Incidence of postoperative delirium according to cognitive status, improved responsiveness and inflammatory response at elderly patients in urgent abdominal surgery

Inna Demyter, Dmytro Gudz, Sergey Vorotyntsev



Background. Postoperative delirium (POD) is a clinical syndrome that is manifested in impaired consciousness and attention, perception, memory, thinking and psychomotor behavior after surgery. Methods. After passing the Bioethics Commission at Zaporizhzhya State Medical University and obtaining informed consent from patients, 30 elderly patients who underwent surgical interventions on the abdominal organs under urgent procedure were sequentially included in a single-center prospective study. Patients with a history of traumatic brain injury or stroke with neurological impairments in the form of sensory-motor aphasia and plegia were excluded from the study.Results .The study involved 30 patients (16 (53%) women and 14 (47%) men), aged 62 years to 92 years, grade III-IV ASA, who underwent urgent surgery for bowel tumors (n = 8), gallstone disease (n = 7), entrained inguinal and postoperative ventral hernias (n = 10), gastric or intestinal perforation (n = 5). Postoperative delirium occurred in 33% of patients. On the first day after surgery, the cognitive status of patients in the first group decreased by 1 point relative to the primary assessment (p = 0.88), when on the second postoperative day the indicator returned to baseline. Patients in the second group showed a sharp impairment of cognitive abilities in the postoperative period, associated with POD and a significant decrease in cognitive status at day 5 (p <0.05) compared with preoperative assessment. The level of inflammatory response of the body in the preoperative period is 1.5 times higher in patients with POD (p = 0.01). The correlation between leukocytosis level and POD revealed a moderately significant relationship between these indicators (rs = 0.45 at p <0.05).Conclusions. In 33% of urgent patients, abdominal surgery revealed postoperative delirium, which is reliably dependent on cognitive deficits for surgery and the level of systemic inflammation (p = 0.01). The level of patient wear does not significantly affect the incidence of POD.


elderly patient; postoperative delirium; cognitive status; urgent abdominal surgery

Full Text:



Scholz A.F., Oldroyd C, McCarthy K, Quinn T.J., Hewitt J. Systematic review and meta-analysis of risk factors for postoperative delirium among older patients undergoing gastrointestinal surgery. Br J Surg. 2016;103:e21–28

Ely E.W., Gautam S., Margolin R., Francis J., May L., Speroff T. et al. The impact of delirium in the intensive care unit on hospital length of stay. Intensive Care Med. 2001; 27: 1892–900

Aldecoa C, Bettelli G, Bilotta F, et all. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur. J. Anaesthesiol. 2017; 34: 192-214.

Inouye S.K., Westendorp R.G., Saczynski J.S. Delirium in elderly people. Lancet 2014; 383:911-922

Rudolph J.L., Jones R.N., Levkoff S.E., et al. Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery. Circulation 2009;119: 229-236

Marcantonio E.R. Postoperative delirium: a 76-year-old woman with delirium following surgery. JAMA2012;308:73-81

Demyter IM, Vorotyntsev SI Postoperative delirium in elderly patients scheduled // Bulletin problems of biology and medicine. 2019. №1, Volume 2 (149): 134-137.

Milstein A., Arak Y, Kleinman G., et al. The incidence of delirium immediately following cataract removal surgery: a prospective study in the elderly. Aging Mental Health 2001; 4:178-81.

Marcantonio E.R., Flacker J.M., Wright R.J., et al. Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc 2001;49:516-22.

Robinson T.N.1, Raeburn C.D., Tran Z.V., Angles E.M., Brenner L.A, Moss M. Postoperative delirium in the elderly: risk factors and outcomes. Ann Surg. 2009 Jan; 249(1):173-8. doi: 10.1097/SLA.0b013e31818e4776.

L. Ansaloni, F. Catena, R. Chattat, D. Fortuna, C. Franceschi, P. Mascitti , R. M. Melotti. Risk factors and incidence of postoperative delirium in elderly patients after elective and emergency surgery. British Journal of Surgery Society 12 January 2010,

Ely EW, Shintani A, Truman B, et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 2004;291:1753-1762

Segal-Gidan, Freddi PA, PhD. Postoperative confusion in older adults. Journal of the American Academy of PAs: April 2017 - Volume 30 - Issue 4 - p 12–16

doi: 10.1097/01.JAA.0000513345.29384.39

Solovyova A. P., Goryachev D.V., Arkhipov V.V. Criteria for Assessment of Cognitive Impairment in Clinical Trials. The Bulletin of Scientific Centre for Expert Evaluation of Medicinal Products 2018. V.8, 4.

