Study looks at postoperative delirium

A retrospective study from the Outcomes Research Consortium, the world’s oldest, largest, and most productive research group, sheds new light on the common and debilitating complication of postoperative delirium.

The article, “Associations of Intraoperative Hypotension and Perioperative Blood Pressure with Delirium After Noncardiac Surgery: A Retrospective Cohort Analysis,” was published in Anesthesiology. The Outcomes Research Consortium is led by Alparslan Turan, MD, professor in the Department of Anesthesiology, Critical Care and Pain Medicine at McGovern Medical School at UTHealth Houston.

The authors included 38,940 noncardiac surgeries from patients who underwent procedures at the Cleveland Clinic from 2018 through 2022, finding the incidence of postoperative delirium at 6.56%. These outcomes were analyzed to determine if intraoperative hypotension, perioperative average blood pressure, or blood pressure variability were associated with postoperative delirium.

Postoperative delirium is characterized by acute and fluctuating disturbances in attention, cognition, and consciousness. It is associated with increased morbidity, extended hospital stays, and higher health care costs. “Despite its incidence and impact on patient experience and outcomes, the pathophysiology of postoperative delirium remains poorly understood and treatment is challenging, making prevention the preferable approach,” the authors wrote.

The study concluded that intraoperative hypotension, defined as an area under the curve of a mean arterial pressure below 65 mmHg, was not associated with postoperative delirium — neither in the full sample nor in a subgroup of patients aged 65 years and above.

Additional authors from the Department of Anesthesiology, Critical Care and Pain Medicine include Orkun Kopac, MD, and from the Outcomes Research Consortium, Kurt Ruetzler, MD, Julian Rössler, MD; Leonardo Marquez Roa, MD; Gausan Ratna Bajracharya, MD; and Lu Wang, PhD.

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