Risk Factors for Delirium after Spine Surgery: An Age-Matched Analysis.

Area of Science:

• Neurosurgery
• Anesthesiology
• Gerontology

Background:

• Over 30 risk factors for delirium after spine surgery have been identified, complicating prioritization.
• Older age is a significant risk factor, potentially influencing other identified factors.
• This study aimed to isolate other risk factors by performing an age-matched analysis.

Purpose of the Study:

• To investigate risk factors for postoperative delirium following spine surgery.
• To exclude the confounding effect of older age, a known strong risk factor.
• To identify and prioritize other significant risk factors for delirium.

Main Methods:

• A retrospective cohort study involving 532 patients undergoing spine surgery.
• Age-matched case-control design: two delirium-negative patients per one delirium-positive patient.
• Univariate and multivariate analyses were used to identify significant risk factors.

Main Results:

• Postoperative delirium occurred in 11.1% of patients.
• Significant risk factors identified in univariate analysis included: large intraoperative bleeding, low preoperative serum sodium, high postoperative C-reactive protein, low hematocrit, low albumin, and high body temperature.
• Large intraoperative bleeding remained a significant risk factor in multivariate analysis.

Conclusions:

• Intraoperative bleeding volume is a critical modifiable risk factor for postoperative delirium.
• Patients undergoing spine surgery, particularly older patients or those with substantial bleeding, require vigilant monitoring and preventive strategies.
• Further research may focus on mitigating the impact of intraoperative bleeding on delirium development.