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Postoperative Delirium: A Review of Risk Factors and Tools of Prediction

  • Perioperative Delirium (JM Leung, Section Editor)
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Abstract

Over one-third of the surgeries in the United States are performed on patients aged 65 and older, and delirium is one of the most common postoperative complications in this population. Postoperative delirium is a heterogeneous disorder, and as such it is not surprising that the reported predisposing and precipitating factors are widely variable. Knowledge of the risk factors that predict postoperative delirium will aid in early identification of patients at highest risk in order to allow targeted use of resources including geriatric consults, specialized units, and nonpharmacologic interventions.

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References

Papers of particular interest, published recently, have been highlighted as: ∙ Of importance ∙∙ Of major importance

  1. Parikh SS, Chung F. Postoperative delirium in the elderly. Anesth Analg. 1995;80:1223–32.

    CAS  PubMed  Google Scholar 

  2. van der Mast RC, Roest FH. Delirium after cardiac surgery: a critical review. J Psychosom Res. 1996;41:13–30.

    Article  PubMed  Google Scholar 

  3. Demeure MJ, Fain MJ. The elderly surgical patient and postoperative delirium. J Am Coll Surg. 2006;203:752–7.

    Article  PubMed  Google Scholar 

  4. Kazmierski J, Kowman M, Banach M, et al. The use of DSM-IV and ICD-10 criteria and diagnostic scales for delirium among cardiac surgery patients: results from the IPDACS study. J Neuropsychiatr Clin Neurosci. 2010;22:426–32.

    Article  Google Scholar 

  5. Dubljanin-Raspopovic E, Markovic Denic L, Marinkovic J, et al. Use of early indicators in rehabilitation process to predict one-year mortality in elderly hip fracture patients. Hip Int. 2012;22:661–7.

    Article  PubMed  Google Scholar 

  6. Bickel H, Gradinger R, Kochs E, et al. High risk of cognitive and functional decline after postoperative delirium. A three-year prospective study. Dement Geriatr Cogn Disord. 2008;26:26–31.

    Article  PubMed  Google Scholar 

  7. Kat MG, Vreeswijk R, de Jonghe JF, et al. Long-term cognitive outcome of delirium in elderly hip surgery patients. A prospective matched controlled study over two and a half years. Dement Geriatr Cogn Disord. 2008;26:1–8.

    Article  PubMed  Google Scholar 

  8. Zakriya K, Sieber FE, Christmas C, et al. Brief postoperative delirium in hip fracture patients affects functional outcome at three months. Anesth Analg. 2004;98:1798–802.

    Article  PubMed  Google Scholar 

  9. ∙ Saczynski JS, Marcantonio ER, Quach L, et al. Cognitive trajectories after postoperative delirium. N Engl J Med. 2012;367:30–9. The participants who developed postoperative delirium had lower mean baseline MMSE scores than those who did not develop delirium. Those with delirium had a larger drop in MMSE score measured at three time points: 2 days, 1 month, and 1 year after surgery.

  10. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington: American Psychiatric Association; 2013.

    Book  Google Scholar 

  11. Inouye SK, Charpentier PA. Precipitating factors for delirium in hospitalized elderly persons. Predictive model and interrelationship with baseline vulnerability. JAMA. 1996;275:852–7.

    Article  CAS  PubMed  Google Scholar 

  12. Fox HM, Rizzo ND, Gifford S. Psychological observations of patients undergoing mitral surgery; a study of stress. Am Heart J. 1954;5:645–70.

    Article  Google Scholar 

  13. Katznelson R, Djaiani GN, Borger MA, et al. Preoperative use of statins is associated with reduced early delirium rates after cardiac surgery. Anesthesiology. 2009;110:67–73.