Hubbard R.E., Peel N.M., Samanta M., Gray L.C., Mitnitski A., Rockwood K . Frailty status at admission to hospital predicts multiplace adverse outcomes. Age Ageing 2017 22: 1-6

Kim M.Y., Park U.J., Kim H.T., Cho W.H. Delirium Prediction based on Hospital Information (Delphi) in general surgery patients. Medicine (Baltimore)2016 Mar;95(12):e3072

Annachiara Marra, MD, PhD(c), E. Wesley Ely, MD, MPH, Pratik P. Pandharipande, MD, MSCI, FCCM, and Mayur B. Patel, MD, MPH, FACS. The ABCDEF Bundle in Critical Care. Crit Care Clin. 2017 Apr; 33(2): 225–243.

Ely E.W., Margolin R., Francis J., May L., Truman B., Dittus R. et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit. Care Med 2001; 29:1370–1379

Nadelson M.R., Sanders R.D., Avidan M.S. Perioperative cognitive trajectory in adults. Br J Anaesth 2014; 112:440–451.

Bettelli G. Preoperative evaluation in geriatric surgery: comorbidity, functional status and pharmacological history // Minerva Anestesiol. – 2011. – Vol. 77. – P. 637–646.

Likhvantsev V.V., Ulitkina O.N., Rezepov N. A postoperative delirium: What new does novel Guidelines by esa-2017 offer? Messenger of Anesthesiology and Resuscitation, 2017, Vol. 14, no 2, P. 41-47(In Russ) DOI: 10 21292/2078-5658-2017-14-2-41-47

Robinson T.N, Raeburn C.D., Tran Z.V., Angles E.M., Brenner L.A., Moss M. Postoperative delirium in the elderly: risk factors and outcomes. Ann Surg. 2009 Jan;249(1):173-8. doi: 10.1097/SLA.0b013e31818e4776.

Peterson J.F., Pun B.T., Dittus R.S., Thomason J.W., Jackson J.C., Shintani A.K., et al. Delirium and its motoric subtypes: a study of 614 critically ill patients. J Am Geriatr Soc 2006; 54: 479–84.

Siddiqi N., Stockdale R., Britton A.M., et al. Interventions for preventing delirium in hospitalised patients. Cochrane Database Syst Rev 2007; (2):CD005563.

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM

Journal of Education, Health and Sport formerly Journal of Health Sciences

Declaration on the original version.

Editors indicates that the main version of the magazine is to issue a "electronic".

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

Archives 2011 - 2014

PBN 2011 - 2014

POL-index 2011 - 2014

BASE 2011 - 2014

Indexed in Bases, Bazy indeksacyjne: ERIH Plus, Worldcat, PBN/POL-Index, ICI Journals Master List, Directory of Open Access Journals (DOAJ), ZBD, Ulrich's periodicals, Google Scholar, Polska Bibliografia Lekarska, EuroPub database, NLM Catalog Result - NCBI, BASE, Russian Sciences Index, Arianta.

US NLM = 101679844

101679844 - NLM Catalog Result - NCBI

Find a library that holds this journal:


PBN Poland



Redaction, Publisher and Editorial Office

Publisher and Editorial Office
Department of Physical Culture,
Faculty of Earth Sciences and Spatial Management,
Nicolaus Copernicus University in Toruń, Poland
Address: Str. Lwowska 1, 87-100 Toruń, Poland

  Open Access ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

The journal has been approved for inclusion in ERIH PLUS.

The ERIH PLUS listing of the journal is available at

Indexed in Index Copernicus Journals Master List.,p24782242,3.html

ICV 2019 = 100.00 ICV 2018 = 95.95 ICV 2017 = 91.30 ICV 2016 = 84.69 ICV 2015 = 93.34 ICV 2014 = 89.51 Standardized Value: 8.27 ICV 2013: 7.32 ICV 2012: 6.41 ICV 20115.48

RG Journal Impact: 0.18 *

*This value is calculated using ResearchGate data and is based on average citation counts from work published in this journal. The data used in the calculation may not be exhaustive.

RG Journal impact history

2020Available summer 2021
2018 / 20190.18

RG Journal impact over time

RG Journal impact

Indexed in Polish Scholarly Bibliography (PBN) (PBN Polska Bibliografia Naukowa) (

is a portal of the Polish Ministry of Science and Higher Education, collecting information on publications of Polish scientists and on Polish and foreign scholarly journals. Polish Scholarly Bibliograhpy is a part of POL-on - System of Information on Higher Education. It is operated by the Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw.

Indexed in Russian Sciences Index Российский индекс научного цитирования (РИНЦ)

Indexed in Arianta Polish scientific and professional electronic journals Aneta Drabek i Arkadiusz Pulikowski


Partnerzy platformy czasopism