Delirium after abdominal surgery at a surgical ward with a high standard of delirium care: incidence, risk factors and outcomes.
BACKGROUND
Although delirium is a common problem in elderly patients undergoing surgery, standard delirium care is not available in all wards. The object of this study was to determine the incidence, risk factors and outcomes of postoperative delirium among patients aged 65 and above undergoing elective abdominal surgery at a surgical ward with a high standard delirium care.


METHODS
Prospective descriptive survey in 71 patients. The Delirium Observation Scale was used to screen for delirium. Patients were classified as having a delirium if they met the DSM IV-criteria. Delirious and nondelirious patients were compared and associated risk factors were calculated using logistic regression analyses.


RESULTS
Incidence of postoperative delirium was 24%. Univariate analysis showed that age above 74 years, CST score, ASA score, length of ICU stay, length of hospital stay and number of complications were significant risk factors for delirium. Older age, however, was the only significant risk factor in multivariate analysis (OR 1.16; 95% CI 1.00-1.35; p = 0.05). Lastly, mortality was significantly higher in the delirium group (29.4 vs. 3.7%; p = 0.001).


CONCLUSIONS
At a surgical ward with high standard delirium care, the incidence of delirium was 24% and mortality was higher in delirious patients undergoing elective abdominal surgery.
Koebrugge
Boukje
B
Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands. boukjekoebrugge@hotmail.com
Koek
Huiberdina L
HL
van Wensen
Remco J A
RJ
Dautzenberg
Paul L J
PL
Bosscha
Koop
K
D000005:Abdomen / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D006757:Hospital Units; D006801:Humans; D015994:Incidence; D008297:Male; D012307:Risk Factors; D016896:Treatment Outcome