Usefulness of the short IQCODE for predicting postoperative delirium in elderly patients undergoing hip and knee replacement surgery.

BACKGROUND/OBJECTIVE: The prevalence of postoperative delirium in elderly patients is >30%. The objective of this prospective study was to determine the usefulness of the short form of the Informant Questionnaire on COgnitive Decline in the Elderly (short IQCODE) to predict the occurrence of postoperative delirium after elective hip and knee arthroplasty in the elderly.

METHODS

Consecutive patients, 60 years and older, who were admitted for elective hip or knee arthroplasty were included. The preoperative cognitive status was determined using the Mini-Mental State Examination (MMSE) and the short IQCODE. Postoperative delirium was diagnosed using the Confusion Assessment Method. Logistic regression was used to analyze the links between the preoperative test scores and the outcome of postoperative delirium.

RESULTS

One hundred and one patients completed the study (mean age 73.6 +/- 6.6 years). The mean +/- SD MMSE score was 26 +/- 3, and the mean short IQCODE score was 50.7 +/- 6.2. Postoperative delirium developed in 15 patients (14.8%). A short IQCODE score >50 was significantly associated with postoperative delirium (OR 12.7, 95% CI 1.4-115.5; p = 0.02).

CONCLUSIONS

The short IQCODE appears to be a useful tool to predict the risk of postoperative delirium in elderly patients undergoing elective surgery. Detecting this complication could be of great interest to improve the postoperative survey of elderly patients.