J Neurol Res

Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc

Journal website https://www.neurores.org

Original Article

Volume 12, Number 1, February 2022, pages 1-8

Reported Incidences of Postoperative Delirium in State and National Hospital Claims Databases

Figure 1. Postoperative delirium incidence across 17 different age groups. SID: State Inpatient Database; NIS: National Inpatient Sample.

**Table 1.** Comparison of the Demographics and the Incidence of Delirium in the Years of 2008 and 2011 (SID Database)
	Incidence of delirium
^aNumber of patients (< 10) is too small to be reported. Data presentation: number of delirium cases (delirium incidence (%) after all surgical procedures). SID: State Inpatient Database; OBGYN: obstetrics and gynecology.
Age category
0 - 17 years	46 (0.06%)	87 (0.12%)	52 (0.19%)	54 (0.22%)
18 - 25 years	39 (0.33%)	30 (0.25%)	24 (0.03%)	29 (0.05%)
26 - 30 years	35 (0.38%)	32 (0.37%)	17 (0.03%)	32 (0.05%)
31 - 35 years	29 (0.31%)	42 (0.45%)	28 (0.04%)	38 (0.06%)
36 - 40 years	70 (0.55%)	63 (0.54%)	38 (0.08%)	36 (0.09%)
41 - 45 years	103 (0.60%)	103 (0.65%)	66 (0.20%)	81 (0.28%)
46 - 50 years	200 (0.86%)	182 (0.79%)	127 (0.39%)	142 (0.46%)
51 - 55 years	249 (0.86%)	274 (0.91%)	156 (0.52%)	187 (0.60%)
56 - 60 years	317 (0.98%)	402 (1.17%)	250 (0.80%)	311 (0.97%)
61 - 65 years	372 (1.16%)	540 (1.51%)	354 (1.14%)	411 (1.15%)
66 - 70 years	505 (1.65%)	626 (1.82%)	394 (1.26%)	556 (1.62%)
71 - 75 years	654 (2.31%)	765 (2.64%)	512 (1.70%)	681 (2.18%)
76 - 80 years	766 (3.04%)	894 (3.68%)	719 (2.48%)	775 (2.81%)
81 - 85 years	663 (3.59%)	739 (4.16%)	763 (3.15%)	876 (3.83%)
86 - 90 years	452 (4.19%)	617 (5.17%)	584 (3.74%)	785 (4.63%)
91 - 95 years	69 (4.86%)	96 (5.89%)	136 (4.26%)	220 (6.24%)
96 - 100 years	2.60%^a	11 (9.40%)	20 (5.38%)	35 (7.78%)
Unknown	896 (1.62%)	1,090 (1.92%)	883 (0.85%)	1,066 (1.06%)
Race
White	3,798 (1.57%)	4,558 (1.90%)	3,765 (1.16%)	4,517 (1.47%)
African American	245 (0.97%)	313 (1.19%)	299 (0.71%)	368 (0.87%)
Hispanic	795 (0.87%)	971 (1.00%)	609 (0.29%)	827 (0.41%)
Asian or Pacific Islander	314 (1.12%)	444 (1.46%)	259 (0.50%)	355 (0.67%)
Native American	0.62%^a	1.40%^a	0.35%^a	0.83%^a
Other	133 (1.34%)	104 (0.99%)	73 (0.54%)	107 (0.72%)
Surgical category
Neurosurgery	370 (1.98%)	455 (2.43%)	226 (1.53%)	256 (1.83%)
Endocrine surgery	14 (0.49%)	19 (0.68%)	17 (0.21%)	29 (0.38%)
Surgeries on the eye	0.51%^a	0.58%^a	0.31%^a	0.92%^a
ENT surgeries	32 (0.44%)	38 (0.56%)	19 (0.37%)	30 (0.62%)
Respiratory/thoracic	255 (1.50%)	288 (1.61%)	185 (1.26%)	243 (1.57%)
Cardiac surgery	912 (1.59%)	1,100 (2.08%)	372 (1.35%)	518 (2.05%)
Vascular surgery	633 (1.34%)	821 (1.65%)	456 (1.11%)	695 (1.63%)
Blood/lymphatic	47 (1.38%)	53 (1.52%)	32 (0.51%)	37 (0.58%)
Gastrointestinal	1,060 (1.36%)	1,242 (1.50%)	934 (1.00%)	1,115 (1.10%)
Urology surgery	235 (1.63%)	239 (1.63%)	127 (1.05%)	122 (1.01%)
Male surgery	78 (0.11%)	93 (0.15%)	0	0
OBGYN surgery	0	0	171 (0.05%)	188 (0.07%)
Musculoskeletal	1,724 (1.66%)	2,114 (1.93%)	2,513 (2.07%)	2,983 (2.31%)
Breast and skin	56 (1.35%)	65 (1.52%)	49 (0.36%)	63 (0.51%)
Transplant and other surgical procedures	43 (5.39%)	57 (7.72%)	19 (4.41%)	28 (5.93%)
Total	5,467 (1.28%)	6,593 (1.54%)	5,123 (0.76%)	6,315 (0.98%)

