Asploro Journal of Biomedical and Clinical Case Reports

Asploro Journal of Biomedical and Clinical Case Reports

Rui Wang^1*
1Department of Anesthesiology, West China Hospital of Sichuan University, Sichuan Province, Chengdu 610041, China

Corresponding Author: Rui Wang
Address: Department of Anesthesiology, West China Hospital of Sichuan University, No.37 Guoxue Alley, Wuhou District, Chengdu City, Sichuan Province, China.
Received date: 01 August 2024; Accepted date: 19 August 2024; Published date: 26 August 2024

Citation: Wang R. Risk Factors for Postoperative Delirium in Thoracic Surgery Patients – A Prospective Cross-sectional Study. Asp Biomed Clin Case Rep. 2024 Aug 26;7(3):250-58.

Copyright © 2024 Wang R. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.

Keywords: Postoperative Delirium, Thoracic Surgery, Risk Factor

Abbreviations: POD: Postoperative Delirium; aCCI: Age-Adjusted Charlson Comorbidity Index; OR: Odds Ratio; CI: Confidence Interval; ASA: American Society of Anesthesiologists; ICU: Intensive Care Unit; NRS: Numerical Rating Scale; 3D-CAM: 3-Minute Diagnostic Confusion Assessment Method; ICU-CAM: ICU-Confusion Assessment Method; Mini-Cog: Mini-Cognitive Assessment; SD: Standard Deviation; LOS: Length of Stay; CCI: Charlson Comorbidity Index; ERAS: Enhanced Recovery After Surgery

Abstract

Background: Postoperative delirium (POD) is a common complication that affects the prognosis and outcome. The risk factors of different surgical types have significance in preventing POD. Still, there are few studies on the risk factors for this complication of thoracic surgery, and further research and exploration are necessary.
Method: This study intends to conduct a prospective cross-sectional study, including patients undergoing elective thoracic surgery. The primary outcome is the incidence of POD 1-7 days after surgery or before discharge. The essential information on patients, surgery, anesthesia, and postoperative details are gathered for statistical analysis. We are exploring the potential relationship between anesthesia-related factors and POD.
Result: One hundred seventy-five patients were included in this study, and 17 (9.7%) patients developed POD. Univariate analysis showed that age-adjusted Charlson Comorbidity Index (aCCI), educational attainment, blood transfusion, artificial blood vessel replacement, and indwelling urinary catheter were statistically different. Logistic regression results showed that the aCCI index (OR 1.811, 95% CI 1.058-3.103; P=0.030), the ambulation time (OR 12.303, 95% CI 2.670-56.686; P=0.001) increased POD risk. In patients undergoing thoracotomy, blood transfusion (RR 16.875, 95% CI 2.149-132.508; P=0.012) was statistically different between POD and non-POD groups.
Conclusion: The results of this study showed that the higher the aCCI index, the later the ambulation time is the risk factor for POD in thoracic surgery patients. The risk of POD may be heightened in thoracic surgery patients who require a blood transfusion. However, additional research is warranted to confirm these findings.