Delirium in Older Acute Care Surgery

Patients older than 65 years were followed after acute care surgery. Some 23% had delirium from a validated chart review.

Postoperative delirium risk factors included Foley catheter use, intestinal surgery, gallbladder surgery, appendix surgery, intensive care unit admission and mild to moderate frailty. Risk factors for prolonged postoperative delirium (> 48 hours) included Foley catheter use and mild to moderate frailty. Surgical approach (open v. laparoscopic) and overall operative time were not found to be significant.

The seemingly innocuous Foley urinary catheter consistently appears as a delirium risk factor and protocols to ask every day whether it can be removed are appropriate.

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