Table 1. Comparison of the Demographics and the Incidence of Delirium in the Years of 2008 and 2011 (SID Database)

Incidence of delirium

Males

Females

2008

2011

2008

2011

^aNumber of patients (< 10) is too small to be reported. Data presentation: number of delirium cases (delirium incidence (%) after all surgical procedures). SID: State Inpatient Database; OBGYN: obstetrics and gynecology.

Age category

0 - 17 years

46 (0.06%)

87 (0.12%)

52 (0.19%)

54 (0.22%)

18 - 25 years

39 (0.33%)

30 (0.25%)

24 (0.03%)

29 (0.05%)

26 - 30 years

35 (0.38%)

32 (0.37%)

17 (0.03%)

32 (0.05%)

31 - 35 years

29 (0.31%)

42 (0.45%)

28 (0.04%)

38 (0.06%)

36 - 40 years

70 (0.55%)

63 (0.54%)

38 (0.08%)

36 (0.09%)

41 - 45 years

103 (0.60%)

103 (0.65%)

66 (0.20%)

81 (0.28%)

46 - 50 years

200 (0.86%)

182 (0.79%)

127 (0.39%)

142 (0.46%)

51 - 55 years

249 (0.86%)

274 (0.91%)

156 (0.52%)

187 (0.60%)

56 - 60 years

317 (0.98%)

402 (1.17%)

250 (0.80%)

311 (0.97%)

61 - 65 years

372 (1.16%)

540 (1.51%)

354 (1.14%)

411 (1.15%)

66 - 70 years

505 (1.65%)

626 (1.82%)

394 (1.26%)

556 (1.62%)

71 - 75 years

654 (2.31%)

765 (2.64%)

512 (1.70%)

681 (2.18%)

76 - 80 years

766 (3.04%)

894 (3.68%)

719 (2.48%)

775 (2.81%)

81 - 85 years

663 (3.59%)

739 (4.16%)

763 (3.15%)

876 (3.83%)

86 - 90 years

452 (4.19%)

617 (5.17%)

584 (3.74%)

785 (4.63%)

91 - 95 years

69 (4.86%)

96 (5.89%)

136 (4.26%)

220 (6.24%)

96 - 100 years

2.60%^a

11 (9.40%)

20 (5.38%)

35 (7.78%)

Unknown

896 (1.62%)

1,090 (1.92%)

883 (0.85%)

1,066 (1.06%)

Race

White

3,798 (1.57%)

4,558 (1.90%)

3,765 (1.16%)

4,517 (1.47%)

African American

245 (0.97%)

313 (1.19%)

299 (0.71%)

368 (0.87%)

Hispanic

795 (0.87%)

971 (1.00%)

609 (0.29%)

827 (0.41%)

Asian or Pacific Islander

314 (1.12%)

444 (1.46%)

259 (0.50%)

355 (0.67%)

Native American

0.62%^a

1.40%^a

0.35%^a

0.83%^a

Other

133 (1.34%)

104 (0.99%)

73 (0.54%)

107 (0.72%)

Surgical category

Neurosurgery

370 (1.98%)

455 (2.43%)

226 (1.53%)

256 (1.83%)

Endocrine surgery

14 (0.49%)

19 (0.68%)

17 (0.21%)

29 (0.38%)

Surgeries on the eye

0.51%^a

0.58%^a

0.31%^a

0.92%^a

ENT surgeries

32 (0.44%)

38 (0.56%)

19 (0.37%)

30 (0.62%)

Respiratory/thoracic

255 (1.50%)

288 (1.61%)

185 (1.26%)

243 (1.57%)

Cardiac surgery

912 (1.59%)

1,100 (2.08%)

372 (1.35%)

518 (2.05%)

Vascular surgery

633 (1.34%)

821 (1.65%)

456 (1.11%)

695 (1.63%)

Blood/lymphatic

47 (1.38%)

53 (1.52%)

32 (0.51%)

37 (0.58%)

Gastrointestinal

1,060 (1.36%)

1,242 (1.50%)

934 (1.00%)

1,115 (1.10%)

Urology surgery

235 (1.63%)

239 (1.63%)

127 (1.05%)

122 (1.01%)

Male surgery

78 (0.11%)

93 (0.15%)

OBGYN surgery

171 (0.05%)

188 (0.07%)

