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Predictive factors for postoperative delirium in thoracic surgery

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Abstract

Objective

We examined cases in which delirium developed after thoracic surgery under general anesthesia at our hospital to determine the predictive factors for postoperative delirium, as well as the perioperative findings in cases showing postoperative delirium.

Methods

This retrospective study included 1674 patients who underwent surgery under general anesthesia at our hospital between 2012 and 2022, A psychiatrist diagnosed postoperative delirium using the Confusion Assessment Method.

Results

There were 99 (5.9%) patients with postoperative delirium in our study, including 85 (86%) men, of whom 31 (31%) had a history of cerebrovascular disease. The incidence of postoperative delirium in patients aged > 80 years was 20% (36/182). The postoperative delirium group showed significantly longer hospital stays and more frequent postoperative complications than the group without postoperative delirium. In univariate analysis, age ≥ 80 years, male sex, history of cerebrovascular disease, hypertension, history of atrial fibrillation, and history of smoking were identified as significant factors, while multivariate analysis identified age ≥ 80 years, male sex, history of cerebrovascular disease, hypertension, and history of smoking as significant factors (odds ratios = 5.15, 2.04, 3.10, 1.67, and 2.36, respectively). In the 169 cases with none of these five factors, the postoperative delirium risk was 0% (0/169).

Conclusions

In patients undergoing thoracic surgery, predictive factors for postoperative delirium include age ≥ 80 years, male sex, history of cerebrovascular disease, hypertension, and smoking history. The findings also indicate that patients with these risk factors may require psychiatric consultation before surgery.

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Acknowledgements

We would like to thank Editage (www.editage.com) for the English language editing.

Funding

This study was supported in part by a Grant-in-Aid for Special Research in Subsidies for the ordinary expenses of private schools from The Promotion and Mutual Aid Corporation for Private Schools of Japan.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Juntendo University Shizuoka Hospital, 1129, Nagaoka, Izunokuni, Shizuoka-Prefecture, Japan

    Takashi Yaguchi, Hideomi Ichinokawa & Mikiko Suzuki

  2. Department of Psychiatry, Juntendo University Shizuoka Hospital, 1129, Nagaoka, Izunokuni, Shizuoka-Prefecture, Japan

    Eiji Kirino

  3. Department of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan

    Kazuyuki Komori, Takeshi Matsunaga, Kazuya Takamochi & Kenji Suzuki

Authors
  1. Takashi Yaguchi
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  2. Hideomi Ichinokawa
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  4. Mikiko Suzuki
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  7. Kazuya Takamochi
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Contributions

T. Y., H. I., M. S., K. K., T. M., K. T., E. K., and K. S. conceived and planned the experiments. T. Y., K. K. and H. I. planned and performed the simulations. T. Y., M. S., K. K., and H. I. contributed to sample preparation. T. Y., T. M., K. T., E. K., and K. S. interpreted the results. T. Y. took the lead in writing the manuscript. All the authors provided critical feedback and helped shape the research, analysis, and manuscript.

Corresponding author

Correspondence to Hideomi Ichinokawa.

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The authors declare no conflict of interest.

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Yaguchi, T., Ichinokawa, H., Kirino, E. et al. Predictive factors for postoperative delirium in thoracic surgery. Gen Thorac Cardiovasc Surg (2024). https://doi.org/10.1007/s11748-024-02014-0

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