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Preoperative anxiety as an independent predictor of postoperative delirium in older patients undergoing elective surgery for lumbar disc herniation

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Abstract

Background

Anxiety is common in older patients suffering from lumbar disc herniation. Postoperative delirium is related to poor prognosis. But the relationship between preoperative anxiety and postoperative delirium among older patients undergoing elective surgery for lumbar disc herniation is not clear.

Aims

The study aimed to investigate if preoperative anxiety is an independent risk factor of postoperative delirium among older patients undergoing elective surgery for lumbar disc herniation.

Methods

The medical records of 1290 patients undergoing elective surgery for lumbar disc herniation at a single institution from 2016 through 2021 were reviewed. Of 863 eligible patients, 225 (26.1%) patients had been diagnosed with anxiety by a board-certified psychiatrist and constituted the Anxiety group; the remaining 638 patients constituted the no-anxiety group. The demographics, baseline, operative variable and postoperative complications were collected and compared between the two groups. The primary outcome of this study was the incidence of delirium, according to the Diagnostic and Statistical Manual of Mental Disorders—Fifth Edition, during a hospital stay after surgery for lumbar disc herniation. The relationship between anxiety and postoperative delirium was determined through multivariate logistic regression analysis.

Results

The demographics and comorbidity were similar between the two groups, except for age, sex, alcohol use and cerebrovascular disease. The operative variables were different between the two groups. The incidence of postoperative complications other than postoperative delirium was also similar between the two groups. In total, 86 patients (9.97%) had an episode of postoperative delirium, with anxiety group patients experiencing approximately a twofold higher rate (15.6% vs 7.99%). In a multivariate logistic regression analysis, anxiety was an independent predictor of postoperative delirium in older patients undergoing elective surgery for lumbar disc herniation (OR 2.228, 95% CI 1.494–3.416, p = 0.009).

Conclusion

This study suggests that anxiety is an independent risk factor of postoperative delirium among older patients undergoing elective surgery for lumbar disc herniation. Preoperative anxiety assessment can help to identify older patients at high risk of postoperative delirium and facilitate perioperative management of older patients undergoing elective surgery for lumbar disc herniation.

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Acknowledgements

We would like to express our thanks to all of the recruited participants.

Funding

This research did not receive any specific grant from funding agencies in the public.

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Authors and Affiliations

  1. Second Department of Spine, Sunshine Union Hospital, Weifang, China

    Qing Mou, Mengling Gao & Xuepeng Liu

  2. Orthopaedic Department, 970 Hospital of PLA, Yantai, China

    Chen Wei

  3. Orthopaedic Department, Haiyang People’s Hospital, Yantai, China

    Gongquan Lan

  4. Orthopaedic Department, Pingdu People’s Hospital, Qingdao, China

    Xiaolong Zhao

  5. Neurology and Psychiatry Department, Sunshine Union Hospital, Weifang, China

    Yaozhong Shan

  6. Nutriology Department, Sunshine Union Hospital, Weifang, China

    Congna Wu

Authors
  1. Qing Mou
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  5. Gongquan Lan
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Corresponding author

Correspondence to Congna Wu.

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The authors declare that they have no competing interests.

Ethical approval

This study received ethical approval from the Ethics Board of Sunshine Union Hospital.

Statement of human and animal rights and Informed consent

This is a retrospective study, and Sunshine Union Hospital Review Board allowed to waive Statement of human and animal rights, or Informed consent.

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Mou, Q., Gao, M., Liu, X. et al. Preoperative anxiety as an independent predictor of postoperative delirium in older patients undergoing elective surgery for lumbar disc herniation. Aging Clin Exp Res 35, 85–90 (2023). https://doi.org/10.1007/s40520-022-02278-7

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  • DOI: https://doi.org/10.1007/s40520-022-02278-7

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