Haxhire Gani, Pirro Prifti, Majlinda Naco, Rudin Domi, Vjollca Beqiri, Durata Torba, Rajmonda Tare.
The incidence of postoperative delirium in elderly patients undergoing urologic surgery.
Anesth Pain Intens Care Jan ;16(3):262-5.
Background & objectives: Postoperative delirium is a frequent disorder in sick and elderly patients and has been associated with extended hospital stay and increased cost. The purpose of this study was to assess its etiology and incidence and the effectiveness of routine screening of vague postoperative delirium in the elderly using Confusion Assessment Method (CAM). We aimed to evaluate the risk factors and strategies for prevention and treatment as well as the impact of this psychiatric disorder on postoperative morbidity and mortality. We also assessed the economic impact of this disorder. Methodology: In this prospective, descriptive study, 640 patients, age 65 years or older, were included who underwent surgery at a urology clinic. All patients with a history of psychological problems and treated for these before admission were excluded from the study. Variables noted were: age, use of medications, signs and symptoms, biochemical and clinical balance, hemodynamic profile, and pre, intra and postoperative evaluation. Results: Postoperative delirium (POD) occurred in 166 (26%) out of 640 patients. Incidence was increased with increasing of age from 19% to 31%. POD was present in 27(26%) patients of the 65-70 year age group or in 4.2% of the total patients, in 74 (25%) patients of the 71-75 year age group or in 11.6% of the total patients, in 45 (26%) patients of the 76-80 year age group or in 7.0% of the total patients and in 20 (32%) patients of the >80 year age group or in 3.1% of the total patients. The association with many co-morbid conditions was not significant. Conclusion: The incidence of postoperative delirium with increasing age is significantly high. Further studies are required to relate it with physiologic changes in the brain due to preexistent or concomitant diseases, with blood biochemistry abnormalities, and with hormonal disturbances and with hemodynamic instability.
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