Delirium in Older Surgical Patients Threatens Recovery

Sudden confusion is a postoperative complication linked to longer hospital stays, researchers say

By Mary Elizabeth Dallas

Wednesday, September 9, 2015

WEDNESDAY, Sept. 9, 2015 (HealthDay News) -- Preventing postsurgical delirium in older patients can help ensure a successful recovery, a new study says.

Patients with delirium following major surgery are more likely to have worse outcomes, including lower quality of life, disability or even death, the researchers found.

"Delirium, which is characterized by a sudden onset of confusion, is a concern for older adults having surgery or who are hospitalized," senior study author Dr. Sharon Inouye, director of the Aging Brain Center at the Institute for Aging Research in Boston and a professor of medicine at Harvard Medical School, said in a Harvard news release.

The study involved 566 patients, aged 70 and older, who didn't suffer from dementia or delirium before they underwent major elective surgery. All were hospitalized for at least three days. Following their procedure, the researchers assessed the participants' level of confusion or delirium.

The study, published Sept. 9 in the journal JAMA Surgery, found 8 percent of the patients experienced a major or life-threatening complication after surgery, forcing them to remain in the hospital for a longer period of time. Meanwhile, 24 percent of the patients developed delirium, which dramatically increased all negative outcomes after surgery, including extended hospital stays and hospital readmission within 30 days.

Patients who had complications plus delirium after surgery had the highest rates of poor outcomes, the researchers noted.

Study first author Dr. Lauren Gleason, from the division of aging at Brigham and Women's Hospital in Boston, said in the news release, "Clinicians should be aware of the negative impact of delirium and look for ways to mitigate its effect on older patients in their care through use of preventative strategies."

Geriatric consultation and shared management of elderly patients by staff members familiar with the needs of seniors can help in this regard, Gleason said. Also beneficial, she said, is the Hospital Elder Life Program, which aims to keep hospitalized seniors oriented to their surroundings by meeting their needs for sleep, fluids, nutrition and more.

In 2007, more than one-third of all inpatient surgeries in the United States involved patients aged 65 or older. The number of older surgical patients is expected to increase as the population ages, the researchers said.

SOURCE: Harvard Medical School, news release, Sept. 9, 2015

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