Reported Incidences of Postoperative Delirium in State and National Hospital Claims Databases

Khaled Al-Robaidi, Muruga Loganathan, Laith Alhuneafat, Samir S. Al-Ghazawi, Keith Vogt, Parthasarathy D. Thirumala


Background: The aim of the study was to evaluate the incidence of postoperative delirium (POD) following a comprehensive list of surgical procedures utilizing data from state and national inpatient hospital databases.

Methods: The incidence of POD occurring during surgical hospital admissions was evaluated across 15 surgical categories, and different patient demographics using California State Inpatient Database (SID) and National Inpatient Sample (NIS).

Results: Analysis of 4 years of SID sample resulted in 47,875 cases of POD with an overall incidence of 1.06%. The incidence was highest following transplant surgeries 6.82%, musculoskeletal surgeries 1.95%, neurological surgeries 1.81% and cardiac surgeries 1.81%. The mean age of patients with delirium was 71.6 ± 15.3 (standard deviation (SD)) compared with 47.8 ± 23.6 (SD) in patients without delirium. Analysis of the NIS database resulted in an annual incidence of 1.78%, estimating at least 200,000 cases of POD occurring every year in the USA.

Conclusions: This study highlights the size and variation of postoperative incidence across different patient characteristics, risk factors, surgical procedures, and research methods. Delirium occurring in the postsurgical period remains to be a serious potentially preventable problem affecting hospitals worldwide. Implementing additional measures for early detection and prevention can help lessen the morbidity and mortality burden associated with delirium.

J Neurol Res. 2022;12(1):1-8


Delirium; Postoperative; Incidence; National Inpatient Sample; State Inpatient Sample; Underdiagnosis; Underreported; Surgery

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