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Postoperative delirium in critically ill surgical patients: Incidence, risk factors, and predictive scores

BMC Anesthesiology Mar 27, 2019

Chaiwat O, et al. - Among surgical intensive care unit (SICU) patients (aged over 18 years), researchers determined the incidence of, and the risk factors for, postoperative delirium (POD). They also identified scores that could predict the development of POD. This study included 250 patients. The delirium occurrence was assessed using the CAM − ICU (The Confusion Assessment Method for the Intensive Care Unit) score. Overall, 61 (24.4%) participants developed delirium. Age, diabetes mellitus, severity of disease [SOFA (Sequential Organ Failure Assessment scales) score], perioperative use of benzodiazepine, and mechanical ventilation were identified as factors that independently conferred risk for delirium. Among surgical patients who were critically ill, a quarter developed POD. They developed a predictive score (age + (5 × SOFA) + (15 × Benzodiazepine use) + (20 × DM [Diabetes mellitus] + (20 × mechanical ventilation) + (20 × modified IQCODE [Modified Informant Questionnaire on Cognitive decline in the Elderly] > 3.42)) which yielded area under the receiver operating characteristic (ROC) curve (AUC) of 0.84. Sensitivity and specificity of 72.13% and 80.95%, respectively, were yielded with a cut point of 125. The delirious than the non-delirious patients showed a significantly greater hospital mortality rate. The risk of POD development could be predicted by using a risk score utilizing 6 variables.
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