Researchers from Zhejiang Chinese Medical University in Hangzhou found that advanced age, presence of comorbidities, general anesthesia and traumatic surgery increased the risk of postoperative delirium (delusion) in people over 50. The research was published in the journal scientific reports.
Postoperative delirium usually occurs two to three days after surgery and can lead to dementia and even death. The condition is accompanied by hallucinations and impaired consciousness and perception.
In the new study, researchers analyzed data from 648 patients who had fracture surgery between January 2018 and December 2020. The ages of the participants ranged from 50 to 103, with an average of 70.
Postoperative delirium was recorded in 115 (17.74%) patients. The risk of this condition was significantly higher in people over the age of 70.
In addition, the risk of delirium was higher in the presence of co-morbidities: hypertension, diabetes, and high blood lipids. This finding is in line with other studies showing that postoperative delusions are significantly more common in patients with lung disease and Alzheimer’s disease. Taking small amounts of the anti-inflammatory drug methylprednisolone did not affect the incidence of postoperative delirium.
Prolonged bed rest, extensive blood loss, and general anesthesia instead of local anesthesia also increased the risk of postoperative delirium. This means surgeons must choose less traumatic methods that require less time in anesthesia. Electroencephalographic monitoring can help avoid very deep anesthesia.
The new study will allow doctors to choose more appropriate interventions for at-risk patients. This is important given that there is no effective medical treatment for postoperative delirium. At the same time, its incidence is increasing due to the increasing proportion of elderly people characterized by fractures requiring surgical treatment.
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