Incidence and risk factors of delirium in post-anaesthesia care unit.
10.47102/annals-acadmedsg.2021297
- Author:
Yuhe KE
1
;
Sophia CHEW
;
Edwin SEET
;
Wan Yi WONG
;
Vera LIM
;
Nelson CHUA
;
Jinbin ZHANG
;
Beatrice LIM
;
Vanessa CHUA
;
Ne Hooi Will LOH
;
Lian Kah TI
Author Information
1. Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore.
- Publication Type:Multicenter Study
- MeSH:
Aged;
Anesthesia;
Anesthesia Recovery Period;
Delirium/etiology*;
Humans;
Incidence;
Postoperative Complications/etiology*;
Prospective Studies;
Risk Factors
- From:Annals of the Academy of Medicine, Singapore
2022;51(2):87-95
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:Post-anaesthesia care unit (PACU) delirium is a potentially preventable condition that results in a significant long-term effect. In a multicentre prospective cohort study, we investigate the incidence and risk factors of postoperative delirium in elderly patients undergoing major non-cardiac surgery.
METHODS:Patients were consented and recruited from 4 major hospitals in Singapore. Research ethics approval was obtained. Patients older than 65 years undergoing non-cardiac surgery >2 hours were recruited. Baseline perioperative data were collected. Preoperative baseline cognition was obtained. Patients were assessed in the post-anaesthesia care unit for delirium 30-60 minutes after arrival using the Nursing Delirium Screening Scale (Nu-DESC).
RESULTS:Ninety-eight patients completed the study. Eleven patients (11.2%) had postoperative delirium. Patients who had PACU delirium were older (74.6±3.2 versus 70.6±4.4 years, P=0.005). Univariate analysis showed those who had PACU delirium are more likely to be ASA 3 (63.6% vs 31.0%, P=0.019), had estimated glomerular filtration rate (eGFR) of >60mL/min/1.73m2 (36.4% vs 10.6%, P=0.013), higher HbA1C value (7.8±1.2 vs 6.6±0.9, P=0.011), raised random blood glucose (10.0±5.0mmol/L vs 6.5±2.4mmol/L, P=0.0066), and moderate-severe depression (18.2% vs 1.1%, P=0.033). They are more likely to stay longer in hospital (median 8 days [range 4-18] vs 4 days [range 2-8], P=0.049). Raised random blood glucose is independently associated with increased PACU delirium on multivariate analysis.
