Incidence and risk factors of postoperative delirium after surgery in the spanish population: The DELPO study

Background: Postoperative delirium increases morbidity, mortality, hospital stays, and costs, though 30-40 % of cases are preventable. This study assessed early delirium incidence in 2442 surgical patients across 43 Spanish hospitals, analyzing it by surgery type and related factors. Conducted from...

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Detalles Bibliográficos
Autores: Guereca Gala, Ane, Tamayo, Eduardo, Herrera Soto, Aurora, Varela Duran, Marina, Illodo Miramontes, Gustavo, Badenes, Rafael, Infantes Morales, Marta E., Marcos Vidal, José Miguel, Martínez López, Adrián, Martínez Ruiz, Alberto, Martínez Rafael, Beatriz, Matute González, A., Pariente Juste, Laura, Contreras López, Laura, Poves Álvarez, Rodrigo, Cuadrillero Sánchez, Ruth, Regueira Fernández, Álvaro, De la Rosa-Estadella, Marta, Renedo Fernández, Ainhoa, De la Torre Riveiro, Iria, Rodríguez Álvarez, A.A., Del Val Peciña, Elena, Rodríguez Calvo, Antonio, Delgado Martí, Carla, Rodríguez Conesa, M.A., Edo Cebollada, Laura, Sánchez González, Carmen Olga, Fernández Fernández, Ricardo, Tobar Gonzalo, Cristina, Fernández Rodríguez, Jorge, Ferrer Gómez, Carolina, De la Varga Martínez, Olga, Navarro Pérez, Rosalía, López Herrero, Rocío, Montesinos Fadrique, Santiago Carlos, Almoguera Fernández, José, Alonso Fernández, Marta, Artiaga-Candia, María, Becerra-Bolaños, Angel, Bugueño, Natalia, Casasempere Sanus, Alma, Varela Rodríguez, Lorena, Veloso de Sousa, Rita, Giné Servén, Marta, Muñoz Moreno, María Fe, González Pereira, Almudena, Escudero Gómez, Gabriel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/224290
Acceso en línea:https://hdl.handle.net/2445/224290
Access Level:acceso abierto
Palabra clave:Deliri
Persones grans
Cirurgia
Factors de risc en les malalties
Delirium
Older people
Surgery
Risk factors in diseases
Descripción
Sumario:Background: Postoperative delirium increases morbidity, mortality, hospital stays, and costs, though 30-40 % of cases are preventable. This study assessed early delirium incidence in 2442 surgical patients across 43 Spanish hospitals, analyzing it by surgery type and related factors. Conducted from November 14 and 21, 2023, with follow-ups on days 2 and 60, it provides insights into factors influencing postoperative delirium and outcomes. 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.

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