Wang et al identified risk factors associated with postoperative delirium after major head and neck surgery in adults. This can help identify a patient who may benefit from more aggressive management and monitoring. The authors are from the Pusan National University in Korea.
Risk factors:
(1) age
(2) hypertension
(3) postoperative oxygenation
(4) postoperative hemoglobin level
The risk of delirium increased with age, being rare before age 40 and highest in those >= 70 years of age.
NOTE: The following table is one way of trying to make the risk factors operational. It is not in the reference although it is based on information from page 49.
|
Parameter |
Finding |
Points |
|
age of the patient |
< 50 years of age |
0 |
|
|
50 - 59 years of age |
1 |
|
|
60 - 69 years of age |
2 |
|
|
>= 70 years of age |
3 |
|
hypertension |
absent |
0 |
|
|
present |
1 |
|
postoperative oxygenation |
normal (oxygen saturation >= 95%) |
0 |
|
|
hypoxemia (oxygen saturation < 95%) |
1 |
|
postoperative hemoglobin |
>= 12.5 g/dL |
0 |
|
|
< 12.5 g/dL |
1 |
where:
• Many algorithms using hemoglobin as a risk factor have different cutoffs for males and females.
total risk score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the higher the risk of postoperative delirium.
|
Total Score |
Risk of Delirium |
|
0 |
low |
|
1 or 2 |
moderate |
|
3 |
high |
|
4 to 6 |
very high |
Specialty: Anesthesiology, Neurology, Surgery, orthopedic