Musculoskeletal

1,724 (1.66%)

2,114 (1.93%)

2,513 (2.07%)

2,983 (2.31%)

Breast and skin

56 (1.35%)

65 (1.52%)

49 (0.36%)

63 (0.51%)

Transplant and other surgical procedures

43 (5.39%)

57 (7.72%)

19 (4.41%)

28 (5.93%)

Total

5,467 (1.28%)

6,593 (1.54%)

5,123 (0.76%)

6,315 (0.98%)

**Table 2.** Selected Surgeries Associated With a High Incidence of Delirium (SID Database)
Type of surgery	Incidence of postoperative delirium
^aNumber of patients (< 10) is too small to be reported. Data presentation: number of delirium cases (delirium incidence (%) after individual surgical procedure). SID: State Inpatient Database.
Neurosurgery
Incision of cerebral meninges	418 (4.88%)	168 (4.13%)	586 (4.6%)
Excision or destruction of lesion or tissue of brain	299 (3.53%)	207 (2.67%)	506 (2.99%)
Excision of lesion or tissue of cerebral meninges	72 (4.73%)	104 (3.18%)	176 (3.52%)
Other incision of brain	78 (3.83%)	48 (3.82%)	126 (3.8%)
Other craniotomy	81 (3.17%)	22 (1.61%)	103 (2.54%)
Cardiac surgery
Open and other replacement of aortic valve with tissue graft	689 (6.47%)	360 (5.84%)	1,049 (6.23%)
(Aorto) coronary bypass of three coronary arteries	453 (4.05%)	130 (3.82%)	583 (3.99%)
(Aorto) coronary bypass of two coronary arteries	454 (3.89%)	163 (3.76%)	617 (3.85%)
Open and other replacement of aortic valve	276 (4.66%)	125 (3.80%)	401 (4.34%)
Open and other replacement of mitral valve with tissue graft	99 (6.95%)	80 (5.11%)	179 (5.98%)
(Aorto) coronary bypass of one coronary artery	198 (4.40%)	80 (3.75%)	278 (4.19%)
(Aorto) coronary bypass of four or more coronary arteries	266 (4.32%)	58 (4.02%)	324 (4.26%)
Implant of pulsation balloon	193 (3.41%)	62 (2.50%)	255 (3.13%)
Single internal mammary-coronary artery bypass	161 (3.69%)	48 (3.09%)	209 (3.53%)
Insertion of implantable heart assist system	49 (10.43%)	9 (7.56%)	58 (9.85%)
Vascular surgery
Resection of vessel with replacement, aorta, abdominal	209 (10.50%)	71 (9.78%)	280 (10.28%)
Resection of vessel with replacement, thoracic vessels	84 (7.40%)	41 (6.31%)	125 (6.98%)
Interruption of the vena cava	331 (2.64%)	269 (2.05%)	600 (2.34%)
Clipping of aneurysm	71 (7.24%)	122 (5.21%)	193 (5.73%)
Other (peripheral) vascular shunt or bypass	192 (2.33%)	135 (2.69%)	327 (2.46%)
Musculoskeletal
Partial hip replacement	953 (8.42%)	1,682 (6.26%)	2,636 (6.88%)
Open reduction of fracture with internal fixation, femur	860 (4.54%)	1,722 (4.82%)	2,585 (4.64%)
Closed reduction of fracture with internal fixation, femur	465 (5.73%)	746 (4.90%)	1,211 (5.07%)
Internal fixation of bone without fracture reduction, femur	135 (3.44%)	275 (4.00%)	410 (3.61%)
Dorsal and dorsolumbar fusion of the posterior column, posterior technique	156 (3.89%)	199 (3.87%)	355 (3.81%)
Other amputation below knee	295 (4.18%)	171 (5.08%)	467 (4.46%)
Amputation above knee	165 (5.14%)	121 (4.47%)	286 (4.82%)
Total knee replacement	1,192 (1.66%)	1,696 (1.45%)	2,900 (1.49%)
Urology surgery
Radical cystectomy	179 (6.28%)	32 (6.05%)	211 (6.23%)
Percutaneous nephrostomy without fragmentation	107 (2.06%)	107 (1.73%)	214 (1.87%)
Other transurethral excision or destruction of lesion or tissue of bladder	112 (1.39%)	38 (1.43%)	150 (1.38%)
Partial nephrectomy	39 (1.27%)	33 (1.49%)	72 (1.31%)
Gastrointestinal
Other partial resection of small intestine	404 (3.82%)	472 (3.86%)	877 (3.8%)
Open and other right hemicolectomy	405 (4.16%)	385 (3.39%)	790 (3.7%)
Open and other sigmoidectomy	324 (3.41%)	300 (3.05%)	624 (3.18%)
Other lysis of peritoneal adhesions	249 (3.09%)	289 (2.31%)	540 (2.59%)
Cholecystectomy	224 (2.40%)	142 (1.43%)	366 (1.87%)
Open and other left hemicolectomy	129 (3.71%)	129 (3.51%)	258 (3.58%)
Radical pancreaticoduodenectomy	112 (6.01%)	84 (5.14%)	196 (5.56%)
Partial gastrectomy with anastomosis to jejunum	92 (5.51%)	50 (3.16%)	142 (4.33%)
Other
Unilateral lung transplantation	18 (13.85%)	6 (5.61%)	24 (10.13%)
Bilateral lung transplantation	30 (11.28%)	16 (7.84%)	46 (9.79%)
Combined heart-lung transplantation	17.65%^a	18.18%^a	17.95%^a
Heart transplantation	35 (4.69%)	11 (3.93%)	46 (4.47%)
Other transplant of liver	124 (7.22%)	67 (6.71%)	191 (7.02%)

