Vélez-Restrepo J A, Betancourt-Ángel P A, Caicedo-Jaramillo J D, Casas-Arroyave F D
Departamento de Anestesiología, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Hospital Alma Mater de Antioquia, Universidad de Antioquia, Medellín, Colombia.
Rev Esp Anestesiol Reanim (Engl Ed). 2025 Aug-Sep;72(7):501855. doi: 10.1016/j.redare.2025.501855. Epub 2025 Jun 5.
Postoperative delirium (POD) is an adverse outcome that has garnered significant interest in perioperative medicine, particularly in older adults, due to its association with increased morbidity, mortality, and health care costs. In Colombia, this disease is under-reported due to the lack of POD diagnosis and prevention protocols. The aim of this study was to determine the incidence and potential risk factors of POD, and its association with other postoperative complications.
This retrospective cohort study was performed at a tertiary care hospital. Patients over 60 years of age who underwent surgery between 2012 and 2019 were included. Random sampling was used to analyse electronic medical records to estimate the incidence of POD, risk factors, and postoperative complications within 7 days of surgery.
A total of 2535 patients were evaluated. The cumulative incidence of POD was 6.0% (95% confidence interval [CI]: 5.1%-6.9%), with most cases (67%) occurring within the first 3 postoperative days. Risk factors associated with POD included a history of psychiatric disorders, preoperative opioid use, ASA (American Society of Anesthesiologists) class III/IV, vascular surgery, urgent or emergency surgery, and functional dependency. POD was also associated with higher in-hospital mortality (OR 2.9 [95% CI 1.66-5.07]).
POD is common in patients aged over 60 undergoing surgery, particularly those that undergo urgent or emergency procedures and vascular surgery, who are ASA class > III, functionally dependent, and present psychiatric disorders. POD is also associated with increased postoperative morbidity and mortality.
术后谵妄（POD）是一种不良后果，因其与发病率、死亡率及医疗费用增加相关，在围手术期医学中备受关注，尤其是在老年人中。在哥伦比亚，由于缺乏POD诊断和预防方案，该病报告不足。本研究旨在确定POD的发病率、潜在危险因素及其与其他术后并发症的关联。
本回顾性队列研究在一家三级医院进行。纳入2012年至2019年间接受手术的60岁以上患者。采用随机抽样分析电子病历，以评估POD的发病率、危险因素及术后7天内的术后并发症。
共评估了2535例患者。POD的累积发病率为6.0%（95%置信区间[CI]：5.1%-6.9%），大多数病例（67%）发生在术后前3天内。与POD相关的危险因素包括精神疾病史、术前使用阿片类药物、美国麻醉医师协会（ASA）Ⅲ/Ⅳ级、血管手术、急诊或紧急手术以及功能依赖。POD还与较高的住院死亡率相关（比值比2.9[95%CI 1.66-5.07]）。
POD在60岁以上接受手术的患者中很常见，尤其是那些接受急诊或紧急手术以及血管手术的患者，这些患者ASA分级>Ⅲ级、功能依赖且患有精神疾病。POD还与术后发病率和死亡率增加相关。
