Delirium Cost After Major Surgery

Abstract

Background: Postoperative delirium is a syndrome that causes serious consequences,
increasing mortality and morbidity rates and extending hospital stay.
Purpose: This research was carried out to determine the cost associated with the
development of delirium in patients over 65 years of age after major surgery.
Method: One hundred twelve patients who were hospitalized for a surgical operation
in the orthopedics, neurosurgery, and general surgery clinic of a state hospital for 3
months were evaluated simultaneously and independently for delirium. Patients were
observed by clinical nurses 3 times over a 24-hour period. 197 samples were observed
for the diagnosis of delirium using the Individual Information Form, Nursing Delirium
Screening Scale (Nu-DESC), Post-Surgery Process Costs Evaluation Form and
Mini-Mental State Examination (MMSE). However, due to the missing and incorrect
completion of the items in the scale, the scale data of 55 samples were excluded by the
observers. The observation results of 112 participants who agreed to participate in the
study on a voluntary basis constituted the sample of the study. As a medical record
examination, the data of the patients’ laboratory, radiological and pharmaceutical
information, their length of hospital stay, and the costs of patients with and without
delirium were analyzed. SPPS 25.0 statistical package program was used to evaluate
the data. For statistical significance, p <0.05 was considered sufficient.
Results: The incidence of delirium after surgery was 25 percent. Delirium was more
common in men aged 75 years or older, with multiple drug use, with long anesthesia,
comorbid disease, low levels of Hb, and albumin, and the results were found statistically
significant (p <0.05). It was found that delirium increased the cost of care
by prolonging the stay in the hospital. As a medical record examination, a significant
difference was found between patients’ laboratory, radiological and pharmaceutical information,
length of hospital stay, and the cost of patients with and without delirium
(p <0.05).
Conclusion; Evidence-based effective treatment protocols for delirium after major
surgery and risk factors for preventive interventions need to be identified. In addition
to increasing the cost of hospitalization, delirium increases the need for post-acute
care and the care of elderly patients to caregivers. Prevention of delirium can not
only reduce the cost of delirium but also reduce the subsequent dementia rate. It
should focus on delirium-prone patients who are at risk when designing future delirium
prevention strategies or in future etiological studies.
Key words: Delirium after surgery–old age–risk factors–cost