    Article  CAS  PubMed  Google Scholar 

  14. Krzych LJ, Wybraniec MT, Krupka-Matuszczyk I, et al. Complex assessment of the incidence and risk factors of delirium in a large cohort of cardiac surgery patients: a single-center 6-year experience. Biomed Res Int. 2013;2013:835850.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Bucerius J, Gummert JF, Borger MA, et al. Predictors of delirium after cardiac surgery delirium: effect of beating-heart (off-pump) surgery. J Thorac Cardiovasc Surg. 2004;127:57–64.

    Article  PubMed  Google Scholar 

  16. Kazmierski J, Kowman M, Banach M, et al. Incidence and predictors of delirium after cardiac surgery: results from The IPDACS Study. J Psychosom Res. 2010;69:179–85.

    Article  PubMed  Google Scholar 

  17. Smulter N, Lingehall HC, Gustafson Y, et al. Delirium after cardiac surgery: incidence and risk factors. Interact CardioVasc Thorac Surg. 2013;17:790–6.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Loponen P, Luther M, Wistbacka JO, et al. Postoperative delirium and health related quality of life after coronary artery bypass grafting. Scand Cardiovasc J. 2008;42:337–44.

    Article  PubMed  Google Scholar 

  19. Rudolph JL, Jones RN, Levkoff SE, et al. Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery. Circulation. 2009;119:229–36.

    Article  PubMed  Google Scholar 

  20. Rudolph JL, Babikian VL, Birjiniuk V, et al. Atherosclerosis is associated with delirium after coronary artery bypass graft surgery. J Am Geriatr Soc. 2005;53:462–6.

    Article  PubMed  Google Scholar 

  21. Otomo S, Maekawa K, Goto T, et al. Pre-existing cerebral infarcts as a risk factor for delirium after coronary artery bypass graft surgery. Interact CardioVasc Thorac Surg. 2013;17:799–804.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Miyazaki S, Yoshitani K, Miura N, et al. Risk factors of stroke and delirium after off-pump coronary artery bypass surgery. Interact CardioVasc Thorac Surg. 2011;12:379–83.

    Article  PubMed  Google Scholar 

  23. Stransky M, Schmidt C, Ganslmeier P, et al. Hypoactive delirium after cardiac surgery as an independent risk factor for prolonged mechanical ventilation. J Cardiothorac Vasc Anesth. 2011;25:968–74.

    Article  PubMed  Google Scholar 

  24. Shioiri A, Kurumaji A, Takeuchi T, et al. White matter abnormalities as a risk factor for postoperative delirium revealed by diffusion tensor imaging. Am J Geriatr Psychiatry. 2010;18:743–53.

    Article  PubMed  Google Scholar 

  25. Rudolph JL, Jones RN, Grande LJ, et al. Impaired executive function is associated with delirium after coronary artery bypass graft surgery. J Am Geriatr Soc. 2006;54:937–41.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Guenther U, Theuerkauf N, Frommann I, et al. Predisposing and precipitating factors of delirium after cardiac surgery: a prospective observational cohort study. Ann Surg. 2013;257:1160–7.

    Article  PubMed  Google Scholar 

  27. Veliz-Reissmuller G, Aguero Torres H, van der Linden J, et al. Pre-operative mild cognitive dysfunction predicts risk for post-operative delirium after elective cardiac surgery. Aging Clin Exp Res. 2007;19:172–7.

    Article  PubMed  Google Scholar 

  28. Tan MC, Felde A, Kuskowski M, et al. Incidence and predictors of post-cardiotomy delirium. Am J Geriatr Psychiatry. 2008;16:575–83.

    Article  PubMed  Google Scholar 

  29. Hudetz JA, Hoffmann RG, Patterson KM, et al. Preoperative dispositional optimism correlates with a reduced incidence of postoperative delirium and recovery of postoperative cognitive function in cardiac surgical patients. J Cardiothorac Vasc Anesth. 2010;24:560–7.

