Risk factors for postoperative delirium after gastrointestinal surgery - using randomized Phase II trial data

Abstract

Background/Aim: Postoperative delirium is a common complication which is associated with increased postoperative mortality and morbidity. The aim of this study was to evaluate the incidence and predictors of postoperative delirium using data from a phase II clinical trial.

Patients and Methods: We analyzed the cases that were enrolled in randomized clinical trial to evaluate TJ-54 (Yokukansan, a traditional Japanese medicine [Kampo]) for the prevention and/or treatment of postoperative delirium (UMIN000005423). The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) was used to diagnose postoperative delirium.

Results: A total of 167 patients were registered, delirium was observed in 9% of them. High age over 80 and low MMSE less than 27 were identified as significant independent risk factors.

Conclusion: Surgeon should pay attention to the possible development of postoperative delirium in patients aged over 80 with a low MMSE less than 27 in performing surgery for gastrointestinal malignancies.