Perioperative medicine & outcomes
Postoperative Delirium in Older Adults Undergoing Noncardiac Surgery
Main finding · Death or major complicationsResult — go to the resultAdjusted odds ratio 3.47 95% CI 3.41–3.53Authors' conclusion
In this national retrospective cohort study of more than 5.5 million hospitalizations, older individuals undergoing major noncardiac surgery who experienced postoperative delirium had 3.5-fold higher odds of death or major complications, 2.8-fold higher odds of death, and 4.0-fold higher odds of nonhome discharge. There was substantial variation in the hospital rate of postoperative delirium after accounting for patient risk
Study context
- Population
- Patients aged ≥65 years undergoing major noncardiac surgery in US hospitals, 2017–2020admissions in 3169 hospitals
- Participants
- 5,530,054 patients
- Exposure
- Postoperative delirium vs no postoperative delirium
- Postoperative deliriumn = 197,921
- Outcome
- Composite of:
- Death
- Major complications
- Follow-up
- 30 days
Methodological detailsnational, multilevel logistic regression
- National
- Multilevel logistic regression
Main finding
Death or major complications
Adjusted odds ratio
3.47
95% CI 3.41–3.53
P < 0.001
Postoperative delirium vs No postoperative delirium
aOR 3.47 (95% CI 3.41–3.53); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| 30-day mortality | aOR 2.77 (95% CI 2.71–2.83) | P < 0.001 | |
| Nonhome discharge | aOR 3.96 (95% CI 3.88–4.04) | P < 0.001 | |
| Hospital-level variation in postoperative deliriumHospitals with higher delirium rate vs Hospitals with lower delirium rate · controlling for patient characteristics | median OR 1.53 (95% CI 1.50–1.56) | ||
| 0.20.5125Ratio (log scale) |
- Incidence of postoperative delirium
- 3.6% · 197 921
Original publication
Postoperative Delirium in Older Adults Undergoing Noncardiac Surgery. JAMA Netw Open. Published 1 July 2025. doi:10.
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