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Post-Op Delirium Linked to Cerebral Vascular Disease

Also associated with low post-op hemoglobin and hematocrit, poor nutrition in elderly fusion patients

MONDAY, Aug. 30 (HealthDay News) -- Delirium after spinal fusion in elderly patients is more common in those with a history of cerebral vascular disease, low hemoglobin and hematocrit levels after surgery, and poor nutrition, according to a study in the Aug. 15 issue of Spine.

Jin Kyu Lee, M.D., and Ye-Soo Park, M.D., of Hanyang University in Seoul, South Korea, and colleagues studied 81 patients, aged 70 or older, who underwent spinal fusion. The researchers compared patients who did and did not suffer postoperative delirium for several variables: operation duration, intraoperative blood loss/transfusion, fusion level, comorbidities, and laboratory data before and after surgery.

Postoperative delirium occurred in 11 of the 81 patients. The researchers found significant associations between delirium and comorbidities, including cerebral vascular disease (27.3 percent of delirium subjects versus 5.7 percent of non-delirium subjects) and gastric ulcer (18.2 versus 0 percent). Also, albumin level before surgery (indicating nutritional status) and hemoglobin and hematocrit levels one day after surgery were significantly lower among the delirium subjects. Oswestry disability index score improved similarly in both groups, but hospitalization was longer in the delirium group than the non-delirium group (49.4 versus 28.9 days).

"History of cerebral vascular disease, low hemoglobin and hematocrit levels at one day after surgery, and bad nutritional status were risk factors for delirium. As it is of great concern in older patients, careful observation is necessary for the management of patients with risk factors for delirium," the authors write.

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