Pre-operative variables in relation to onset of postoperative delirium of all. included patients having elective surgery for AAA or colorectal cancer.

<p>Values in parentheses are percentages unless indicated oth</p><p>erwise; values are ǂ median (Interquartile Range)</p><p><i>P</i>-value is calculated with Chi-square test</p><p>a = Fisher exact test</p><p>b = Mann-Whitney U test</p><p>* Katz-ADL Score 5 or less indicates functional impairment [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0136071#pone.0136071.ref015" target="_blank">15</a>]</p><p># SNAQ-RC Score 3 or more indicates severe undernourishment [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0136071#pone.0136071.ref016" target="_blank">16</a>]</p><p>Pre-operative variables in relation to onset of postoperative delirium of all. included patients having elective surgery for AAA or colorectal cancer.</p

Risk Factors and Outcomes for Postoperative Delirium after Major Surgery in Elderly Patients

<div><p>Background</p><p>Early identification of patients at risk for delirium is important, since adequate well timed interventions could prevent occurrence of delirium and related detrimental outcomes. The aim of this study is to evaluate prognostic factors for delirium, including factors describing frailty, in elderly patients undergoing major surgery.</p><p>Methods</p><p>We included patients of 65 years and older, who underwent elective surgery from March 2013 to November 2014. Patients had surgery for Abdominal Aortic Aneurysm (AAA) or colorectal cancer. Delirium was scored prospectively using the Delirium Observation Screening Scale. Pre- and peri-operative predictors of delirium were analyzed using regression analysis. Outcomes after delirium included adverse events, length of hospital stay, discharge destination and mortality.</p><p>Results</p><p>We included 232 patients. 51 (22%) underwent surgery for AAA and 181 (78%) for colorectal cancer. Postoperative delirium occurred in 35 patients (15%).</p><p>Predictors of postoperative delirium included: delirium in medical history (Odds Ratio 12 [95% Confidence Interval 2.7–50]), advancing age (Odds Ratio 2.0 [95% Confidence Interval 1.1–3.8]) per 10 years, and ASA-score ≥3 (Odds Ratio 2.6 [95% Confidence Interval 1.1–5.9]). Occurrence of delirium was related to an increase in adverse events, length of hospital stay and mortality.</p><p>Conclusion</p><p>Postoperative delirium is a frequent complication after major surgery in elderly patients and is related to an increase in adverse events, length of hospital stay, and mortality. A delirium in the medical history, advanced age, and ASA-score may assist in defining patients at increased risk for delirium. Further attention to prevention of delirium is essential in elderly patients undergoing major surgery.</p></div

Pre-operative characteristics in patients with AAA or colorectal cancer receiving elective surgery.

<p>Values in parentheses are percentages unless indicated otherwise; values are ǂ median</p><p>(IQR: Interquartile Range)</p><p>EVAR: EndoVascular Aortic Repair</p><p>P-value is calculated with Chi-square test</p><p>a = Fisher exact test</p><p>b = Mann-Whitney U test</p><p>Pre-operative characteristics in patients with AAA or colorectal cancer receiving elective surgery.</p

Adverse events, Hospital length of stay, ICU stay and mortality in relation to onset of postoperative delirium.

<p>Data are presented as n and (%), unless otherwise specified.</p><p><i>P</i>-value is calculated with Fisher's exact test</p><p>a = Chi-square test</p><p>b = Mann-Whitney U test</p><p># other complications: intoxication with morphine requiring ICU admission, bleeding gastric stress ulcer, iatrogenic injury (spleen, bladder and gallbladder), mild ischemic colitis after AAA surgery.</p><p>Adverse events, Hospital length of stay, ICU stay and mortality in relation to onset of postoperative delirium.</p

Data on anesthesia, hemoglobin and blood transfusion in relation to onset of postoperative delirium of all included patients having elective surgery.

<p>Data are presented as n and (%), unless otherwise specified.</p><p>IQR = Interquartile Range</p><p><i>P</i>-value is calculated with Chi-square test</p><p>a = Fishers’ Exact test</p><p>b = Mann-Whitney U test</p><p>* anemia is defined as a Hb <7.6 mmol/L for women and <8.2 mmol/L for men [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0136071#pone.0136071.ref019" target="_blank">19</a>]</p><p>Data on anesthesia, hemoglobin and blood transfusion in relation to onset of postoperative delirium of all included patients having elective surgery.</p

Univariate and multivariate logistic regression analysis on risk factors for delirium of all included patients having elective surgery for AAA or colorectal cancer.

<p>* Anemia is defined as a Hb <7.6 mmol/L for women and <8.2 mmol/L for men[<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0136071#pone.0136071.ref019" target="_blank">19</a>]</p><p>^# Katz-ADL Score 5 or less indicates functional impairment [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0136071#pone.0136071.ref015" target="_blank">15</a>]</p><p>Univariate and multivariate logistic regression analysis on risk factors for delirium of all included patients having elective surgery for AAA or colorectal cancer.</p

Pre-operative variables in relation to onset of postoperative delirium of all. included patients having elective surgery for AAA or colorectal cancer.

<p>Values in parentheses are percentages unless indicated oth</p><p>erwise; values are ǂ median (Interquartile Range)</p><p><i>P</i>-value is calculated with Chi-square test</p><p>a = Fisher exact test</p><p>b = Mann-Whitney U test</p><p>* Katz-ADL Score 5 or less indicates functional impairment [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0136071#pone.0136071.ref015" target="_blank">15</a>]</p><p># SNAQ-RC Score 3 or more indicates severe undernourishment [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0136071#pone.0136071.ref016" target="_blank">16</a>]</p><p>Pre-operative variables in relation to onset of postoperative delirium of all. included patients having elective surgery for AAA or colorectal cancer.</p