Olga de la Varga-Martínez, Rosalía Navarro Pérez, Rocío López Herrero, Eduardo Santamaría-Vázquez, Gema Rodríguez-Cerón, Beatriz Martínez-Rafael, Ángel Becerra-Bolaños, Alma María Espinosa Moreno, Marta de la Rosa-Estadella, Natalia Bugueño, Marta Giné Servén, Adrián Martínez-López, Diana Marcela Narváez Cubillos, Marta Eugenia Infante Morales, Luis Aníbal Gómez Arredondo, Alma Casasempere Sanus, Jorge Almoguera-Fernández, Rebeca Badenes-García, Nekane Romero-García, Beneharo Darias-Delbey, Guadalupe Población García, Rita Veloso-de Sousa, María Heredia-Rodríguez, Cristina Tobar Gonzalo, José Miguel Marcos Vidal, Carolina Ferrer-Gómez, Lorena Varela Rodríguez, Laura Contreras López, Laura Pariente Juste, Marta Alonso Fernández, Ricardo Fernández Fernández, Cristina Sánchez González, Elena Del Val Peciña, María Aránzazu Rodríguez Conesa, Almudena González Pereira, Aurora Herrera Soto, Ángel Antonio Rodríguez Álvarez, Iria de la Torre Riveiro, Gustavo Illodo Miramontes, Itzamara Loo Yau, Carla Delgado Martí, Rodrigo Poves-Álvarez, Marina Varela Duran, Rafael Badenes, Eduardo Tamayo
{"title":"Postoperative delirium and 1-year functional decline, institutionalization and mortality.","authors":"Olga de la Varga-Martínez, Rosalía Navarro Pérez, Rocío López Herrero, Eduardo Santamaría-Vázquez, Gema Rodríguez-Cerón, Beatriz Martínez-Rafael, Ángel Becerra-Bolaños, Alma María Espinosa Moreno, Marta de la Rosa-Estadella, Natalia Bugueño, Marta Giné Servén, Adrián Martínez-López, Diana Marcela Narváez Cubillos, Marta Eugenia Infante Morales, Luis Aníbal Gómez Arredondo, Alma Casasempere Sanus, Jorge Almoguera-Fernández, Rebeca Badenes-García, Nekane Romero-García, Beneharo Darias-Delbey, Guadalupe Población García, Rita Veloso-de Sousa, María Heredia-Rodríguez, Cristina Tobar Gonzalo, José Miguel Marcos Vidal, Carolina Ferrer-Gómez, Lorena Varela Rodríguez, Laura Contreras López, Laura Pariente Juste, Marta Alonso Fernández, Ricardo Fernández Fernández, Cristina Sánchez González, Elena Del Val Peciña, María Aránzazu Rodríguez Conesa, Almudena González Pereira, Aurora Herrera Soto, Ángel Antonio Rodríguez Álvarez, Iria de la Torre Riveiro, Gustavo Illodo Miramontes, Itzamara Loo Yau, Carla Delgado Martí, Rodrigo Poves-Álvarez, Marina Varela Duran, Rafael Badenes, Eduardo Tamayo","doi":"10.1097/EJA.0000000000002499","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium is a common and serious complication in older surgical patients and has been associated with increased morbidity, healthcare costs, long-term functional decline and mortality.</p><p><strong>Objective: </strong>To determine whether postoperative delirium is associated with functional status, quality of life, institutionalisation and mortality at 1 year after surgery in a large multicentre surgical cohort.</p><p><strong>Design: </strong>Prospective multicentre observational study.</p><p><strong>Setting: </strong>Forty-three hospitals in Spain. Surgical patients were recruited in November 2023 and assessed for delirium 48 h after surgery, with follow-up at 1 year.</p><p><strong>Patients, other participants: </strong>A total of 2442 adult surgical patients undergoing elective or urgent procedures requiring hospital admission. Postoperative delirium was assessed using the Confusion Assessment Method (CAM), CAM for the Intensive Care Unit (CAM-ICU) or the telephone-administered 4AT according to clinical setting.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measures: </strong>Functional status and quality of life at 1 year assessed using the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0). Secondary outcomes included institutionalisation and mortality.</p><p><strong>Results: </strong>After excluding 81 deaths and 462 nonresponders, the 1-year telephone follow-up was completed for 1899 patients. Postoperative delirium within the first 48 h was independently associated with a 4.6-point higher WHODAS score at 1 year: adjusted mean difference = 4.60 [95% confidence interval (CI), 1.57 to 7.64, P = 0.003]. Delirium was also associated with increased institutionalisation and higher mortality: odds ratio (OR) 2.5 (95% CI, 1.07 to 5.84, P = 0.03), and (16.7 vs. 3.1%; P < 0.001), including 30-day, 60-day, and 365-day mortality (all P < 0.001), respectively.</p><p><strong>Conclusions: </strong>Postoperative delirium is independently associated with long-term functional decline, loss of independence, institutionalisation and increased 1-year mortality. These findings highlight delirium as a key perioperative complication and support prevention strategies and structured long-term follow-up after surgery.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (identifier: NC-T06127901).</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":7.8000,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Anaesthesiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/EJA.0000000000002499","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Postoperative delirium is a common and serious complication in older surgical patients and has been associated with increased morbidity, healthcare costs, long-term functional decline and mortality.
Objective: To determine whether postoperative delirium is associated with functional status, quality of life, institutionalisation and mortality at 1 year after surgery in a large multicentre surgical cohort.
Setting: Forty-three hospitals in Spain. Surgical patients were recruited in November 2023 and assessed for delirium 48 h after surgery, with follow-up at 1 year.
Patients, other participants: A total of 2442 adult surgical patients undergoing elective or urgent procedures requiring hospital admission. Postoperative delirium was assessed using the Confusion Assessment Method (CAM), CAM for the Intensive Care Unit (CAM-ICU) or the telephone-administered 4AT according to clinical setting.
Interventions: None.
Main outcome measures: Functional status and quality of life at 1 year assessed using the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0). Secondary outcomes included institutionalisation and mortality.
Results: After excluding 81 deaths and 462 nonresponders, the 1-year telephone follow-up was completed for 1899 patients. Postoperative delirium within the first 48 h was independently associated with a 4.6-point higher WHODAS score at 1 year: adjusted mean difference = 4.60 [95% confidence interval (CI), 1.57 to 7.64, P = 0.003]. Delirium was also associated with increased institutionalisation and higher mortality: odds ratio (OR) 2.5 (95% CI, 1.07 to 5.84, P = 0.03), and (16.7 vs. 3.1%; P < 0.001), including 30-day, 60-day, and 365-day mortality (all P < 0.001), respectively.
Conclusions: Postoperative delirium is independently associated with long-term functional decline, loss of independence, institutionalisation and increased 1-year mortality. These findings highlight delirium as a key perioperative complication and support prevention strategies and structured long-term follow-up after surgery.
期刊介绍：
The European Journal of Anaesthesiology (EJA) publishes original work of high scientific quality in the field of anaesthesiology, pain, emergency medicine and intensive care. Preference is given to experimental work or clinical observation in man, and to laboratory work of clinical relevance. The journal also publishes commissioned reviews by an authority, editorials, invited commentaries, special articles, pro and con debates, and short reports (correspondences, case reports, short reports of clinical studies).
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
