Factors Affecting Postoperative Delirium in Patients With Colorectal Cancer

As the population ages, the number of patients with colorectal cancer (CRC) is increasing. It is also said that older adults are at higher risk of delirium. The aim of this study was to investigate risk factors for delirium after CRC surgery, and its impact on perioperative outcomes.

In this multicenter, retrospective, observational study, 6434 consecutive patients with CRC who underwent colorectal surgery were divided into two groups: those with delirium (n=50), and those without delirium (n=6384). Clinical features were compared between the groups.

Patients in the delirium group were older (over 80 years: 62.0% vs. 23.2%, p<0.001), more commonly underwent open surgery (30.0% vs. 8.8%, p<0.001), had a shorter operative time (192 vs. 221 min, p=0.048) and lower rates of pathological T4 stage (12.0% vs. 29.3%, p=0.007). Multivariate analysis revealed age ≥80 years (odds ratio=4.904, 95% confidence interval=2.747-8.756; p<0.001) and open surgery (odds ratio=2.171, 95% confidence interval=1.087-4.336; p=0.028) as independent predictors of delirium.

Elderly age and open surgery are risk factors for delirium after CRC surgery and are associated with longer hospital stays. In elderly patients, selecting the least invasive surgical procedure possible is crucial for preventing postoperative delirium.