Delirium after Emergency/Elective Open and Endovascular Aortoiliac Surgery at a Surgical Ward with a High-standard Delirium Care Protocol

Abstract

Delirium is a common problem in elderly patients undergoing surgery. Standard delirium care is not available at all surgical wards. We determined the incidence, risk factors, and outcomes of postoperative delirium among patients undergoing elective/emergency aortoiliac surgery at a surgical ward with high-standard delirium care. A prospective descriptive survey in 107 patients was conducted. High-standard delirium care was given to patients above age 65, consisting of an extended focus on risk factors and intensive screening. The Delirium Observation Scale was used as a screening instrument for delirium. Patients were classified as having delirium if they met the DSM-IV criteria. The overall incidence of delirium was 23%. The incidence was 14% after elective surgery. Delirium occurred in 59% after emergency surgery and more often after open than after endovascular aneurysm repair ( p < .01). Delirium was associated with age ( p < .01) and emergency surgery ( p = .01) and is an important and frequent complication after aortoiliac surgery.