Incidence and Risk Factors of Postoperative Delirium by Operation

The incidence of postoperative delirium in clinical trials varies from 4-66%.¹^,² Patient-specific and iatrogenic factors may place patients at greater risk.³

High, low, and mean, incidence of postoperative delirium by procedure.

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Risk factor for postoperative delirium

An understanding of the risk factors for postoperative delirium is important for identifying patients who may benefit from increased vigilance.

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Risk factors for postoperative delirium by type

PROCEDURAL

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Risk Factor	Odds Ratio
Emergency surgery²⁶	2.65
Surgery duration, min¹⁸	1.01

BLOOD LOSS/ TRANSFUSION MANAGEMENT

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Risk Factor	Odds Ratio
Blood loss ≥1517 mL⁵	2.7
Higher volume of red blood cell transfusions¹⁸	0.83
High amount of blood transfusions²⁰	1.001
Fresh frozen plasma administration²⁶	1.2
Pre-operative anemia²⁵	1.66
Postoperative hematocrit <30%¹³	2
Postoperative hemoglobin level(mmol/l)²⁰	2.16
Volume load during operation¹⁶	2.77

MEDICATIONS

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Risk Factor	Odds Ratio
Morphine usage³	3.01
Preoperative beta-blocker use¹¹	1.7

COGNITIVE IMPAIRMENT

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Risk Factor	Odds Ratio
Cognitive impairment^3,11,12	2.5-3.231
MMSE <25⁴	28

CO-MORBIDITIES

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Risk Factor	Odds Ratio
Atrial fibrillation^10,12,27	2.65-2.75
Carotid artery disease²⁷	3.88
Cerebralvascular disease⁷	4.91
Chronic heart failure^3,7	2.46-5.28
Depression⁵	3.3
Diabetes mellitus^16,⁶	3.49-6.23
End stage renal failure⁷	5
Gastritis/Peptic Ulcer¹⁶	4
History of hypertension¹⁰	3.66
Hypercholesterolemia³⁰	5.5
Hypertension⁸	7.6
Multiple Comorbidities³	1.37
Stroke^11,18	8.618

LAB ABNORMALITIES

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Risk Factor	Odds Ratio
Creatinine > 1.3 mg/dl¹⁰	2.05
CRP value¹⁸	1.028
Electrolyte disturbance¹²	2.09
Higher blood glucose,(umol/l)¹⁸	1.228
Higher total bilirubin, (umol/l)¹⁸	1.077
Hypoalbuminemia^13,18	2.4
Potassium <3.5 mmol/L³⁰	3.18
Sodiurm concentration in ICU (mmol/l)¹⁶	1.19

PATIENT-SPECIFIC

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Risk Factors	Odds Ratio
Advancing age^{5,7,10,11,16,18,25,26,27}	1.05-2.0
High ASA Score^25,26	2.23-3.7
Delirium in medical history^11,25	3.57-12
Living in an institution³	2.94
Male sex⁷	7.6
Smoking^27,34	3.99-10.5

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1. Eide LS, Ranhoff AH, Fridlund B, et al. Comparison of frequency, risk factors, and time course of postoperative delirium in octogenarians after transcatheter aortic valve implantation versus surgical aortic valve replacement. Am J Cardiol. 2015;115(6):802-809.
2. Krzych LJ, Wybraniec MT, Krupka-Matuszczyk I, et al. Detailed insight into the impact of postoperative neuropsychiatric complications on mortality in a cohort of cardiac surgery subjects: a 23,000-patient-year analysis. J Cardiothorac Vasc Anesth. 2014;28(3):448-457.
3. Yang Y, Zhao X, Dong T, Yang Z, Zhang Q, Zhang Y. Risk factors for postoperative delirium following hip fracture repair in elderly patients: a systematic review and meta-analysis. Aging Clin Exp Res. 2017;29(2):115-126.
4. Bohner H, Hummel TC, Habel U, et al. Predicting delirium after vascular surgery: a model based on pre- and intraoperative data. Ann Surg. 2003;238(1):149-156.
5. Tse L, Bowering JB, Schwarz SK, Moore RL, Burns KD, Barr AM. Postoperative delirium following transcatheter aortic valve implantation: a historical cohort study. Can J Anaesth. 2015;62(1):22-30.
6. van Eijsden WA, Raats JW, Mulder PG, van der Laan L. New aspects of delirium in elderly patients with critical limb ischemia. Clin Interv Aging. 2015;10:1537-1546.
7. Sasajima Y, Sasajima T, Azuma N, et al. Factors related to postoperative delirium in patients with lower limb ischaemia: a prospective cohort study. Eur J Vasc Endovasc Surg. 2012;44(4):411-415.
8. Visser L, Prent A, van der Laan MJ, et al. Predicting postoperative delirium after vascular surgical procedures. J Vasc Surg. 2015;62(1):183-189.

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Incidence and Risk Factors of Postoperative Delirium by Operation

Identify at-risk patients early

Incidence by Procedure

High, low, and mean, incidence of postoperative delirium by procedure.

View Data

Risk factor for postoperative delirium

An understanding of the risk factors for postoperative delirium is important for identifying patients who may benefit from increased vigilance.

E-Learning

Discover our broad online education offering.

Risk factors for postoperative delirium by type

PROCEDURAL

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Procedural Risk Factors

BLOOD LOSS/ TRANSFUSION MANAGEMENT

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Blood loss/ Transfusion Management Risk Factors

MEDICATIONS

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Medication Risk Factors

COGNITIVE IMPAIRMENT

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Cognitive Impairment Risk Factors

CO-MORBIDITIES

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Co-morbidity Risk Factors

LAB ABNORMALITIES

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Lab Abnormality Risk Factors

PATIENT-SPECIFIC

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Patient-specific Risk Factors

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