    Article  PubMed  Google Scholar 

  30. Schoen J, Meyerrose J, Paarmann H, et al. Preoperative regional cerebral oxygen saturation is a predictor of postoperative delirium in on-pump cardiac surgery patients: a prospective observational trial. Crit Care. 2011;15:R218.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Radtke FM, Franck M, MacGuill M, et al. Duration of fluid fasting and choice of analgesic are modifiable factors for early postoperative delirium. Eur J Anaesthesiol. 2010;27:411–6.

    Article  CAS  PubMed  Google Scholar 

  32. Katznelson R, Djaiani G, Mitsakakis N, et al. Delirium following vascular surgery: increased incidence with preoperative beta-blocker administration. Can J Anaesth. 2009;56:793–801.

    Article  PubMed  Google Scholar 

  33. Ushida T, Yokoyama T, Kishida Y, et al. Incidence and risk factors of postoperative delirium in cervical spine surgery. Spine (Phila Pa 1976). 2009;34:2500–4.

    Article  Google Scholar 

  34. Lowery DP, Wesnes K, Ballard CG. Subtle attentional deficits in the absence of dementia are associated with an increased risk of post-operative delirium. Dement Geriatr Cogn Disord. 2007;23:390–4.

    Article  PubMed  Google Scholar 

  35. ∙ Jankowski CJ, Trenerry MR, Cook DJ, et al. Cognitive and functional predictors and sequelae of postoperative delirium in elderly patients undergoing elective joint arthroplasty. Anesth Analg. 2011;112:1186–93. Variables that independently predicted postoperative delirium included age, history of psychiatric illness, decreased functional status, and decreased verbal memory. In those who developed postoperative delirium, there was no evidence of adverse cognitive or functional outcomes 3 months postoperatively.

  36. Greene NH, Attix DK, Weldon BC, et al. Measures of executive function and depression identify patients at risk for postoperative delirium. Anesthesiology. 2009;110:788–95.

    Article  PubMed  Google Scholar 

  37. Leung JM, Sands LP, Mullen EA, et al. Are preoperative depressive symptoms associated with postoperative delirium in geriatric surgical patients? J Gerontol A Biol Sci Med Sci. 2005;60:1563–8.

    Article  PubMed  Google Scholar 

  38. Smith PJ, Attix DK, Weldon BC, et al. Executive function and depression as independent risk factors for postoperative delirium. Anesthesiology. 2009;110:781–7.

    Article  PubMed  Google Scholar 

  39. Benoit AG, Campbell BI, Tanner JR, et al. Risk factors and prevalence of perioperative cognitive dysfunction in abdominal aneurysm patients. J Vasc Surg. 2005;42:884–90.

    Article  PubMed  Google Scholar 

  40. Hattori H, Kamiya J, Shimada H, et al. Assessment of the risk of postoperative delirium in elderly patients using E-PASS and the NEECHAM confusion scale. Int J Geriatr Psychiatry. 2009;24:1304–10.

    Article  PubMed  Google Scholar 

  41. Do TD, Lemogne C, Journois D, et al. Low social support is associated with an increased risk of postoperative delirium. J Clin Anesth. 2012;24:126–32.

    Article  PubMed  Google Scholar 

  42. Shah S, Weed HG, He X, et al. Alcohol-related predictors of delirium after major head and neck cancer surgery. Arch Otolaryngol Head Neck Surg. 2012;138:266–71.

    Article  PubMed  Google Scholar 

  43. Patti R, Saitta M, Cusumano G, et al. Risk factors for postoperative delirium after colorectal surgery for carcinoma. Eur J Oncol Nurs. 2011;15:519–23.

    Article  PubMed  Google Scholar 

  44. Ganai S, Lee KF, Merrill A, et al. Adverse outcomes of geriatric patients undergoing abdominal surgery who are at high risk for delirium. Arch Surg. 2007;142:1072–8.

    Article  PubMed  Google Scholar 

  45. Tei M, Ikeda M, Haraguchi N, et al. Risk factors for postoperative delirium in elderly patients with colorectal cancer. Surg Endosc. 2010;24:2135–9.

