Incidence and risk factors of emergence delirium in elderly patients after general or spinal anesthesia for both elective and emergency surgery

Background: Emergence delirium is a poorly understood incident in elderly patients in PACU. The aim of this study was to determine the incidence of emergence delirium and its predictors in elderly patients after general or spinal anesthesia for both elective and emergency surgery.

Methods: In this prospective observational study, 172 consecutive patients were included. The study was performed in the post-anesthesia care unit for three months in 2020. We included elderly patients in both elective and emergency surgery. Patient interviews, chart reviews, and direct observation were among the data collection methods. The Nursing Delirium Screening Scale was the assessment tool. The outcome variable and independent variables' association was determined by bivariate and multivariate logistic regression analysis.

Results: The incidence of emergence delirium at the post-anesthesia care unit was 40.7% (95% CI = 32-48).Postoperative pain (AOR = 3.9:95%CI = 1.13-13.60), preoperative anxiety (AOR = 7:95% CI = 1.76-28.55), perioperative narcotics (AOR = 5.1:95% CI = 1.27-20.57) and excessive blood loss (AOR = 6.5:95% CI = 2.47-17.02) were predictors of emergence delirium.

Conclusions: Delirium in the post-anesthesia care unit is common. Anxiety, perioperative narcotics, and intraoperative blood loss were predictors of emergence delirium.