Researchers found that delirium alone contributes significantly to adverse outcomes after surgery, such as length of stay, institutional discharge and readmission, and should be considered a leading postoperative complication for predicting adverse hospital outcomes.
The prospective cohort study included 566 participants aged older than 70 years without recognized dementia who underwent elective major orthopedic, vascular or abdominal surgical procedures with a minimum 3-day hospitalization. They measured delirium daily using the Confusion Assessment Method and a validated medical record review method.
The included adverse events were length of stay (LOS) of more than 5 days, institutional discharge and rehospitalization within 30 days of discharge.
Forty-seven patients (8.3%) developed major complications and 135 (23.9%) developed delirium.
Major complications only were related to a prolonged LOS, whereas delirium alone was related to prolonged LOS, institutional discharge and 30-day readmission..
The subgroup that experienced complications and delirium had the highest rates of all adverse outcomes.
At the population level, delirium attributed the highest risk compared with all other adverse events.
Delirium should be a leading postoperative complication for predicting adverse hospital outcomes, according to the researchers.
The researchers noted that other published rates for delirium ranged from 9% to 29.1%, comparable to the rate in this study.
The researchers suggest managing delirium and major postoperative complications simultaneously to reduce the most risk posed by both conditions. – by Abigail Sutton
Disclosure: The researchers reported no relevant financial disclosures.