Risk factors for postoperative delirium in patients with colorectal cancer

Aim: The purpose of this study was to identify the incidence of postoperative delirium in PCC (patients with colorectal cancer) and the related factors of postoperative delirium by analysing the differences in the general, disease-related and operation-related characteristics.

Background: Previous studies had some limitations in generalising the risk factors for postoperative delirium in PCC due to the lack of relevant factors, such as disease- and operation-related characteristics. There is a need to investigate the factors of postoperative delirium by including cancer and surgical characteristics.

Design: The current study is a cross-sectional study to investigate the correlated factors of postoperative delirium in PCC.

Methods: A total of 196 patients who underwent colorectal cancer surgery at the Keimyung University Dongsan Hospital in Korea participated in the study. Data collection was performed from 15 August 2018 to 10 July 2019. Patients' general, disease-related and operation-related characteristics were collected from questionnaires and electronic medical records. Data analysis was performed using descriptive statistics, t test, Chi-square test and logistic regression using SPSS/WIN 22.0. The STROBE checklist has been used to report this study.

Results: The results of this study showed that 26 (13.2%) PCC exhibited postoperative delirium and the risk factors for postoperative delirium were physical activity (OR = 2.94, p = .001), infection (OR = 2.17, p = .001) and nutritional status (OR = 1.10, p = .028).

Conclusion: To reduce and prevent the occurrence of postoperative delirium in PCC, encouraging participation in physical activity before and after surgery are required, and regular monitoring of the infection symptoms and nutritional status.

Relevance to clinical practice: Based on the results of this study, postoperative delirium in PCC could be decreased by encouraging physical activity immediately following operation, monitoring the signs and symptoms of infection using diverse objective laboratory findings and maintaining the nutritional status within the normal range.