    Article  PubMed  Google Scholar 

  46. Juliebo V, Bjoro K, Krogseth M, et al. Risk factors for preoperative and postoperative delirium in elderly patients with hip fracture. J Am Geriatr Soc. 2009;57:1354–61.

    Article  PubMed  Google Scholar 

  47. Tognoni P, Simonato A, Robutti N, et al. Preoperative risk factors for postoperative delirium (POD) after urological surgery in the elderly. Arch Gerontol Geriatr. 2011;52:e166–9.

    Article  CAS  PubMed  Google Scholar 

  48. Brouquet A, Cudennec T, Benoist S, et al. Impaired mobility, ASA status and administration of tramadol are risk factors for postoperative delirium in patients aged 75 years or more after major abdominal surgery. Ann Surg. 2010;251:759–65.

    Article  PubMed  Google Scholar 

  49. Leung JM, Sands LP, Wang Y, et al. Apolipoprotein E e4 allele increases the risk of early postoperative delirium in older patients undergoing noncardiac surgery. Anesthesiology. 2007;107:406–11.

    Article  CAS  PubMed  Google Scholar 

  50. van Munster BC, Korevaar JC, Zwinderman AH, et al. The association between delirium and the apolipoprotein E epsilon 4 allele: new study results and a meta-analysis. Am J Geriatr Psychiatry. 2009;17:856–62.

    Article  PubMed  Google Scholar 

  51. Bryson GL, Wyand A, Wozny D, et al. A prospective cohort study evaluating associations among delirium, postoperative cognitive dysfunction, and apolipoprotein E genotype following open aortic repair. Can J Anaesth. 2011;58:246–55.

    Article  PubMed  Google Scholar 

  52. Andrejaitiene J, Sirvinskas E. Early post-cardiac surgery delirium risk factors. Perfusion. 2012;27:105–12.

    Article  CAS  PubMed  Google Scholar 

  53. Bakker RC, Osse RJ, Tulen JH, et al. Preoperative and operative predictors of delirium after cardiac surgery in elderly patients. Eur J Cardiothorac Surg. 2012;41:544–9.

    Article  PubMed  Google Scholar 

  54. Norkiene I, Ringaitiene D, Misiuriene I, et al. Incidence and precipitating factors of delirium after coronary artery bypass grafting. Scand Cardiovasc J. 2007;41:180–5.

    Article  PubMed  Google Scholar 

  55. Osse RJ, Fekkes D, Tulen JH, et al. High preoperative plasma neopterin predicts delirium after cardiac surgery in older adults. J Am Geriatr Soc. 2012;60:661–8.

    Article  PubMed  Google Scholar 

  56. Hudetz JA, Iqbal Z, Gandhi SD, et al. Postoperative delirium and short-term cognitive dysfunction occur more frequently in patients undergoing valve surgery with or without coronary artery bypass graft surgery compared with coronary artery bypass graft surgery alone: results of a pilot study. J Cardiothorac Vasc Anesth. 2011;25:811–6.

    Article  PubMed  Google Scholar 

  57. Detroyer E, Dobbels F, Verfaillie E, et al. Is preoperative anxiety and depression associated with onset of delirium after cardiac surgery in older patients? A prospective cohort study. J Am Geriatr Soc. 2008;56:2278–84.

    Article  PubMed  Google Scholar 

  58. Siepe M, Pfeiffer T, Gieringer A, et al. Increased systemic perfusion pressure during cardiopulmonary bypass is associated with less early postoperative cognitive dysfunction and delirium. Eur J Cardiothorac Surg. 2011;40:200–7.

    Article  PubMed  Google Scholar 

  59. Murzi M, Cerillo AG, Miceli A, et al. Antegrade and retrograde arterial perfusion strategy in minimally invasive mitral-valve surgery: a propensity score analysis on 1280 patients. Eur J Cardiothorac Surg. 2013;43:e167–72.

