Postoperative Confusion in Patients with Parkinson'S Disease Undergoing Deep Brain Stimulation of the Subthalamic Nucleus.

Postoperative Confusion in Patients with Parkinson'S Disease Undergoing Deep Brain Stimulation of the Subthalamic Nucleus.

World Neurosurg. 2019 Feb 11;:

Authors: Paim Strapasson AC, Martins Antunes ÁC, Oppitz PP, Dalsin M, Roberto de Mello Rieder C

Abstract
BACKGROUND: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established treatment for patients suffering from Parkinson's disease (PD). One of its adverse events is the development of postoperative confusion.
OBJECTIVE: To report the incidence and associated factors of postoperative confusion after STN-DBS surgery Methods: retrospective cohort study by chart review of patients with PD, who underwent STN-DBS surgery in a Brazilian public academic hospital from January 2013 to October 2017. The primary outcome was the incidence of postoperative confusion. The association of the outcome and imaging and clinical variables was evaluated.
RESULTS: Forty-nine patients were submitted to STN-DBS surgery for PD. The incidence of postoperative confusion was 26.5% (CI95% 15-41.1%). Univariate analysis identified the following variables associated with the development of confusion: age (63.2±7.8 versus 55.4±9.1 years-old, p= 0.009), disease duration (16.5±5.1 versus 13.2±4.2 years, p=0.027), Charlson comorbidity index (2 [1-3] versus 1 [0-1], p= 0.002), width of the third ventricle (5.4±2.1 versus 4±1.6mm, p= 0.018) and cella media index (5±1 versus 5.6±0.8, p= 0.018). After adjustment, the Charlson comorbidity index remained significant (adjusted RR 1.64 [CI95% 1.17-2.3], p= 0.004).
CONCLUSION: The incidence of postoperative confusion in this cohort was 26.5%. After confounding factors analysis, the Charlson comorbidity index was significantly associated with postoperative confusion.

PMID: 30763744 [PubMed - as supplied by publisher]

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