Delirium After Spinal Surgery in Korean Population

Abstract

Study Design. The incidence and risk factors of postoperative delirium were retrospectively examined in patients who had spine surgery for degenerative lumbar disease. Objective. The aim of this study is to examine the incidence, pre- and postoperative risk factors and clinical results of postoperative delirium after spine surgery. Summary of Background Data. Postoperative delirium is of great concern in older patients. Patients with postoperative delirium tend to have delay in functional restoration and difficulty in postoperative care. But to author's knowledge this is the first report to postoperative delirium after spine surgery in South Korean population. Methods. Eighty-one patients over 70 years of age, who underwent spinal fusion for degenerative lumbar disease from November 2000 and March 2007 were selected. We analyzed the relation between postoperative delirium and such variables as operation time, intraoperative blood loss and transfusion, fusion level, comorbidity and laboratory data checked before surgery and at 1 day after surgery. Results. Postoperative delirium was found in 11 patients (13.6%). There were significant relationships between postoperative delirium and comorbidity such as cerebral vascular disease and gastric ulcer. Hemoglobin and hematocrit levels at 1 day after surgery and albumin level before surgery was significantly lower than in control group. Oswestry disability index was improved from 50.4% to 27.6% in delirium group and from 48.5% to 24.9% in control group. Hospitalization period was significantly longer in delirium group. Conclusion. History of cerebral vascular disease, low hemoglobin and hematocrit levels at 1 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.