    Article  PubMed  Google Scholar 

  60. Norkiene I, Ringaitiene D, Kuzminskaite V, et al. Incidence and risk factors of early delirium after cardiac surgery. Biomed Res Int. 2013;2013:323491.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Brown CH 4th, Grega M, Selnes OA, et al. Length of red cell unit storage and risk for delirium after cardiac surgery. Anesth Analg. 2014;119:242–50.

    Article  PubMed  PubMed Central  Google Scholar 

  62. ∙∙ Whitlock EL, Torres BA, Lin N, et al. Postoperative delirium in a substudy of cardiothoracic surgical patients in the BAG-RECALL clinical trial. Anesth Analg. 2014;118:809–17. There was a nonsignificant trend toward less delirium in the BIS-guided anesthetic group compared to the end-tidal anesthetic concentration-guided group. Low average volatile anesthetic dose, intraoperative transfusion, ASA physical status, and European System for Cardiac Operative Risk Evaluation were independent predictors of delirium.

  63. Burkhart CS, Dell-Kuster S, Gamberini M, et al. Modifiable and nonmodifiable risk factors for postoperative delirium after cardiac surgery with cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2010;24:555–9.

    Article  PubMed  Google Scholar 

  64. Marcantonio ER, Goldman L, Orav EJ, et al. The association of intraoperative factors with the development of postoperative delirium. Am J Med. 1998;105:380–4.

    Article  CAS  PubMed  Google Scholar 

  65. Olin K, Eriksdotter-Jonhagen M, Jansson A, et al. Postoperative delirium in elderly patients after major abdominal surgery. Br J Surg. 2005;92:1559–64.

    Article  CAS  PubMed  Google Scholar 

  66. Gao R, Yang ZZ, Li M, et al. Probable risk factors for postoperative delirium in patients undergoing spinal surgery. Eur Spine J. 2008;17:1531–7.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Bohner H, Hummel TC, Habel U, et al. Predicting delirium after vascular surgery: a model based on pre- and intraoperative data. Ann Surg. 2003;238:149–56.

    PubMed  PubMed Central  Google Scholar 

  68. Lescot T, Karvellas CJ, Chaudhury P, et al. Postoperative delirium in the intensive care unit predicts worse outcomes in liver transplant recipients. Can J Gastroenterol. 2013;27:207–12.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Behrends M, DePalma G, Sands L, et al. Association between intraoperative blood transfusions and early postoperative delirium in older adults. J Am Geriatr Soc. 2013;61:365–70.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Kalisvaart KJ, Vreeswijk R, de Jonghe JF, et al. Risk factors and prediction of postoperative delirium in elderly hip-surgery patients: implementation and validation of a medical risk factor model. J Am Geriatr Soc. 2006;54:817–22.

    Article  PubMed  Google Scholar 

  71. Koebrugge B, van Wensen RJ, Bosscha K, et al. Delirium after emergency/elective open and endovascular aortoiliac surgery at a surgical ward with a high-standard delirium care protocol. Vascular. 2010;18:279–87.

    Article  PubMed  Google Scholar 

  72. Salata K, Katznelson R, Beattie WS, et al. Endovascular versus open approach to aortic aneurysm repair surgery: rates of postoperative delirium. Can J Anaesth. 2012;59:556–61.

    Article  PubMed  Google Scholar 

  73. Mason SE, Noel-Storr A, Ritchie CW. The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-operative delirium: a systematic review with meta-analysis. J Alzheimers Dis. 2010;22(Suppl 3):67–79.

    Article  PubMed  Google Scholar 

  74. Ellard L, Katznelson R, Wasowicz M, et al. Type of anesthesia and postoperative delirium after vascular surgery. J Cardiothorac Vasc Anesth. 2014;28:458–61.

