Incidence of postoperative delirium is high even in a population without known risk factors.
OBJECTIVE
Postoperative delirium is a recognized complication in populations at risk. The aim of this study is to assess the prevalence of early postoperative delirium in a population without known risk factors admitted to the ICU for postoperative monitoring after elective major surgery. The secondary outcome investigated is to identify eventual independent risk factors among demographic data and anesthetic drugs used.


METHODS
An observational, prospective study was conducted on a consecutive cohort of patients admitted to our ICU within and for at least 24 h after major surgical procedures. Exclusion criteria were any preexisting predisposing factor for delirium or other potentially confounding neurological dysfunctions. Patients were assessed daily using the confusion assessment method for the ICU scale for 3 days after the surgical procedure. Early postoperative delirium incidence risk factors were then assessed through three different multiple regression models.


RESULTS
According to the confusion assessment method for the ICU scale, 28 % of patients were diagnosed with early postoperative delirium. The use of thiopentone was significantly associated with an eight-fold-higher risk for delirium compared to propofol (57.1% vs. 7.1%, RR = 8.0, χ2 = 4.256; df = 1; 0.05 < p < 0.02).


CONCLUSIONS
In this study early postoperative delirium was found to be a very common complication after major surgery, even in a population without known risk factors. Thiopentone was independently associated with an increase in its relative risk.
Service of Anesthesiology, Bellinzona Regional Hospital, Via Ospedale 1, 6500, Bellinzona, Switzerland, saporito_andrea@hotmail.com.
Andrea
A
Saporito
Evelina
E
Sturini
D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects; D000777:Anesthetics / Q000009:adverse effects*; D019162:Anesthetics, Combined; D003693:Delirium / Q000139:chemically induced* / Q000175:diagnosis; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced* / Q000175:diagnosis; D015742:Propofol / Q000009:adverse effects*; D011446:Prospective Studies; D012307:Risk Factors; D013874:Thiopental / Q000009:adverse effects*
D000777:Anesthetics; D019162:Anesthetics, Combined; D013874:Thiopental; D015742:Propofol