Prospective Evaluation of Delirium in Geriatric Patients Undergoing Emergency General Surgery

Abstract Introduction The prevalence of delirium and its impact on outcomes following emergency general surgery (EGS) remains unexplored. The aims of our study were to assess the impact of frailty on delirium and the impact of delirium on outcomes in geriatric EGS patients. Study Design We performed a 1-year (2017) prospective cohort analysis of all geriatric (age ≥ 65) patients who underwent EGS. Frailty was calculated using the emergency general surgery specific frailty index (ESFI). Delirium was assessed using the confusion assessment method (CAM). Patients were dichotomized as delirious or non-delirious. We performed regression analysis controlling for demographics, admission vitals, ASA score, comorbidities, and the diagnosis and type of surgery. Results A total of 163 patients underwent emergency general surgery and were included. Mean age was 71±7 years, and 59% were male. Overall, the incidence of postoperative delirium was 26%. Patients who developed postoperative delirium were more likely to be frail (40% vs. 14%, p 3 medications (OR: 1.3 [1.1-1.4], p Conclusions The incidence of delirium after EGS was 26%. Frailty and polypharmacy were associated with increased risk of delirium. Delirium appears to be associated with higher rates in-hospital adverse events.