Abstract
Background and objectives: Delirium is an acute state that causes confusion and occurs frequently after surgery in elderly patients. Delirium is also related to various clinical complications. With increasing numbers of surgeries performed on elderly Koreans, the number of cases of delirium and associated complications will likely rise. The purpose of the present study was to determine whether postoperative delirium in elderly Korean patients negatively influenced other clinical outcomes and their long-term mortality. Materials and Methods: The medical records of 1016 elderly patients (65 years or older) who underwent major abdominal surgery from January 2014 to December 2016 were retrospectively investigated. To determine long-term mortality, patients were followed for up to 12 months post-operation. Results: Delirium occurred in 194 patients (18.3%). Postoperative delirium was significantly associated with the length of hospital stay (B = 2.72), length of ICU stay (B = 18.78), adverse medical events (OR = 2.26, CI = 1.45–3.52), reoperation (OR = 5.50, CI = 1.66–18.22), ICU readmission (OR = 14.10, CI = 2.97–66.90), medical costs (B = 2473.85), discharge to somewhere other than the patient’s home (OR = 6.01, CI = 3.35–10.76), hospital readmission (OR = 2.73, CI = 1.45–5.14), in-hospital mortality (OR = 3.34, CI = 1.21–9.19), three-month mortality (HR = 3.22, CI = 1.27–8.14), six-month mortality (HR = 2.85, CI = 1.28–6.36), and 12-month mortality (HR = 2.19, CI = 1.10–4.32). Conclusions: Postoperative delirium in elderly Korean patients was associated with negative clinical outcomes and mortality. For rapid recovery and increased survival rates in surgical patients, effective delirium-prevention care and active delirium treatments are necessary.
Highlights
Delirium involves rapid cognitive changes which occur in a short period of time and are provoked by environment changes [1]
Postoperative delirium in elderly Korean patients was associated with negative clinical outcomes and mortality
The results of a 24‐month follow‐up with elderly patients who underwent hip surgery revealed that the activities of daily living among patients with delirium were reduced by more than 1.7‐fold [3], while their cognitive functioning after major surgery decreased by more than four‐fold [15]
Summary
Delirium involves rapid cognitive changes which occur in a short period of time and are provoked by environment changes [1]. Major predisposing factors for delirium include old age, cognitive disorders, comorbidity, and health status. Precipitating factors, such as hospitalization, surgery, and medication administration, further increase the risk of delirium [2]. The prevalence of postoperative delirium ranges from 5.0% to 50.0%. More than 80.0% of delirium cases occur one‐three days post‐surgery and are temporary [13,14]. Delirium is an acute state that causes confusion and occurs frequently after surgery in elderly patients. With increasing numbers of surgeries performed on elderly Koreans, the number of cases of delirium and associated complications will likely rise. The purpose of the present study was to determine whether postoperative delirium in elderly Korean patients negatively influenced other clinical outcomes and their long‐term mortality.
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