    Article  PubMed  Google Scholar 

  75. Slor CJ, de Jonghe JF, Vreeswijk R, et al. Anesthesia and postoperative delirium in older adults undergoing hip surgery. J Am Geriatr Soc. 2011;59:1313–9.

    Article  PubMed  Google Scholar 

  76. ∙∙ Sieber FE, Zakriya KJ, Gottschalk A, et al. Sedation depth during spinal anesthesia and the development of postoperative delirium in elderly patients undergoing hip fracture repair. Mayo Clin Proc. 2010;85:18–26. During spinal anesthesia, light propofol sedation decreased the prevalence of delirium by 50% compared with deep sedation.

  77. ∙ Chan MT, Cheng BC, Lee TM, et al. BIS-guided anesthesia decreases postoperative delirium and cognitive decline. J Neurosurg Anesthesiol. 2013;25:33–42. When compared to routine care, BIS-guided anesthesia decreased the incidence of postoperative delirium and the incidence of postoperative cognitive dysfunction 3 months postoperatively.

  78. ∙ Radtke FM, Franck M, Lendner J, et al. Monitoring depth of anaesthesia in a randomized trial decreases the rate of postoperative delirium but not postoperative cognitive dysfunction. Br J Anaesth. 2013;110 Suppl 1:i98–105. The use of BIS-guided anesthesia decreased the incidence of postoperative delirium but did not change the incidence of postoperative cognitive dysfunction in a cohort of elderly patients undergoing elective surgery.

  79. LuratiBuse GA, Schumacher P, Seeberger E, et al. Randomized comparison of sevoflurane versus propofol to reduce perioperative myocardial ischemia in patients undergoing noncardiac surgery. Circulation. 2012;126:2696–704.

    Article  CAS  Google Scholar 

  80. Vaurio LE, Sands LP, Wang Y, et al. Postoperative delirium: the importance of pain and pain management. Anesth Analg. 2006;102:1267–73.

    Article  PubMed  Google Scholar 

  81. Nie H, Zhao B, Zhang YQ, et al. Pain and cognitive dysfunction are the risk factors of delirium in elderly hip fracture Chinese patients. Arch Gerontol Geriatr. 2012;54:e172–4.

    Article  PubMed  Google Scholar 

  82. Liu P, Li YW, Wang XS, et al. High serum interleukin-6 level is associated with increased risk of delirium in elderly patients after noncardiac surgery: a prospective cohort study. Chin Med J (Engl). 2013;126:3621–7.

    CAS  Google Scholar 

  83. Contin AM, Perez-Jara J, Alonso-Contin A, et al. Postoperative delirium after elective orthopedic surgery. Int J Geriatr Psychiatry. 2005;20:595–7.

    Article  CAS  PubMed  Google Scholar 

  84. Marino J, Russo J, Kenny M, et al. Continuous lumbar plexus block for postoperative pain control after total hip arthroplasty. A randomized controlled trial. J Bone Joint Surg Am. 2009;91:29–37.

    Article  PubMed  Google Scholar 

  85. Kinjo S, Lim E, Sands LP, et al. Does using a femoral nerve block for total knee replacement decrease postoperative delirium? BMC Anesthesiol. 2012;12:4.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Mouzopoulos G, Vasiliadis G, Lasanianos N, et al. Fascia iliaca block prophylaxis for hip fracture patients at risk for delirium: a randomized placebo-controlled study. J Orthop Traumatol. 2009;10:127–33.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Leung JM, Sands LP, Vaurio LE, et al. Nitrous oxide does not change the incidence of postoperative delirium or cognitive decline in elderly surgical patients. Br J Anaesth. 2006;96:754–60.

    Article  CAS  PubMed  Google Scholar 

  88. Shiiba M, Takei M, Nakatsuru M, et al. Clinical observations of postoperative delirium after surgery for oral carcinoma. Int J Oral Maxillofac Surg. 2009;38:661–5.

