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.