Delirium Could Cause Post-Surgery Problems

Delirium after elective surgery linked to adverse outcomes in older adults

(RxWiki News) Delirium is common in the elderly during hospitalizations, but it may bring with it some serious risks.

In a new study, researchers from Beth Israel Deaconess Medical Center in Boston found that postoperative delirium may contribute to other negative outcomes in older adults, such as stroke, infection and extended hospital stays.

"Delirium is not consistently considered a major postoperative complication," said lead study author Sharon K. Inouye, MD, MPH, director of the Aging Brain Center at the Institute for Aging Research and a professor of medicine at Harvard Medical School, in a press release. "However, given its prevalence and clinical effect, delirium should be considered a leading postoperative complication for predicting adverse hospital outcomes."

Delirium is a serious disturbance in mental function where patients become confused and unaware of their environments. The onset of delirium is usually rapid — within a few hours or days.

Delirious patients may have hallucinations, become easily agitated or have trouble speaking. Medication, infection, breathing problems and disturbances in the body’s metabolic balance (such as low sodium or potassium levels) can all cause delirium.

Dr. Inouye and team looked at the medical records of 566 patients age 70 or older who underwent major surgery and stayed in the hospital for at least three days.

Patients were assessed for delirium every day. Major postoperative complications — such as stroke, infection or an unplanned return to surgery — were recorded.

Dr. Inouye and team also looked at less severe issues like extended hospital stays and being rehospitalized within 30 days of discharge.

Patients fell into four groups: neither complications nor delirium, complications but not delirium, delirium but not complications, and both complications and delirium.

About 8 percent of patients developed major complications, while 24 percent developed delirium.

Those who developed delirium tended to have longer hospital stays and more readmissions. These patients were also more likely to be discharged to institutional care post-surgery instead of returning home.

"These results suggest that it is important to manage delirium and major postoperative complications simultaneously to reduce the risks posed by both conditions," Dr. Inouye and colleagues wrote.

This study was published online Sept. 9 in the journal JAMA Surgery.

The National Institute on Aging, the Health Resources and Services Administration, and the John A. Hartford Foundation Center of Excellence funded this research.

No conflicts of interest were disclosed.

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Review Date: 
September 9, 2015