    Article  CAS  PubMed  Google Scholar 

  89. McAlpine JN, Hodgson EJ, Abramowitz S, et al. The incidence and risk factors associated with postoperative delirium in geriatric patients undergoing surgery for suspected gynecologic malignancies. Gynecol Oncol. 2008;109:296–302.

    Article  CAS  PubMed  Google Scholar 

  90. Marcantonio ER, Juarez G, Goldman L, et al. The relationship of postoperative delirium with psychoactive medications. JAMA. 1994;272:1518–22.

    Article  CAS  PubMed  Google Scholar 

  91. Morrison RS, Magaziner J, Gilbert M, et al. Relationship between pain and opioid analgesics on the development of delirium following hip fracture. J Gerontol A Biol Sci Med Sci. 2003;58:76–81.

    Article  PubMed  Google Scholar 

  92. Adunsky A, Levy R, Heim M, et al. Meperidine analgesia and delirium in aged hip fracture patients. Arch Gerontol Geriatr. 2002;35:253–9.

    Article  CAS  PubMed  Google Scholar 

  93. Yildizeli B, Ozyurtkan MO, Batirel HF, et al. Factors associated with postoperative delirium after thoracic surgery. Ann Thorac Surg. 2005;79:1004–9.

    Article  PubMed  Google Scholar 

  94. Takeuchi M, Takeuchi H, Fujisawa D, et al. Incidence and risk factors of postoperative delirium in patients with esophageal cancer. Ann Surg Oncol. 2012;19:3963–70.

    Article  PubMed  Google Scholar 

  95. Lin YY, He B, Chen J, et al. Can dexmedetomidine be a safe and efficacious sedative agent in post-cardiac surgery patients? A meta-analysis. Crit Care. 2012;16:R169.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Maldonado JR, Wysong A, van der Starre PJ, et al. Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery. Psychosomatics. 2009;50:206–17.

    Article  CAS  PubMed  Google Scholar 

  97. Deiner S, Lin H, Bodansky D, et al. Do stress markers and anesthetic technique predict delirium in the elderly. Dement Geriatr Cogn Disord. 2014;38:366–74.

    Article  CAS  PubMed  Google Scholar 

  98. Wang SG, Lee UJ, Goh EK, et al. Factors associated with postoperative delirium after major head and neck surgery. Ann Otol Rhinol Laryngol. 2004;113:48–51.

    Article  PubMed  Google Scholar 

  99. Morimoto Y, Yoshimura M, Utada K, et al. Prediction of postoperative delirium after abdominal surgery in the elderly. J Anesth. 2009;23:51–6.

    Article  PubMed  Google Scholar 

  100. Mangnall LT, Gallagher R, Stein-Parbury J. Postoperative delirium after colorectal surgery in older patients. Am J Crit Care. 2011;20:45–55.

    Article  PubMed  Google Scholar 

  101. Balasundaram B, Holmes J. Delirium in vascular surgery. Eur J Vasc Endovasc Surg. 2007;34:131–4.

    Article  CAS  PubMed  Google Scholar 

  102. Pol RA, van Leeuwen BL, Visser L, et al. Standardised frailty indicator as predictor for postoperative delirium after vascular surgery: a prospective cohort study. Eur J Vasc Endovasc Surg. 2011;42:824–30.

    Article  CAS  PubMed  Google Scholar 

  103. Sasajima Y, Sasajima T, Azuma N, et al. Factors related to postoperative delirium in patients with lower limb ischaemia: a prospective cohort study. Eur J Vasc Endovasc Surg. 2012;44:411–5.

    Article  CAS  PubMed  Google Scholar 

  104. Flink BJ, Rivelli SK, Cox EA, et al. Obstructive sleep apnea and incidence of postoperative delirium after elective knee replacement in the nondemented elderly. Anesthesiology. 2012;116:788–96.

