A retrospective analysis of the incidence of postoperative delirium and the importance of database selection for its definition

作者：Qinfeng Yang, Jinlang Fu, Xin Pan, Danping Shi, Kunlian Li, Min Sun, Jie Ding, Zhanjun Shi, Jian Wang · 发表于：BMC Psychiatry · 年份：2023 · DOI：10.1186/s12888-023-04576-4 · 被引用次数：38 · 研究领域：Intensive Care Unit Cognitive Disorders、Cardiac, Anesthesia and Surgical Outcomes、Thermal Regulation in Medicine

BACKGROUND: Postoperative delirium (POD) is a common complication after major surgery, resulting in various adverse reactions. However, incidence and risk factors associated with POD after shoulder arthroplasty (SA) have not been well studied using a large-scale national database. METHODS: A retrospective database analysis was performed based on the Nationwide Inpatient Sample (NIS) from 2005 to 2014, the largest fully paid hospital care database in the United States. Patients undergoing SA were included. The patient's demographics, comorbidities, length of stay (LOS), total costs, type of insurance, type of hospital, in-hospital mortality, and medical and surgical perioperative complications were assessed. RESULTS: A total of 115,147 SA patients were obtained from the NIS database. The general incidence of delirium after SA was 0.89%, peaking in 2010. Patients with delirium after SA had more comorbidities, prolonged LOS, increased hospitalization costs, and higher in-hospital mortality (P < 0.0001). These patients were associated with medical complications during hospitalization, including acute renal failure, acute myocardial infarction, pneumonia, pulmonary embolism, stroke, urinary tract infection, sepsis, continuous invasive mechanical ventilation, blood transfusion, and overall perioperative complications. Risk factors associated with POD include advanced age, neurological disease, depression, psychosis, fluid and electrolyte disturbances, and renal failure. Protective ...