Predictive value of a preoperative respiratory failure index on the development of postoperative delirium

Introduction

The development of delirium within the ICU and postoperatively is an important problem in the ICU, and it has previously been associated with an increased hospital mortality.

Methods

The preoperative risk of cardiac or respiratory events was scored using the revised cardiac risk index (RCRI) and the preoperative respiratory failure index (PRFI) in 403 patients. The outcome measure of delirium was included with those of cardiac and respiratory events

Results

Of the 403 noncardiac surgical patients, 50 were cared for in the ICU and 353 were cared for in a high-intensity bed or a surgical ward bed postoperatively. Delirium occurred in 10 (20%) patients admitted into the ICU versus 15 (4.2%) of those admitted to the surgical wards (P < 0.001). Independent predictors of developing delirium included the patient's age, the PRFI, and assignment to the ICU a priori. The RCRI was not an independent predictor of delirium. (See Table 1.)

Table 1 (abstract P409)

Conclusion

In a cohort of patients undergoing high-risk noncardiac surgery, age, PRFI, and assignment to the ICU a priori predicted the development of delirium.