Incidence and risk factors of postoperative delirium in elderly patients undergoing transurethral resection of prostate: a prospective cohort study

Abstract

AimThe aim of the present study was to investigate the occurrence of postoperative delirium (POD) in elderly patients undergoing transurethral resection of prostate (TURP) and to identify those factors associated with delirium.MethodsFrom July 2010 to February 2015, 358 patients, aged ≥65 years and undergoing TURP were prospectively enrolled. Personal, medical and cognitive data, laboratory assessments, pain intensity, preoperative medications, and details of hemodynamic control were collected as predictors of delirium. POD was assessed using the Confusion Assessment Method.ResultsIn the present study, POD occurred in 28 out of 358 cases (7.8%) after TURP, with duration of 1–4 days. The multivariate analysis showed that old age and visual analog scale pain scores were associated with POD. Marital status, body mass index, education, alcohol consumption, smoking history, preoperative psychotropic medication usage, activities of daily living scores, preoperative Mini-Mental Status Examination score, anesthesia type, American Society of Anesthesiologists classification, or hypotensive episodes during surgery did not significantly correlate with the occurrence of POD.ConclusionOld age and pain intensity after surgery were found as the risk factors for the development of delirium in elderly patients undergoing TURP. These findings might help develop preventive strategies to decrease POD through targeted evaluation.

Incidence and risk factors of postoperative delirium in elderly patients undergoing urological surgery: A multi‐institutional prospective study

“…Tai et al . and Xue et al . reported that the incidences of postoperative delirium associated with TURP were 21.2% and 7.8%, respectively.…”

“…The other potential explanation is differences in the definition of delirium among studies. In other studies, delirium was assessed using the Confusion Assessment Method or Diagnostic and Statistical Manual of Mental Disorders‐IV . We used the ICDSC, which can be easily employed by a clinician or a nurse to screen all patients even when communication is compromised .…”

“…In the present study, not only mental conditions, but also physical conditions were independently associated with the incidence. Many other studies have suggested preoperative cognitive impairment as a risk factor . A history of CVD is a well‐known risk factor for delirium .…”

“…There are a few reports regarding postoperative delirium associated with urological surgery. However, they are small single‐institution series with limited types of surgery …”

“…However, they are small single-institution series with limited types of surgery. [14][15][16][17] This multi-institutional prospective observational study aimed to identify the incidence and risk factors for postoperative delirium associated with elective urological surgery among patients aged ≥65 years.…”