine whether patients with Parkinson disease are at an increased risk for postoperative confusion.
Design: Retrospective chart review of patients with Parkinson disease who remained in the hospital at least 48 hours after their surgery. Current data were compared with published historical controls.
Setting: Recent medical records of a university-affiliated hospital, Veterans Administration hospital, and community hospital.
Patients: Available charts of patients with Parkinson disease who had had surgery in the last 2 years. Patients were excluded if they were disoriented at admission or had serious metabolic disturbances.
Measurements and Main Results: Fifteen of twenty-five postoperative patients with Parkinson disease (60%; CI, 39% to 78%) suffered significant acute confusion, and 9 of these patients had documented hallucinations. Neuropsychiatric changes were frequently delayed after surgery. The acute confusional state lasted an average 2.5 days; several patients, however, were discharged before resolution. These disturbances did not appear to be related to type of antiparkinsonian medication or anesthetic.
Conclusion: In comparison with historical controls, the relative risk of patients with Parkinson disease having an acute postoperative confusional state is between 2. 8 and 8.1. These patients may need environmental supports during the postoperative period.
Golden WE, Lavender RC, Metzer WS. Acute Postoperative Confusion and Hallucinations in Parkinson Disease. Ann Intern Med. ;111:218–222. doi: 10.7326/0003-4819-111-3-218
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Published: Ann Intern Med. 1989;111(3):218-222.
Neurology, Parkinson's Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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