- Explain to patients who ask that postoperative delirium among older patients is a risk factor for discharge to a nursing facility or in-hospital death.
SAN FRANCISCO, Aug. 24 -- Older surgical patients who carry the (ApoE4) allele, a risk factor for early-onset Alzheimer's disease, are an at increased risk for postoperative delirium, according to researchers here.
Among patients over 65 who had major surgery other than cardiac procedures, a quarter of all those who had delirium on the first two postop days had at least one copy of the apolipoprotein (E4 ApoE4) allele, found Jacqueline M. Leung, M.D., M.P.H., of the University of California San Francisco, and colleagues.
The rate of postop delirium was nearly four-fold higher among the carriers of the risk allele compared with patients who had other versions of the gene, the investigators reported in the September issue of Anesthesiology.
"Postoperative delirium is common in older patients after noncardiac surgery, and is associated with increased rates of nursing home placement and hospital mortality," they wrote. "Despite this prevalence and clinical importance, no specific etiologic factor has been identified."