Postoperative delirium among elderly patients undergoing elective surgery at Muhimbili Orthopedic Institute

Abstract

Introduction Postoperative delirium is identified as one of the commonest complications in the elderly who have undergone surgery. Associated risk factors have been found to be advanced age, smoking, alcohol consumption and trauma-related injuries. Broad Objective The aim of the study was to ascertain the incidence of postoperative delirium among elderly patients undergoing elective surgery at Muhimbili Orthopaedic Institute and determine the associated risk factors for development of postoperative delirium Methodology This was a prospective cohort study that enrolled elderly patients (≥ 60years) who were admitted and underwent elective orthopaedic surgery at Muhimbili Orthopaedic Institute from October 2018 to February 2019. Preoperative assessment was done and detailed medical history recorded. Delirium was assessed in the study subjects daily in the postoperative period using the Confusion Assessment Method. Results A total of 132 patients were included in the study. Of these 18 (13.6%) were diagnosed with postoperative delirium. Age, sex, smoking, alcohol consumption and intraoperative blood transfusion were found to have an association with development of postoperative delirium. Multivariate analysis of the above variables confirmed that advanced age (AOR: 7.4 [CI 0.93-59.57] p=0.05), smoking (AOR: 10.57 [CI 2.14-52.19] p=0.004), alcohol consumption (AOR: 3.9 [CI 1.25-12.12] p=0.019) and trauma-related injuries (AOR: 3.9 [CI1.21-12.53] p=0.023) were independently associated with postoperative delirium. Conclusion Postoperative delirium was identified as a common complication after surgery in elderly patients. Risk factors in this study were advanced age, history of smoking, alcohol consumption and sustained injuries from trauma