Postoperative delirium after colorectal surgery in older patients

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Journal Article
American Journal of Critical Care, 2011, 20 (1), pp. 45 - 55
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Background: Postoperative delirium in older patients results in worse outcomes and increased costs. The prevalence and predictors of postoperative delirium in patients undergoing major colorectal surgery are not clear. Objectives: To determine the prevalence and predictors of postoperative delirium in older patients after major colorectal surgery. Methods: Patients older than 50 years, without preexisting cognitive impairment, were recruited before surgery. These patients were assessed after surgery for delirium daily for 3 days by using the Confusion Assessment Method. Regression analysis was used to determine independent predictors of postoperative delirium. Results: Patients (n=118) had a mean age of 71.81 years, and approximately half were women (54%). Most participants (64%) were married, and comorbid conditions were common. Delirium developed in 35% of the patients in the 3 days after surgery and in 21% in the first 24 hours. New cases of delirium were identified on each of the 3 days after surgery, and a few patients (7%) had delirium for the entire 3 days. Odds for delirium in the first 24 hours were increased for patients who had early admission (odds ratio [OR]=4.48; P=.06) and decreased for patients who were married (OR=0.25; P=.01). Odds for delirium in the first 3 days after surgery were increased for men (OR=4.27; P=.02), older patients (OR=1.05; P=.04), and patients who stayed overnight in the critical care unit (OR=2.97; P=.06). Conclusions: Postoperative delirium is common and persistent in older patients in the first 3 days after colorectal surgery. © 2010 American Association of Critical-Care Nurses.
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