Study: Preoperative depression boosts risk of postoperative delirium

Editor's Note

Patients with depressive symptoms are nearly twice as likely to experience delirium after major surgery, according to a meta-analysis published September 4 in the journal Anaesthesia.

The evaluation of the link between preoperative depression and postoperative delirium included data from 42 studies involving more than 4.6 million patients. The incidence of postoperative delirium was 29% among patients with pre-existing depression, compared to 15% in those without depression. The study also revealed that the relative risk of delirium was 1.91 times higher for patients with depression.

Subgroup analyses showed that this risk was consistent across various surgical types. In patients undergoing cardiac surgery, the incidence of delirium was notably higher, with 41% of depressed patients experiencing this complication. Older adults (aged 65 and above) and those undergoing non-elective procedures also showed a heightened risk. For instance, older adults with depression had an increased incidence of delirium at 41%, compared to 23% among younger patients. The risk was similarly elevated in non-elective surgeries, where the incidence reached 38%, compared to 26% in elective procedures.

Despite variability in depression and delirium definitions across studies, the findings highlight the importance of perioperative screening and intervention strategies, including non-pharmacologic interventions like cognitive training and psychotherapy, for patients with psychiatric comorbidities, researchers write.