Risk factors for postoperative delirium in elderly patients after spinal fusion surgery

Abstract

Background: Postoperative delirium (POD) has an incidence rate of 9% to 41%. It is directly linked to decreasing cognitive function, increasing length of hospitalization and cost, as well as other complications and mortality. We aimed to assess the risk factors for POD among elderly patients by analyzing data from those who underwent spinal surgery.Methods: This study included 446 patients aged 65 years or older who underwent spinal surgery at our institution between March 2013 and May 2018. Data were collected retrospectively from the patients’ electronic medical records, and logistic regression was used to identify the risk factors associated with POD. The diagnosis of POD was based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and was made through consultation with a psychiatrist during postoperative hospitalization and before discharge.Results: Seventy-eight (78/446, 17.4%) patients were diagnosed with POD. The most relevant risk factor for POD was preoperative cognitive dysfunction (odds ratio [OR], 4.37; 95% confidence interval [CI], 1.60 to 11.93; P = 0.004), followed by emergency surgery (OR, 2.70; 95% CI, 1.27 to 5.74; P = 0.01), age (OR, 1.19; 95% CI, 1.13 to 1.26; P < 0.001), and anesthesia time (OR, 1.01; 95% CI 1.00 to 1.01; P = 0.002).Conclusions: Preoperative cognitive dysfunction, emergency surgery, age, and anesthesia time were factors that affected POD occurrence after spinal surgery. Patients with such associated factors may be at a higher risk for POD when undergoing spinal surgery, and hence, careful management may be necessary for these patients.

The Relationship Between Suboptimal Social Networks and Postoperative Delirium: The PNDABLE Study

“…People with rich social networks have more opportunities to communicate with the outside world, and are more likely to promote cognitive, physical and social participation, enhance physical and mental stimulation, and effectively reduce negative psychological states, thereby reducing the risk of cognitive dysfunction. Moreover, Preoperative cognitive status was related to POD ( Choi et al, 2020 ), which is supported by our results. Besides, we could apply the results of this study to identify patients at a high risk for POD.…”

The Relationship between Perioperative Blood Transfusion and Postoperative Delirium in Patients Undergoing Spinal Fusion Surgery: Clinical Data Warehouse Analysis

“…The incidence of POD varied between 9% and 41% depending on the type of surgery [1,2,5,[10][11][12]. In this study, the incidence of POD was 5.9% and lower than other studies [5,[18][19][20].…”

“…However, questions remain about the generalizability and application of risk factors of POD to patients undergoing specified surgery, because risk factors of POD were determined on the basis of the analysis of various types of surgeries. According to studies, the wellknown risk factors of POD were sometimes denied [10][11][12]. Consequently, the incidences of POD were various among studies [5,[10][11][12].…”

“…According to studies, the wellknown risk factors of POD were sometimes denied [10][11][12]. Consequently, the incidences of POD were various among studies [5,[10][11][12].…”

“…It might result in an increase in the numbers of risk factors and variety of risk factors among studies and type of surgery [1,3]. In previous studies, the preoperative anemia or blood transfusion associated with intraoperative blood loss Medicina 2022, 58, 268 2 of 15 may predict the development of POD [5,[8][9][10]. However, other studies have reported inconsistent findings (There was no significant relationship between preoperative anemia and blood transfusion and POD) [11,12].…”