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Incidence and clinical significance of postoperative delirium after brain tumor surgery

  • Original Article - Brain Tumors
  • Published:
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Abstract

Background

Delirium is an acute and reversible deterioration of mental state. Postoperative delirium (POD) can develop after surgical procedures and is associated with impaired health status and worse recovery. So far, there is little data about postoperative delirium after brain surgery. The aim of this study was to evaluate frequency, risk factors, and prognostic value of POD in predicting short-term postoperative outcomes after brain tumor surgery.

Methods

Five-hundred and twenty-two patients who underwent elective brain tumor surgery in 2010–2017 were included in this prospective study. Patients were monitored for POD using the Confusion Assessment Method for the ICU (CAM-ICU) for 2 to 7 days after the surgery. At hospital discharge, outcomes were evaluated using the Glasgow Outcome Scale (GOS).

Results

POD was diagnosed in 22 (4.2%) patients. Risk factors of POD were low level of hemoglobin, poor functional status at time of admission, low education level and older age (65 years and older). POD incidence was not associated with brain tumor laterality, location, extent of resection, histological diagnosis, or affected brain lobe. POD was associated with greater risk for unfavorable outcomes at hospital discharge (OR = 5.3; 95% CI [2.1–13.4], p = 0.001).

Conclusions

POD is not a common complication after elective brain tumor surgery. Older age, poor functional status, low education level and anemia are associated with greater POD risk. Extent of surgical intervention and brain tumor location are not associated with POD risk. POD is associated with worse outcome at hospital discharge.

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Acknowledgments

We would like to thank Dr. Marius Rimaitis, M.D., for his consultations regarding anesthesiology section of the paper.

Funding

The study was financially supported by the Research Council of Lithuania (grant number: MIP-044/2015).

Author information

Author notes

  1. Adomas Bunevičius

    Present address: Neuroscience Institute, Lithuanian University of Health Sciences, Eiveniu str 2, LT-50009, Kaunas, Lithuania

Authors and Affiliations

  1. Department of Neurosurgery, Hospital of Lithuanian University of Health Sciences, Kaunas, Lithuania

    Antanas Budėnas, Šarūnas Tamašauskas, Albertas Šliaužys, Aistė Pranckevičienė, Vytenis Pranas Deltuva, Arimantas Tamašauskas & Adomas Bunevičius

  2. Lithuanian University of Health Sciences, Kaunas, Lithuania

    Ieva Navickaitė & Miglė Sidaraitė

  3. Neuroscience Institute, Lithuanian University of Health Sciences, Eiveniu str 2, LT-50009, Kaunas, Lithuania

    Aistė Pranckevičienė, Vytenis Pranas Deltuva & Arimantas Tamašauskas

  4. Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Adomas Bunevičius

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  1. Antanas Budėnas
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Corresponding author

Correspondence to Adomas Bunevičius.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all patients included in the study.

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Comments

This study indicates that postoperative delirium occurs after surgery for brain tumours, albeit infrequently. Also, demographic rather than tumour-related factors are associated with the occurrence. Since the patients’ performance level was assessed at discharge, this study is unlikely to say much about how postoperative delirium affects long-term performance.

Kirsten Moeller

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This article is part of the Topical Collection on Brain Tumors

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Budėnas, A., Tamašauskas, Š., Šliaužys, A. et al. Incidence and clinical significance of postoperative delirium after brain tumor surgery. Acta Neurochir 160, 2327–2337 (2018). https://doi.org/10.1007/s00701-018-3718-2

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  • DOI: https://doi.org/10.1007/s00701-018-3718-2

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