Greater Risk Of Postoperative Delirium Is Associated With Advanced Age, Anemia, And Low Cognitive Reserve

Abstract

INTRODUCTION: Delirium is an acute change in cognition and attention, common in the postoperative period in older patients, associated with increased costs and longer hospital stay. OBJECTIVE: To evaluate the frequency, risk factors, and influence of postoperative delirium in older patients submitted to elective noncardiac surgery. METHOD: This was a cross-sectional, observational study of older adults (65 years or older) hospitalized for elective noncardiac surgery. During the immediate preoperative period (24 hours), risk factors such as age, sex, cognition (MiniCog), functional status (Katz and Timed Up and Go), medications, and clinical aspects were evaluated. Delirium, in the immediate postoperative period (up to 72 hours), was evaluated using the Confusion Assessment Method (CAM). RESULTS: A total of 83 patients were included in the study. Of these, 44.6% (n = 37) had undergone orthopedic surgery, 42.16% (n = 35), general surgery, and 13.3% (n = 11), urological surgery. Most participants were men (53%), with a mean age of 73 (65–94) years. Overall, 9.6% (n = 8) had postoperative delirium: 6% of the hyperactive subtype (n = 5), 2.4% of the hypoactive subtype (n = 2), and 1.2% of the mixed subtype (n = 1). These patients were older (p = 0.02), had greater cognitive decline (p = 0.01), anemia (p = 0.04), and prolonged hospital stay (p = 0.001). CONCLUSION: Postoperative delirium was more commonly observed in the older old with cognitive decline and anemia, with an impact on hospital length of stay, highlighting the importance of a more comprehensive preventive evaluation in the preoperative period.

Keywords

• delirium
• postoperative period
• health of the elderly