The incidence of postoperative delirium in elderly patients after urologic surgery

Postoperative delirium (POD) is a frequent postoperative disorder to the sick and elderly, and always has been associated with extended of day stay in hospital, and certainly more cost for the hospital as well. Additionally, delirium is associated with increased postoperative complications, longer length of stay, longer intensive care unit stay (ICU), and much higher rates of discharge to a nursing home. As a result, delirium adds significant cost to hospitalization and subsequent medical care. The delirium causes an increased mortality and an increasing of mental status deterioration characterized by reduction of environmental recognition as well as the disorder of alertness. The purposes of this study are: a) the effectiveness of routine screening of postoperative Delirium in the elderly using Confusion Assessment Method (CAM)). In those cases psychiatrists are not necessary; b) understanding of risk factors and strategies for prevention and treatment; c) understanding of the impact of this psychotic disorders in postoperative morbidity and mortality; d) recognition of the economic impact of these disorders in the health service; e) describing of the etiology and incidence of Delirium post-operative.

In this study are included 640 patients aged over 65 years who underwent an operation at the urologic clinic. This study is prospective and casual. Are excluded from the study all patients with psychological problems in admission and that were treated for these pathologies before admission in Urology Clinic.

Are evaluated all the data taken from patients and from their examinations as: age, use of medications, symptoms and problems, biochemical and clinical balance, hemodynamic examination, and preoperative, intra operative and postoperative evaluations. Is observed that post operative Delirium occurred at 166 patients from 640 in total on the average of 26% of patients. Incidence was increased with increasing of age from 19% to 31%.

Postoperative Delirium occurs as a result of the combination of several factors, not just those related to internal physiological age, but combining of these factors with the diseases which carries this age, with medications used for this age, with surgical stress, with biochemical imbalances, hemodynamic problems, and electrolytic disorders as well.