Prevalence and Factors Affecting Postoperative Delirium in a Neurosurgical Intensive Care Unit

Abstract

PURPOSE: The aim of this study was to identify the prevalence of, and factors affecting, postoperative delirium (POD) in patients in the neurosurgical intensive care unit. METHODS: A cross-sectional study of 127 Turkish neurosurgical intensive care unit patients admitted between May 2018 and May 2019 was conducted. Patients were assessed for the development of POD using the Intensive Care Delirium Screening Checklist. We collected other independent data variables daily. Data were analyzed using independent sample t test, χ2 test, and logistic regression. RESULTS: The prevalence rates of POD on the first and second postoperative days were 18.9% and 8.7%, respectively. Logistic regression analysis showed that the Glasgow Coma Scale score, albumin level, Spo 2 level, hemoglobin values, undergoing cranial surgery, and having intra-arterial catheter were the independent risk factors for POD. CONCLUSION: These findings may contribute to identifying patients at risk for developing POD and developing strategies to improve patient outcomes.

A Scoping Review of the Incidence, Predictors, and Outcomes of Delirium Among Critically Ill Stroke Patients

“…Current estimates suggest ICU delirium rates range from 18.9% to 83% among diverse cohorts of critically ill patients 2,4,5. Decades of research suggest ICU-acquired delirium is associated with poor clinical outcomes.…”

“…Current estimates suggest ICU delirium rates range from 18.9% to 83% among diverse cohorts of critically ill patients. 2,4,5 Decades of research suggest ICU-acquired delirium is associated with poor clinical outcomes. In a variety of ICUs, delirium has shown to be an independent predictor of prolonged hospital and ICU length of stay (LOS); 6 higher ICU, 7 hospital, 7,8 and 6-month mortality; 8 prolonged mechanical ventilation; 7 postdischarge disability; 9 and severe long-term cognitive impairment.…”

Family Presence May Reduce Postoperative Delirium After Spinal Surgery

“…21,22 Although we found no difference in delirium or confusion based on family presence, our study examined only the first postop night. Although ICU delirium may take up to 72 hours to manifest, 23 Kose et al 5 found that 18.9% of postop neurosurgical patients experience delirium on their first postop day. It is also possible that because confusion and delirium are known to wax and wane, our observation of baseline and first postop day may have failed to capture undetected incidences of delirium or confusion.…”

“…Postop occurrence estimates range from 17% to 61% and are higher in the geriatric population 4. Evidence supports that roughly 1 in 5 persons will experience delirium after spinal surgery,5 but this is not well studied in the postop spinal surgical population. Delirium can include hallucinations, confusion, anxiety, neurologic changes, restlessness, lethargy, disrupted sleep, memory loss, difficult concentrating, and unclear speech 6.…”

Letter Regarding “Prevalence and Factors Affecting Postoperative Delirium in a Neurosurgical Intensive Care Unit”

“…With great interest, we read the recent article by Kose et al 1 assessing the prevalence and factors affecting postoperative delirium (POD) in the neurosurgical intensive care unit. Because POD has been significantly associated with adverse outcomes and high costs after neurosurgery, 2 this study has potentially practical implications.…”