Korean J Urol KJU Korean Journal of Urology 0494-4747 The Korean Urological Association 10.4111/kju.2006.47.9.953 Original Article The Risk Factor of Delirium after Transurethral Resection of the Prostate Jung Sung Won Park Seung Chol Rim Joung Sik Department of Urology, Wonkwang University School of Medicine, Iksan, Korea. Corresponding author (sc.park@wonkwang.ac.kr) 09 2006 30 09 2006 47 9 953 957 03 04 2006 20 07 2006 Copyright © 2006 The Korean Urological Association 2006 Purpose

Transurethral resection of the prostate (TURP) is the surgical treatment for symptomatic benign prostate hyperplasia with a good result, but some cases of postoperative delirium have been associated with this treatment. The purpose of this study is to develop and validate clinical prediction of postoperative delirium using the preoperative and postoperative data.

 Materials and Methods

We analyzed 417 patients who were admitted for TURP between January 1999 and December 2004. All patients underwent evaluations, including a medical history and laboratory tests, and we recorded the operative time, resection volume, complications, medications and length of stay from the medical records. Postoperative delirium was diagnosed using DMS-IV. Logistic regression test was used to assess the data of the patients and to determine the risk factor of postoperative delirium.

 Results

Postoperative delirium occurred in 33 patients (7.9%) of the 417 patients. The hospital stay of the patients with delirium was longer than that of the patients without delirium. Delirium was associated with an age≥70 years, a postoperative Hb<10g/dl and decreased Hb≥2.0g/dl (p<0.05). A postoperative Hb<10g/dl and a decreased Hb≥2.0g/dl were associated with an increased risk of delirium on the multivariate analysis (odds ratio=4.6 and 5.7).

 Conclusions

The incidence of postoperaitve delirium in elderly patients with symptomatic benign prostate hyperplasia was 7.9%, and a postoperative Hb<10g/dl and a decreased Hb≥2.0g/dl were identified as risk factors. Because delirium was associated with a variety of adverse outcomes, difficult treatment and high mortality, those patients with risk factor for delirium must be kept under close observation after TURP.

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The diagnostic and statistical manual version IV diagnostic criteria

Clinical parameters between the two groups

Preoperative and postoperative laboratory parameters

Complications of TURP

*: Fisher's exact test, TURP: transurethral resection of prostate

Logistic regression multivariate analysis for postoperative delirium