Delirium in elderly postoperative patients: A prospective cohort study

Area of Science:

• Geriatric Medicine
• Neuroscience
• Surgical Care

Background:

• Postoperative delirium is a significant concern in elderly patients, impacting recovery and outcomes.
• Identifying incidence, duration, and risk factors is crucial for effective management.

Purpose of the Study:

• To determine the incidence, time to onset, and risk factors for postoperative delirium in patients aged 65 and older.
• To compare delirium incidence in this cohort with existing surgical and ortho-geriatric populations.

Main Methods:

• Prospective cohort study involving 202 elderly patients.
• Daily screening using the 4A's Test and Delirium Observation Screening Scale.
• Psychiatric assessment per DSM-V criteria and logistic regression analysis for risk factors.

Main Results:

• Postoperative delirium diagnosed in 7.5% of patients, with 73.3% developing it within 48 hours.
• Median delirium duration was 1 day.
• Higher odds of delirium associated with age over 80, heart failure, surgical drains, bladder catheter, and central venous catheter.

Conclusions:

• The incidence of postoperative delirium in this sample was lower than in other reported populations.
• While age is a factor, several modifiable postoperative elements are linked to delirium occurrence.
• Targeting modifiable factors presents opportunities for delirium prevention in elderly surgical patients.