POSTOPERATIVE DELIRIUM AFTER COLORECTAL SURGERY IN OLDER PATIENTS

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. (American Journal of Critical Care. 2011;20:45-55)