Incidence and Associated Factors of Postoperative Delirium among Elderly Elective Surgical Patients in Northwest Ethiopia: A Multi-Center Prospective Observational Study, 2022

Abstract

Abstract Background: Delirium is a condition characterized by a disturbance of consciousness with reduced ability to focus, shift attention and decline in cognitive function. Postoperative delirium is a major and undiagnosed problem postoperatively in elderly surgical patients. Occurring in 9%-87% of older patients after an operation. Identification of the possible contributing factors and magnitude of the burden will help in the management of the elderly patients. Objective: The objective of this study was to determine the incidence of postoperative delirium and associated factors among elderly surgical patients, Northwest Ethiopia from April 1, to June 30, 2022. Methods: A multi-center prospective observational study was conducted among elderly elective surgical patients in four Northwest Ethiopia referral hospitals from April 1 to June 30, 2022 and patients aged ?50 years old and who had done elective surgery were included in this study. Simple random sampling technique was used to select total of 422 participants. Data were collected by chart review and interview of patients. Both bivariate and multivariable binary logistic regression model were used for statistical analysis .The strength of the association was presented by odds ratio and 95% Confidence interval. P-value <0.05 was considered statistically significant. Result: The incidence of postoperative delirium among elective elderly surgical patients was 39.6% with(95%CI=35%-44.4%). Being male (AOR=1.945, CI=1.117-3.387), older age (AOR= 2.186, CI =1.196-3.995), blood transfusion (AOR=2.782,CI=1.132-6.838), postoperative pain (AOR=5.022, CI=2.812-8.969) and Preoperative depression (AOR= 3.282, CI=1.940-5.550) were significantly associated with postoperative delirium. Conclusion and recommendations: The incidence of POD is 39.6% in elderly elective surgical patients. Being male, older age, blood transfusion, postoperative pain and Preoperative depression were found significant factors associated with postoperative delirium. Clinicians who are responsible in the postoperative care of elderly surgical patients should assess postoperative delirium regularly and act accordingly. Additionally more emphasis should be given to modifiable risk factors like: blood transfusion, postoperative pain and preoperative depression. Key words: Surgery, Delirium, Aging, Confusion Assessment Method, risk factors