Postoperative confusion increases in elderly long-term benzodiazepine users

Area of Science:

• Geriatric Medicine
• Anesthesiology
• Psychiatry

Background:

• Elderly patients often use benzodiazepines for anxiety or sleep disorders.
• Postoperative confusion is a common and serious complication in older adults undergoing surgery.
• The impact of chronic benzodiazepine use on postoperative cognitive function remains an important clinical question.

Purpose of the Study:

• To investigate the association between benzodiazepine use duration and postoperative confusion in elderly surgical patients.
• To examine the influence of preoperative anxiety, depressive state, and cognitive function on this relationship.

Main Methods:

• A study of 328 elderly patients (65-80 years) undergoing orthopedic surgery.
• Assessment of benzodiazepine use via interviews and medicine chest review.
• Evaluation of postoperative confusion using a standardized confusion-assessment method.
• Preoperative cognitive function assessed using the Mini-Mental State (MMS) examination.

Main Results:

• Postoperative confusion occurred in 26% of benzodiazepine users versus 13% of nonusers (P < 0.01).
• Long-term benzodiazepine users (>1 year) had a significantly higher incidence of confusion (35%) compared to short-term users (10%) and nonusers.
• Lower preoperative MMS scores (<23) were more frequent in long-term benzodiazepine users (14%) than short-term users (0%).

Conclusions:

• Long-term benzodiazepine use is a significant risk factor for postoperative confusion in elderly patients.
• Preoperative cognitive status, as measured by MMS, is also affected by long-term benzodiazepine use.
• Clinicians should carefully consider benzodiazepine duration in elderly patients prior to surgery to mitigate postoperative cognitive risks.