Epidemic Preventive Management during the Coronavirus Disease 2019 Pandemic Is a Risk Factor for Delirium after Spinal Cord Injury Surgery

Spine Surg Relat Res, 2023 · DOI: 10.22603/ssrr.2023-0033 · Published: June 9, 2023

Spinal Cord Injury Critical Care COVID-19

Simple Explanation

This study investigates the impact of COVID-19 preventive measures on patients undergoing spinal cord injury (SCI) surgery, focusing on the occurrence of postoperative delirium. The research reveals that strict preventive management during the pandemic, including reduced rehabilitation and limited social interaction, is a significant risk factor for delirium after SCI surgery. The findings suggest that healthcare providers should be aware of the increased risk of delirium in SCI patients during pandemics and consider appropriate preventive strategies.

Study Duration

April 2017 and June 2021

Participants

231 patients with traumatic SCI

Evidence Level

Not specified

Key Findings

1
Age ≥73 years, treatment during the COVID-19 pandemic, and psychiatric disorders were identified as independent risk factors for delirium after SCI surgery.
2
Epidemic preventive management during the COVID-19 pandemic was associated with a 3.8-fold increase in the occurrence of delirium after SCI surgery.
3
Patients who experienced delirium had significantly higher rates of pneumonia, transfusion, cardiopulmonary dysfunction, and deep venous thrombosis.

Research Summary

This retrospective study analyzed 231 patients who underwent SCI surgery between 2017 and 2021 to determine the predictors of delirium after surgery. The study found that age, treatment during the COVID-19 pandemic, and psychiatric disorders were significantly associated with postoperative delirium. The authors conclude that comprehensive preventive management during the COVID-19 pandemic was a risk factor for delirium after SCI surgery and that patients should be cautioned regarding this risk.

Practical Implications

Modify Epidemic Preventive Management

Implement strategies to balance infection control with patient's mental and physical well-being, such as modified rehabilitation protocols and enhanced social interaction.

Screen High-Risk Patients

Identify patients at higher risk of delirium (elderly, psychiatric disorders) and implement targeted preventive measures.

Improve Postoperative Care

Enhance postoperative monitoring and care to detect and manage delirium promptly, reducing perioperative complications and improving patient outcomes.

Study Limitations

1
Retrospective data review from a single center limited the ability to deduce causal relationships.
2
The sample size of patients with delirium was relatively small.
3
Failure to control for possible differences in baseline characteristics between patients with SCI before and during the pandemic.

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