Incidence and Risk Factors of Delirium Following Brain Tumor Resection: A Retrospective

OBJECTIVE: The aim of this study was to evaluate the occurrence and factors predisposing to delirium following brain tumor resection. METHODS: Data from patients who underwent brain tumor resection surgery from 2016 to 2019 were extracted from the National Inpatient Sample database and retrospectively analyzed. The difference between the 2 groups was compared by Wilcoxon rank test or c2 test was used. Univariate and multivariate logistic regression analyses were used to identify the risk factors of delirium after brain tumor resection. RESULTS: From 2016 to 2019, 28,340 patients who underwent brain tumor resection were identified in the National Inpatient Sample database, with the incidence of delirium being 4.79% (1357/28,340). It was found that increased incidence of delirium was significantly associated with age over 75 years and males (all P < 0.001). Besides, patients with delirium were more likely to have multiple comorbidities and to receive elective surgery (all P < 0.001). The results of logistic regression analysis showed that self-pay (odds ratio [OR] = 0.51; confidence interval [CI] = 0.31-0.83;- 0.83; P = 0.007), elective admission (OR = 0.53; CI = 0.47-0.60;- 0.60; P < 0.001), obesity (OR = 0.77; CI = 0.66-0.92;- 0.92; P = 0.003), females (OR = 0.79; CI = 0.71-0.88;- 0.88; P < 0.001), and private insurance (OR = 0.80; CI = 0.67-0.95;- 0.95; P = 0.012) were associated with lower occurrence of delirium. Besides, delirium was related to extra total hospital charges (P< P < 0.001), increased length of stay (P P < 0.001), higher inpatient mortality (P P = 0.001), and perioperative complications (including heart failure, acute renal failure, urinary tract infection, urinary retention, septicemia, pneumonia, blood transfusion, and cerebral edema) (P< P < 0.001). CONCLUSIONS: Many factors were associated with the occurrence of delirium after brain tumor resection. Therefore, clinicians should identify high-risk patients prone to delirium in a timely manner and take effective management measures to reduce adverse outcomes.