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Predicting postoperative delirium after vascular surgical procedures.

Linda Visser1, Anna Prent1, Maarten J van der Laan1

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Postoperative delirium (POD) in vascular surgery patients is predicted by preoperative cognitive impairment and major open surgery. POD increases mortality and institutionalization, necessitating targeted care for high-risk individuals.

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Area of Science:

  • Vascular Surgery
  • Geriatric Medicine
  • Anesthesiology

Background:

  • Postoperative delirium (POD) is a common complication in elderly surgical patients.
  • Identifying risk factors for POD in vascular surgery is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the incidence of POD in elective vascular surgery patients.
  • To identify preoperative and intraoperative risk factors associated with POD.

Main Methods:

  • Prospective database of vascular surgery patients (March 2010-November 2013).
  • Collection of preoperative, intraoperative, and postoperative risk factors.
  • Analysis of POD incidence, surgical complications, hospital stay, and mortality.

Main Results:

  • 4.8% of patients developed POD.
  • Independent predictors of POD included preoperative cognitive impairment, open aortic or amputation surgery, current smoking, hypertension, and age ≥80 years.
  • POD was associated with longer hospital stays, increased complications, and higher mortality.

Conclusions:

  • Preoperative cognitive impairment and major open surgery are significant risk factors for POD in vascular surgery.
  • POD is linked to adverse outcomes, including increased mortality and institutionalization.
  • High-standard delirium care should be considered for at-risk patients.