Postoperative delirium after lung resection for primary lung cancer: Risk factors, risk scoring system, and prognosis

Autoři: Kazuki Hayashi aff001;  Makoto Motoishi aff002;  Satoru Sawai aff003;  Kanna Horimoto aff003;  Jun Hanaoka aff001
Působiště autorů: Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Shiga, Japan aff001;  Department of Thoracic Surgery, Mitsubishikyoto Hospital, Kyoto, Japan aff002;  Department of Thoracic Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan aff003
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223917


Delirium is a common post-surgical complication, but few studies have examined postoperative delirium following lung cancer surgery. The purpose of this study was to clarify the risk factors of postoperative delirium, to construct a useful scoring system, and to clarify the relationship between delirium and prognosis after lung cancer surgery. We retrospectively analyzed data from 570 patients who underwent surgery for primary lung cancer. Logistic regression analysis was used to determine the effects of various factors on the onset of delirium. Kaplan–Meier analysis was performed to determine the relationship between delirium and prognosis. Postoperative delirium occurred in 6.7% of the patients. Three risk factors were identified, and the risk scores were determined as follows: 2×(cerebrovascular disease history) + 1×(squamous cell carcinoma) + 1×(age older than 75 years). Scores 0–1 denoted low risk, 2 denoted intermediate risk, and 3–4 denoted high risk. Additionally, we found that patients who developed delirium had significantly shorter overall survival. However, there was no difference in the frequency between cancer-related death and non-cancer related death when comparing the delirium and non-delirium groups. We identified the risk factors, i.e., cerebrovascular disease history, squamous cell carcinoma, and age older than 75 years, that determine the onset of delirium after lung cancer surgery and constructed a useful scoring system. In addition, although the prognosis of the delirium group was poor, the factor that determines prognosis may not be cancer per se but vulnerability in the patient background.

Klíčová slova:

Cancer risk factors – Cerebrovascular diseases – Lung and intrathoracic tumors – Prognosis – Squamous cell carcinomas – Surgical and invasive medical procedures – Surgical oncology – Surgical resection


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2019 Číslo 11