Post-Op Delirium Common in Elderly Spinal Surgery Patients
Older patients, particularly women, with greater comorbidities are at increased risk of delirium
MONDAY, Sept. 23 (HealthDay News) -- There is an overall incidence of delirium events of 8.4 per 1,000 in patients undergoing lumbar spine surgical procedures, according to a study published in the Sept. 15 issue of Spine.
Steven J. Fineberg, M.D., from the Rush University Medical Center in Chicago, and colleagues analyzed data from the Nationwide Inpatient Sample (2002 to 2009) to identify patients undergoing lumbar decompression or lumbar fusion for degenerative pathologies.
The researchers identified 292,177 lumbar decompressions and 286,280 lumbar fusions performed during the study period. There were 8.4 events of delirium per 1,000 cases. There was a statistically greater incidence of delirium in patients undergoing lumbar fusion, compared to patients undergoing lumbar decompression (11.8 versus 5.0 per 1,000). Older and female patients were significantly more likely to be affected. Patients with delirium in both cohorts demonstrated significantly greater comorbidities, length of stay, greater costs, and more frequent discharge to skilled nursing facilities. There was an increased mortality rate in lumbar decompression-treated patients who experienced delirium (6.1 versus 0.8 per 1,000). Independent predictors of delirium included older age (≥65 years), alcohol/drug abuse, depression, psychotic disorders, neurological disorders, deficiency anemia, fluid/electrolyte disorders, and weight loss.
"We recommend that physicians put greater effort into recognizing risk factors of delirium and diagnosing it in a timely manner to mitigate its effects," the authors write.
Abstract (http://journals.lww.com/spinejournal/Abstract/2013/09150/Incidence_and_Risk_Factors_for_Postoperative.19.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/spinejournal/Abstract/2013/09150/Incidence_and_Risk_Factors_for_Postoperative.19.aspx )