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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2014 December;21(4):209-16
The risk factors of postoperative delirium after vascular surgery
Kim M. Y. 1, 2, Park U. J. 1, Kim H. T. 1, Cho W. H. 1, Kim M. A. 2
1 Department of Vascular Surgery, Dongsan Medical Center, Keimyung University, Daegu, Korea;
2 School of Nursing, Keimyung University, Daegu, Korea
AIM: Vascular surgery has been reported to be associated with a high incidence of postoperative delirium. The aims of the current study were to evaluate the incidence of postoperative delirium and identify risk factors for its development.
METHODS: After receiving institutional review board approval, data on patients who underwent vascular surgery in an academic hospital during the period January 2010 to December 2012 were collected retrospectively. Delirium was diagnosed through the use of the Confusion Assessment Method. The incidence, onset time, and duration of postoperative delirium were analyzed. Multivariable logistic regression analysis was used to identify independent perioperative predictors of postoperative delirium.
RESULTS: Mean patient age was 67.2 (SD±10.4) years and 84.0% of patients were male. Postoperative delirium developed in 56 patients (26.4%), most frequently on the operation day and postoperative day one (range; 0-3 days). Mean duration of delirium was 2.2 days (range; 1-7 days). Logistic regression analysis identified old age (odds ratio [OR]; 1.107, 95% confidence interval [CI]; 1.043 to 1.174; P=0.001), hearing impairment (OR; 14.915, 95% CI; 1.350 to 12.615; P=0.027), low physical activity (OR; 3.294, 95% CI; 1.129 to 9.609; P=0.029), pain score (OR; 1.629, 95% CI; 1.095 to 2.423; P=0.016), low serum albumin (<3.2 g/dL; OR; 3.409, CI; 1.206 to 9.634; P=0.021), and low serum cholesterol (< 120 mg/dL; OR; 3.118, CI; 1.202 to 8.086; P=0.019) as risk factors.
CONCLUSION: Based on the incidence data analyzed, delirium presents in more than a fourth of all vascular surgery cases. The results of the current study regarding patient populations vulnerable to delirium should be taken into account such that these patients are identified preoperatively or in the immediate postoperative period.