When elderly patients undergo elective surgery, both delirium and major postoperative complications are related with adverse outcomes, according to a study in JAMA Surgery.
Researchers from Beth Israel Deaconess Medical Center in Boston set out to examine the association of major postoperative complications and delirium with adverse outcomes. They looked at 566 patients who were 70 years old or older and underwent elective orthopedic, vascular or abdominal surgical procedures at two hospitals.
Of the 566 patients, 47 developed major complications, which contributed greatly to longer lengths of stay, and 135 developed delirium, which contributed to longer lengths of stay as well as institutional discharge and readmission. When major complications and delirium occurred in tandem (which happened to 20 participants), it greatly affected adverse outcomes.
"These results suggest that it is important to manage delirium and major postoperative complications simultaneously to reduce the risks posed by both conditions," the study authors concluded. "Efforts should be implemented in those at high risk of delirium or complications following elective noncardiac surgery. Preventive strategies, such as the Hospital Elder Life Program, proactive geriatric consultation and co-management services, have been shown to be effective to reduce delirium, ideally when implemented before and continued after surgery."