Early Assessment of Risk Factors for Emergence Delirium in Adult Patients Undergoing General Anesthesia: A...

Most studies assess emergence delirium (ED) in the postanesthesia care unit (PACU), but immediate post-extubation evaluation and its associated risk factors remain understudied. We aimed to evaluate the incidence of ED immediately after extubation and to identify risk factors associated with its occurrence during this early post-extubation period in surgical patients.

This study employed an observational, cross-sectional, correlational design with convenience sampling.

A cross-sectional correlational study was conducted involving 299 adult patients who underwent surgery at a tertiary medical center. ED was assessed using the Nursing Delirium Screening Scale (Nu-DESC) immediately following extubation, which was performed once patients regained consciousness and were able to follow commands. Demographic and clinical data were collected, including age, sex, comorbidities, type and duration of surgery, and anesthetic agents used. Descriptive statistics and multivariable logistic regression were used to analyze the data.

The incidence of ED was 45.5% (136/299). Multivariable logistic regression analysis demonstrated that anesthetic duration ≥76 min (OR 2.33; 95% CI, 1.23 to 4.42; P = 0.009), lower education level (≤9 years; OR 2.19; 95% CI, 1.17 to 4.08; P = 0.014), and a history of smoking (OR 2.12; 95% CI, 1.16 to 3.88; P = 0.014) were independently associated with an increased risk of ED.

Early identification of risk factors facilitates timely recognition of ED. Lower educational attainment, smoking history, and prolonged anesthetic duration were associated with an increased risk. Immediate assessment of delirium after extubation shows potential value. In the future, it may support targeted monitoring, inform preoperative risk stratification, and help improve anesthesia nursing plans to enhance patient safety.