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Evidence-based Practice and Quality Improvement

Quality of life in patients with postoperative delirium


Antunes, M. V.; Norton, M.; Moreira, J. F.; Moreira, A.; Abelha, F.

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European Journal of Anaesthesiology (EJA): June 2013 - Volume 30 - Issue - p 11-11
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Background and Goal of Study: Delirium is a transient global disorder of cognition. Patients who develop this condition represent a subgroup at risk for prolonged and even permanent cognitive disorder that may negatively affect health-related quality of life (HRQOL). The aim of our study was to evaluate quality of life in patients that developed postoperative delirium (POD).

Materials and Methods: Observational prospective study approved by the Centro Hospitalar São João Ethics Committee and written informed consent was obtained. All consecutive adult Portuguese-speaking patients submitted to elective non-cardiac, non-obstetric and non-neurological surgery were eligible to the study, during a 6-week period of time. Each patient included was evaluated for diagnosis of POD using the Nursing Delirium Screening Scale (NUDESC) in the recovery room and on the first postoperative day. HRQOL was assessed by SF-36 Health Survey (SF-36) before surgery and 3 months after surgery. Descriptive analyses of variables were used to summarize data and non-parametric tests were performed.

Results and Discussion: From the 221 patients, 25 (11%) developed POD. Three months after surgery and compared with patients without POD, patients that developed POD had worse values in 2 of the SF-36 domains: general perception of health (median 65 versus 50, p=0.016) and social functioning (median 100 versus 75, p=0.043).

In patients with POD and comparing each of SF-36 domains before and 3 months after surgery, similar scores for every 8 SF-36 domains were obtained except for physical functioning (median 80 versus 85, p=0.027) and vitality (median 46 versus 50, p=0.007). Patients without POD had better scores for 7 domains: physical functioning (median 80 versus 85, p=0.030), role limitations caused by physical problems (median 56 versus 75, p=0.001), bodily pain (median 61 versus 84, p< 0.001), vitality (median 46 versus 50, p< 0.001), social functioning (median 88 versus 100, p=0.035), role limitations caused by emotional problems (median 75 versus 100, p< 0.001) and mental health (median 56 versus 68, p< 0.001); they had similar scores for general health perception.

Conclusion(s): The health-related quality of life after surgery improved in patients without POD, while patients that developed POD did not have improvement in their quality of life after surgery. Three months after surgery, development of POD was associated with worse general perception of health and social functioning.

© 2013 European Society of Anaesthesiology