Ann Hepatobiliary Pancreat Surg.  2023 Aug;27(3):301-306. 10.14701/ahbps.23-012.

Postoperative delirium after cholecystectomy in older patients: A retrospective study

• Park YM
• Seo HI
• Noh BG
• Kim S
• Hong SB
• Lee NK
• Kim DU
• Han SY

• KMID: 2545777
• DOI: http://doi.org/10.14701/ahbps.23-012

Abstract

Backgrounds/Aims
Postoperative delirium (POD) is a common complication that increases mortality and morbidity in older patients. This study aimed to evaluate the clinical significance of post-cholecystectomy delirium in older patients.
Methods
This retrospective study included 201 patients aged > 75 years who underwent cholecystectomy for acute or chronic cholecystitis between January 2016 and December 2019. Patients were divided into the POD (n = 21) and non-POD (n = 180) groups, and their demographic features and clinical results were compared.
Results
The mean patient age was 78.88 years; the female/male ratio was 44.8%/55.2%. Laparoscopic surgery was performed in 93.5% of patients. The univariate analysis showed that lower body mass index (BMI), immobilized admission status, neuropsychiatric disease history, preoperative intervention (percutaneous drainage), high C-reactive protein, hypoalbuminemia, neutrophilia, hypo-/hyperkalemia, and longer operative time were more frequently observed in the POD group. The multivariate analysis showed that lower BMI (odds ratio [OR], 2.796; p = 0.024), neuropsychiatric disease history (OR, 3.019; p = 0.049), hyperkalemia (OR, 5.972; p = 0.007), and longer operative time (OR, 1.011; p = 0.013) were significant risk factors for POD.
Conclusions
POD was associated with inflammation degree, general condition, poor nutritional status, electrolyte imbalance, and stressful conditions. Recognizing risk factors requiring multidisciplinary team approaches is important to prevent and treat POD.

Keyword

Delirium; Cholecystectomy; Body mass index; Nutrition; Older patients

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