• Tendo Sato, Shingo Hatakeyama, Teppei Okamoto, Hayato Yamamoto, Shogo Hosogoe, Yuki Tobisawa, Tohru Yoneyama, Eiji Hashiba, Takahiro Yoneyama, Yasuhiro Hashimoto, Takuya Koie, Kazuyoshi Hirota, and Chikara Ohyama.
• Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
• Plos One. 2016 Jan 1; 11 (5): e0153961.

ObjectivesThe aim of this study was to identify risk factors associated with postoperative delirium in patients undergoing urological surgery.MethodsWe prospectively evaluated pre- and postoperative risk factors for postoperative delirium in consecutive 215 patients who received urological surgery between August 2013 and November 2014. Preoperative factors included patient demographics, comorbidities, and frailty assessment. Frailty was measured by handgrip strength, fatigue scale of depression, fall risk assessment, and gait speed (the timed Get-up and Go test). Postoperative factors included types of anesthesia, surgical procedure, renal function and serum albumin decline, blood loss, surgery time, highest body temperature, and complications. Uni- and multivariate logistic regression analyses were performed to assess pre- and postoperative predictors for the development of postoperative delirium.ResultsMedian age of this cohort was 67 years. Ten patients (4.7%) experienced postoperative delirium. These patients were significantly older, had weak handgrip strength, a higher fall risk assessment score, slow gait speed, and greater renal function decline compared with patients without delirium. Multivariate analysis revealed slow gait speed (>13.0 s) and rapid renal function decline (>30%) were independent risk factors for postoperative delirium.ConclusionsSlow gait speed and rapid renal function decline after urological surgery are significant factors for postoperative delirium. These data will be helpful for perioperative patient management. This study was registered as a clinical trial: UMIN: R000018809.

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