July 31 (UPI) -- Older adults who develop brain dysfunction after surgery spend more time in the hospital and are less likely to be discharged home, a study published Friday by JAMA Network Open found.
Seniors who experience delirium during recovery from an operation are hospitalized for up to two days longer and, when they are discharged, up to 78% are sent to a rehabilitation or skilled nursing facility, according to the researchers.
As a result, they can incur more than $17,000 in additional healthcare costs, the researchers said.
"There is increased awareness of these disorders in the medical community and, interestingly, among patients and their families," study co-author Dr. M. Dustin Boone told UPI.
"Many factors drive this, [including] older age, lower socioeconomic status and poorer health, risk factors not amenable to quick change," said Boone, an anesthesiologist at Dartmouth-Hitchcock Medical Center.
Post-operative neurocognitive dysfunction, or PND, occurs in as many as 65% of patients who undergo surgery, and is particularly common in adults 65 and older, research indicates.
The most common form is delirium -- or confusion or disorganized thinking -- and it might be caused by dehydration, an infection or unrelieved pain both during and after surgery, Boone said.
For their research, he and his colleagues reviewed data on nearly 2.4 million Medicare patients who had surgery between January 2013 and December 2016. The average age of patients in the study was 75 years, they said.
Just under 45,000 -- or roughly 2% -- of patients were diagnosed with PND, according to the researchers.
Those with the condition remained in the hospital for an average of about six days -- two more than those without the complication -- the researchers said.
Just 22% of patients with PND were discharged home from the hospital following recovery, compared to 40% of those without PND, they said.
Ten percent of the PND patients died within one year of surgery, compared to 4.4% of those without the complication, the researchers said.
Surgeons can identify patients at high risk for PND before surgery, and treatments are available to help reduce the risk, according to guidelines from American College of Surgeons, the American Geriatrics Society and the American Society of Anesthesiologists.
"These [guidelines] are publicly available and serve as a good resource," Boone said. "Patients and caregivers [should] discuss this complication with their surgeons, anesthesiologists and their primary care providers."