title: Postoperative delirium in patients with history of alcohol abuse.
abstract: BACKGROUND
  Postoperative delirium (POD) is an acute confusional state characterized by changes in consciousness and cognition, which may be fluctuating, developing in a small period of time. The aim of this study was to evaluate the relationship between alcohol abuse and the development of POD.
  
  
  METHODS
  We prospectively evaluated consecutively all postoperative patients admitted in the Post-anesthesia Care Unit over a 1-month period for delirium, using the Portuguese versions of the the Nursing Delirium Screening Scale. Before surgery, alcohol consumption was inquired and alcohol abuse was assessed by the CAGE (Cutting Down, Annoyance, Guilt and Eye-opener) questionnaire; a score ≥2 defined alcohol abuse. Fischer exact test or chi-square was applied for comparisons. Risk factors were analyzed in a multivariate analysis using a logistic regression with odds ratios (OR) and 95% confidence intervals (95%CI).
  
  
  RESULTS
  Two hundred twenty-one patients were enrolled. Delirium was seen in 11% patients. The incidence of alcohol abuse was 10%. Patients with alcohol abuse were more frequently men (P<.001) and had a higher ASA physical status III/IV (P=.021). POD was more frequent in patients with alcohol abuse (30% vs. 9%; P=.002). Age (OR: 5.9; 95%CI: 2.2-15.9; P<.001 for patients ≥65years), ASA physical statusIII/IV (OR: 4.2; 95%CI: 1.7-10.7; P=.002) and alcohol abuse (OR: 4.2; 95%CI: 1.4-12.9; P=.013) were found to be independent predictors for POD.
  
  
  CONCLUSIONS
  Older patients, higher ASA physical status and alcohol abuse were more frequent in patients with POD. Alcohol abuse was considered an independent risk factor for POD.
authors.affiliation: Department of Anaesthesiology, Hospital de São João, Oporto, Portugal.
authors.forename: G
authors.initials: G
authors.lastname: Sousa
authors.affiliation: Department of Anaesthesiology, Hospital de São João, Oporto, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Pinho
authors.affiliation: Department of Anaesthesiology, Hospital de São João, Oporto, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Santos
authors.affiliation: Department of Anaesthesiology, Hospital de São João, Oporto, Portugal; Department of Anaesthesiology and Perioperative Medicine, Faculty of Medicine, University of Porto, Oporto, Portugal. Electronic address: fernando.abelha@gmail.com.
authors.forename: F J
authors.initials: FJ
authors.lastname: Abelha
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications*; D003693:Delirium / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors
keywords: Abuso de sustancias; Alcohol; Complicaciones postoperatorias; Delirio; Delirium; Postoperative complications; Substance abuse