    Article  PubMed  Google Scholar 

  105. Lee HB, Mears SC, Rosenberg PB, et al. Predisposing factors for postoperative delirium after hip fracture repair in individuals with and without dementia. J Am Geriatr Soc. 2011;59:2306–13.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Meziere A, Paillaud E, Belmin J, et al. Delirium in older people after proximal femoral fracture repair: role of a preoperative screening cognitive test. Ann Fr Anesth Reanim. 2013;32:e91–6.

    Article  CAS  PubMed  Google Scholar 

  107. Fineberg SJ, Nandyala SV, Marquez-Lara A, et al. Incidence and risk factors for postoperative delirium after lumbar spine surgery. Spine. 2013;38:1790–6.

    Article  PubMed  Google Scholar 

  108. Harasawa N, Mizuno T. A novel scale predicting postoperative delirium (POD) in patients undergoing cerebrovascular surgery. Arch Gerontol Geriatr. 2014;59:264–71.

    Article  PubMed  Google Scholar 

  109. Marcantonio ER, Goldman L, Mangione CM, et al. A clinical prediction rule for delirium after elective noncardiac surgery. JAMA. 1994;271:134–9.

    Article  CAS  PubMed  Google Scholar 

  110. Priner M, Jourdain M, Bouche G, et al. Usefulness of the short IQCODE for predicting postoperative delirium in elderly patients undergoing hip and knee replacement surgery. Gerontology. 2008;54:116–9.

    Article  PubMed  Google Scholar 

  111. Krzych LJ, Wybraniec MT, Krupka-Matuszczyk I, et al. Delirium screening in cardiac surgery (DESCARD): a useful tool for nonpsychiatrists. Can J Cardiol. 2014;30:932–9.

    Article  PubMed  Google Scholar 

  112. Freter SH, Dunbar MJ, MacLeod H, et al. Predicting post-operative delirium in elective orthopaedic patients: the delirium elderly at-risk (DEAR) instrument. Age Ageing. 2005;34:169–71.

    Article  PubMed  Google Scholar 

  113. Koster S, Hensens AG, Schuurmans MJ, et al. Prediction of delirium after cardiac surgery and the use of a risk checklist. Eur J Cardiovasc Nurs. 2013;12:284–92.

    Article  PubMed  Google Scholar 

  114. Fisher BW, Flowerdew G. A simple model for predicting postoperative delirium in older patients undergoing elective orthopedic surgery. J Am Geriatr Soc. 1995;43:175–8.

    Article  CAS  PubMed  Google Scholar 

  115. Goldenberg G, Kiselev P, Bharathan T, et al. Predicting post-operative delirium in elderly patients undergoing surgery for hip fracture. Psychogeriatrics. 2006;6:43–8.

    Article  Google Scholar 

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Acknowledgments

This research is supported by NIH GEMSSTAR1 R03 AG040624-01, NIH R01 AG029656-01A1, the American Geriatrics Society Jahnigan Scholar Program, the Foundation for Anesthesia Education and Research (FAER), and the Oregon Alzheimer Disease Center P30AG008017.

Author information

Authors and Affiliations

  1. Department of Anesthesiology & Perioperative Medicine, Oregon Health and Science University, Mail Code HRC-5N, 3181 SW Sam Jackson Park Rd., Portland, OR, 97239, USA

    Katie J. Schenning

  2. Departments of Anesthesiology, Neurosurgery, Geriatrics and Palliative Care, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1010, New York, NY, 10029, USA

    Stacie G. Deiner

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  1. Katie J. Schenning
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  2. Stacie G. Deiner
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Correspondence to Katie J. Schenning.

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This article is part of the Topical Collection on Perioperative Delirium.

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Schenning, K.J., Deiner, S.G. Postoperative Delirium: A Review of Risk Factors and Tools of Prediction. Curr Anesthesiol Rep 5, 48–56 (2015). https://doi.org/10.1007/s40140-014-0086-1

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  • DOI: https://doi.org/10.1007/s40140-014-0086-1

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