Vol. 2, Issue 2, Part A (2018)

Background: Postoperative delirium (POD) is a frequent neuropsychiatric complication among elderly surgical patients, often leading to prolonged hospitalization, increased morbidity, and functional decline. Despite its clinical significance, POD remains underdiagnosed and poorly understood in routine surgical care.

Materials and Methods: A prospective observational study was conducted at the Department of Psychiatry, Kasturba Medical College, Mangalore, Karnataka, from March 2017 to February 2018. A total of 210 patients aged ≥65 years undergoing major non-cardiac surgery were assessed. Cognitive baseline was evaluated preoperatively using the Mini-Mental State Examination (MMSE). Postoperative assessments were conducted using the Confusion Assessment Method (CAM) on postoperative days 1 to 5. Data on comorbidities, anaesthetic technique, intraoperative variables, and postoperative complications were collected. Logistic regression was applied to determine independent predictors.

Results: The incidence of POD was 23.8% (n=50). Significant predictors of POD included age ≥75 years (p=0.004), preoperative MMSE <24 (p<0.001), duration of surgery >3 hours (p=0.02), intraoperative hypotension (p=0.01), and use of benzodiazepines (p=0.005). POD was associated with longer hospital stays (mean 10.6 vs. 6.2 days, p<0.001) and increased postoperative complications (p=0.03).

Conclusion: Postoperative delirium is a common yet preventable complication among elderly surgical patients. Key predictors include advanced age, cognitive impairment, prolonged surgery, and intraoperative hypotension. Early identification of at-risk individuals can guide preventive strategies and optimize outcomes.