A recent study conducted at hospitals in Ethiopia has shed light on the concerning prevalence of postoperative delirium among elderly surgical patients, with findings indicating a staggering incidence rate of 41%. The research highlights numerous significant risk factors associated with this acute confusional state, particularly impacting individuals aged 75 and older.
Characterized by fluctuations in mental status and cognitive disturbances, postoperative delirium is recognized as the most frequent complication affecting elderly surgical patients. It not only contributes to increased morbidity and mortality rates but also leads to extended hospital stays and healthcare costs. The findings from Ethiopia are particularly alarming, as there is limited research on the subject within developing nations, making this study pivotal for future healthcare strategies.
The observational study was undertaken from January to November 2023 across three hospitals within the South Gondar Zone, engaging participants aged 65 or older who were scheduled for elective surgeries. The researchers employed the Nursing Delirium Screening Scale and multivariable logistic regression analysis methods to investigate the association of various risk factors with postoperative delirium.
Key findings from the research identify several risk factors significantly associated with postoperative delirium, including being aged 75 or older, the American Society of Anesthesiologists (ASA) classification of III, severe functional impairment of activities of daily living, premedication with benzodiazepines, intraoperative estimated blood loss exceeding 1000 ml, and intraoperative ketamine use. The study confirmed the strong correlation between these factors and the likelihood of developing postoperative delirium.
According to the authors, "The incidence of postoperative delirium was found to be high. Risk factors identified for postoperative delirium include being aged 75 or older, having ASA classification of III, severe functional impairment of ADL, premedication with benzodiazepines, intraoperative estimated blood loss greater than 1000 ml, and intraoperative ketamine use." This insight calls for immediate attention within healthcare systems, particularly to develop strategies for managing potential complications arising from surgery among elderly patients.
The research highlights the urgent necessity for when treating elderly patients undergoing surgical procedures, which often sees more than one-third of surgeries performed on individuals within this age group. With the increasing proportion of older adults undergoing surgeries, it is imperative for healthcare providers to recognize and manage the associated risks of postoperative delirium effectively.
Notably, the presence of postoperative delirium also correlates with extended time spent within the post-anesthesia care unit (PACU) and overall hospital stay durations. The research asserts, "The development of postoperative delirium was found to be significantly associated with prolonged stays in the PACU and hospital"—a situation which not only adds to healthcare burdens but may also increase the risk of hospital-acquired infections.
These alarming findings advocate for more awareness and potentially the establishment of management protocols targeted at reducing the occurrence of postoperative delirium for elderly patients. The authors acknowledge the high prevalence of this condition and express concern over the lack of structured guidelines or awareness surrounding postoperative delirium management within the Ethiopian healthcare system.
Finally, the study serves as a foundational step toward addressing the gap in knowledge surrounding postoperative delirium among the elderly, particularly within developing contexts. The authors urge for more extensive research to validate these findings and propagate the development of preventative strategies to mitigate future occurrences of postoperative delirium among surgical patients.