Incidence and risk factors of postoperative delirium after surgery in the spanish population: The DELPO study.
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de la Varga-Martínez O, Navarro Pérez R, López Herrero R, Montesinos Fadrique S, Almoguera Fernández J, Alonso Fernández M, Artiaga-Candia M, Becerra-Bolaños A, Bugueño N, Casasempere Sanus A, Contreras-López L, Cuadrillero Sánchez R, De la Rosa-Estadella M, de la Torre Riveiro I, Del Val Peciña E, Delgado Martí C, Edo Cebollada L, Fernández Fernández R, Fernández Rodríguez J, Ferrer Gómez C, Giné Servén M, González Pereira A, Guereca Gala A, Herrera Soto A, Illodo Miramontes G, Infantes Morales M E, Marcos-Vidal J M, Martínez López A, Martínez Ruiz A, Martínez-Rafael B, Matute González A, Pariente Juste L, Poves-Álvarez R, Regueira Fernández A, Renedo Fernández A, Rodríguez Álvarez A A, Rodríguez Calvo A, Rodríguez Conesa M A, Sánchez González C, Tobar Gonzalo C, Varela Rodríguez L, Veloso de Sousa R, Muñóz-Moreno M F, Escudero Gómez G, Tamayo E, Varela Duran M, Badenes R
Аннотация
METHODS: The study included three phases: (1) recruitment and assessment of surgical patients on November 14 and 21, 2023, across all centers; (2) monitoring for delirium by postoperative day 2; and (3) a follow-up at 60 days. Delirium was diagnosed using the CAM, CAM-ICU, and 4AT scales. The sample size was estimated and multivariable logistic regression and Cox regression analysis were performed to identify independent risk factors and assess the impact of delirium on mortality.
RESULTS: A total of 2442 surgical patients were recruited, mainly male (51.9 %), with a mean age of 76 ± 16 years. The delirium incidence was 3.93 %, with four preoperative independent risk factors identified through multivariate analysis.: Patient age (odds ratio (OR) 1.05, 95 % CI 1.04 to 1.08, p > 0.001), cognitive impairment (SBT > 6 points) (OR 1.12, 95 % CI 1.08 to 1.15, p < 0.001), substance use disorder (SUD) (OR 3.97, 95 % CI 1.05 to 14.93, p = 0.042) and alcoholism (OR 1.92, 95 % CI 1.20 to 3.07, p = 0.006), with a model AUROC of 0.81 (95 % CI 0.76 to 0.85). Postoperative delirium was associated with longer hospital stays and significantly higher mortality at 60 days (8.3 % vs 0.6 %).
CONCLUSION: This Spanish study found that postoperative delirium, linked to longer hospital stays and higher mortality, requires early detection and prevention to improve outcomes.