Predictive Factors in Development of Postoperative Delirium in Chronic Subdural Hematomas: A Prospective Multicenter...

Area of Science:

• Neurosurgery
• Geriatrics
• Critical Care Medicine

Background:

• Chronic subdural hematoma (CSDH) is a common neurosurgical condition, particularly in the elderly.
• Postoperative delirium is a frequent complication in elderly patients undergoing surgery, leading to increased morbidity and hospital stays.
• Risk factors for delirium specifically in CSDH patients remain under-investigated.

Purpose of the Study:

• To identify independent risk factors for postoperative delirium in patients undergoing surgery for chronic subdural hematoma.
• To analyze clinical indicators associated with delirium development post-CSDH surgery.
• To develop a predictive model for postoperative delirium in this patient population.

Main Methods:

• A prospective study involving 202 consecutive patients with CSDH across European neurosurgical centers.
• Data collection included various clinical indicators and patient demographics.
• Univariate and multivariate regression analyses were employed to identify significant risk factors for delirium.

Main Results:

• Postoperative delirium occurred in 31.2% (63 out of 202) of patients.
• Multivariate analysis identified restraint belt use, electrolyte imbalance, visual analog scale (VAS) pain score, and midline shift as independent predictors of delirium.
• Factors such as age and hematoma thickness were not significant predictors in the multivariate model.

Conclusions:

• Restraint belt use, electrolyte imbalance, elevated VAS pain scores, and greater midline shift are significant risk factors for delirium following CSDH surgery.
• These findings highlight the importance of monitoring and managing these specific factors to mitigate delirium risk.
• The developed prediction models can serve as a valuable reference for clinical risk assessment in CSDH patients.