A Simple Tool to Predict Development of Delirium After Elective Surgery

Area of Science:

• Geriatric Medicine
• Neuroscience
• Surgical Care

Background:

• Postoperative delirium is a significant concern in elderly surgical patients.
• Early identification of patients at high risk is crucial for timely intervention.
• Existing risk assessment tools may lack efficiency or predictive accuracy.

Purpose of the Study:

• To evaluate a rapid clinical tool for assessing delirium risk post-elective surgery.
• To identify predictive factors for postoperative delirium in older veterans.

Main Methods:

• Prospective observational study involving veterans aged 65+ undergoing elective surgery.
• Preoperative assessment included cognitive tests (Mini-Cog), health questionnaires (PHQ-9), and comorbidity scores (Charlson-Deyo).
• Postoperative delirium was assessed using the Confusion Assessment Method (CAM) or Family Confusion Assessment Method (FAM-CAM).

Main Results:

• 13% of participants developed delirium within 72 hours post-surgery.
• Factors associated with increased delirium risk included low education, poor cognitive scores (Mini-Cog, orientation), alcohol use, and higher comorbidity index.
• The Mini-Cog score demonstrated significant predictive power (AUC=0.77) for postoperative delirium.

Conclusions:

• The Mini-Cog is a valuable and efficient tool for predicting postoperative delirium risk in older veterans undergoing elective surgery.
• This finding supports the integration of the Mini-Cog into preoperative assessments for enhanced patient safety.