Psychiatry Research EG

Background Postoperative delirium (POD) is a common and serious problem that is characterized by fluctuating symptoms of inattention, disturbance of consciousness, and disorganized thinking. It is associated with adverse outcomes in a number of settings. POD has a multifactorial pathogenesis, and its incidence ranges from 10 to 46% in the general surgical population. Aim of the work The aim of this study was to investigate preoperative, operative, and postoperative factors that predict for POD. Materials and methods Between November 2014 and April 2015, 123 consecutive elective vascular surgery patients were evaluated for the diagnosis of POD. Various risk factors such as preoperative, operative, and postoperative were evaluated. Results Patients who developed delirium were significantly older (66.93 ± 4.80, P < 0.001). Those who developed delirium had a significantly higher frequency of history of diabetes mellitus and renal impairment. The Mini-Mental State Examination indicated that preoperative cognitive functioning was significantly impaired (19.36 ± 1.78, P < 0.001) in patients who had POD. Patients who developed POD were also more likely to report a history of moderate levels of depressive symptoms (22.64 ± 7.91, P < 0.001). Postoperative C-reactive protein was significantly higher (112.86 ± 12.35, P < 0.001) in delirious patients. Tendency for ICU admittance was significantly more frequent [36 (85.7%), P < 0.001] in delirious patients. Also, the prolonged hospital stay was significantly related to POD (9.36 ± 2.69, P < 0.001). Conclusion This study provides evidence that preoperative factors such as age, medical comorbidities (diabetes and renal impairment), cognitive impairment, and presence of depressive symptoms can be used as predictors for an increased risk for POD after vascular surgery. In addition, the type of surgical procedure and other postoperative factors such as high levels of postoperative C-reactive protein, ICU admittance, and prolonged hospital stay can predict POD. Keywords: delirium, predictors, vascular surgery