Preliminary Insights into the Association Between Room Transfer and Delirium Symptoms After Orthopedic Surgery: A...

Because of population aging in recent decades, the number of patients at risk of postoperative delirium has increased. Delirium can lead to adverse events such as falls, prolonged hospital stays, and increased mortality, making postoperative delirium prevention a critical issue.

This study was to identify environmental factors associated with delirium symptoms, which are specifically screened for in STEP 2 of the multidisciplinary Delirium Team Approach (DELTA) Program after orthopedic surgery under general anesthesia.

This was a retrospective, single-center study using a medical record review. Of the 72 target patients, 36 patients with confirmed STEP 2 delirium symptoms (defined by attention disturbance, altered levels of consciousness, acute onset/fluctuation, and sleep-wake rhythm) within the DELTA Program formed the case group, and the remaining 36 formed the control group. The control group was matched according to age and sex. We also examined other factors, including the number of room transfers, to link the methods to the objective of studying environmental factors. The number of days from surgery to the development of STEP 2 symptoms was determined for the case group, and data for the same number of days were examined for the control group.

The mean age (standard deviation) of the case group was 75.9 (9.5) years, and of the control group was 75.1 (10.0) years. The mean number of days from admission date to the date of surgery was 5.4 (5.4) days for the case group and 4.6 (3.6) days for the control group. Binary logistic regression analysis showed that the factors associated with the presence of STEP 2 symptoms after controlling for the number of days from admission to surgery were the preoperative room changes (odds ratio (OR) 8.61, 95% confidence interval (CI) 1.47-50.42) and the postoperative room changes. (OR 4.10, 95% CI 1.34-12.45).

This study suggests a potential association between room transfers and the development of STEP 2 delirium symptoms after orthopedic surgery under general anesthesia. In wards managed by the DELTA Program, avoiding room changes both pre- and post surgery may help reduce the incidence of postoperative delirium. However, as this was a retrospective study, we couldn't adjust for all confounding factors such as surgery type or blood loss. Therefore, these findings are not definitive, and further detailed investigations are necessary to confirm this relationship.