Incidence of and risk factors for postoperative delirium in older adult patients undergoing noncardiac surgery: a prospective study

Autor: Onuma Chaiwat, Nattikan Wiwatnodom, Nichakarn Rewuri, Titima Wongviriyawong, Arissara Iamaroon, Patumporn Suraarunsumrit
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: BMC Geriatrics, Vol 20, Iss 1, Pp 1-8 (2020)
BMC Geriatrics
ISSN: 1471-2318
Popis: Background To identify the incidence of, risk factors for, and outcomes associated with postoperative delirium (POD) in older adult patients who underwent noncardiac surgery. Methods This prospective study recruited patients aged ≥ 60 years who were scheduled to undergo noncardiac surgery at Siriraj Hospital (Bangkok, Thailand). Functional and cognitive statuses were assessed preoperatively using Barthel Index (BI) and the modified Informant Questionnaire on Cognitive Decline in the Elderly, respectively. POD was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition criteria. Incidence of POD was reported. Univariate and multivariate analyses were used to identify risk factors for POD. Results Of the 249 included patients, 29 (11.6%) developed POD. Most patients (61.3%) developed delirium on postoperative day 1. Univariate analysis showed age ≥ 75 years, BI score ≤ 70, pre-existing dementia, preoperative use of opioid or benzodiazepine, preoperative infection, and hematocrit p p = 0.027) to be independent risk factors for POD. Median length of hospital stay was 10 (range: 3–36) days for patients with POD versus 6 (range: 2–76) days for those without delirium (p < 0.001). Conclusions POD remains a common surgical complication, with an incidence of 11.6%. Patients with pre-existing dementia and age ≥ 75 years are the most vulnerable high-risk group. A multidisciplinary team consisting of anesthesiologists and geriatricians should implement perioperative care to prevent and manage POD.
Databáze: OpenAIRE
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