Table 2. Selected Surgeries Associated With a High Incidence of Delirium (SID Database)

Type of surgery

Incidence of postoperative delirium

Males

Females

Total

^aNumber of patients (< 10) is too small to be reported. Data presentation: number of delirium cases (delirium incidence (%) after individual surgical procedure). SID: State Inpatient Database.

Neurosurgery

Incision of cerebral meninges

418 (4.88%)

168 (4.13%)

586 (4.6%)

Excision or destruction of lesion or tissue of brain

299 (3.53%)

207 (2.67%)

506 (2.99%)

Excision of lesion or tissue of cerebral meninges

72 (4.73%)

104 (3.18%)

176 (3.52%)

Other incision of brain

78 (3.83%)

48 (3.82%)

126 (3.8%)

Other craniotomy

81 (3.17%)

22 (1.61%)

103 (2.54%)

Cardiac surgery

Open and other replacement of aortic valve with tissue graft

689 (6.47%)

360 (5.84%)

1,049 (6.23%)

(Aorto) coronary bypass of three coronary arteries

453 (4.05%)

130 (3.82%)

583 (3.99%)

(Aorto) coronary bypass of two coronary arteries

454 (3.89%)

163 (3.76%)

617 (3.85%)

Open and other replacement of aortic valve

276 (4.66%)

125 (3.80%)

401 (4.34%)

Open and other replacement of mitral valve with tissue graft

99 (6.95%)

80 (5.11%)

179 (5.98%)

(Aorto) coronary bypass of one coronary artery

198 (4.40%)

80 (3.75%)

278 (4.19%)

(Aorto) coronary bypass of four or more coronary arteries

266 (4.32%)

58 (4.02%)

324 (4.26%)

Implant of pulsation balloon

193 (3.41%)

62 (2.50%)

255 (3.13%)

Single internal mammary-coronary artery bypass

161 (3.69%)

48 (3.09%)

209 (3.53%)

Insertion of implantable heart assist system

49 (10.43%)

9 (7.56%)

58 (9.85%)

Vascular surgery

Resection of vessel with replacement, aorta, abdominal

209 (10.50%)

71 (9.78%)

280 (10.28%)

Resection of vessel with replacement, thoracic vessels

84 (7.40%)

41 (6.31%)

125 (6.98%)

Interruption of the vena cava

331 (2.64%)

269 (2.05%)

600 (2.34%)

Clipping of aneurysm

71 (7.24%)

122 (5.21%)

193 (5.73%)

Other (peripheral) vascular shunt or bypass

192 (2.33%)

135 (2.69%)

327 (2.46%)

Musculoskeletal

Partial hip replacement

953 (8.42%)

1,682 (6.26%)

2,636 (6.88%)

Open reduction of fracture with internal fixation, femur

860 (4.54%)

1,722 (4.82%)

2,585 (4.64%)

Closed reduction of fracture with internal fixation, femur

465 (5.73%)

746 (4.90%)

1,211 (5.07%)

Internal fixation of bone without fracture reduction, femur

135 (3.44%)

275 (4.00%)

410 (3.61%)

Dorsal and dorsolumbar fusion of the posterior column, posterior technique

156 (3.89%)

199 (3.87%)

355 (3.81%)

Other amputation below knee

295 (4.18%)

171 (5.08%)

467 (4.46%)

Amputation above knee

165 (5.14%)

121 (4.47%)

286 (4.82%)

Total knee replacement

1,192 (1.66%)

1,696 (1.45%)

2,900 (1.49%)

Urology surgery

Radical cystectomy

179 (6.28%)

32 (6.05%)

211 (6.23%)

Percutaneous nephrostomy without fragmentation

107 (2.06%)

107 (1.73%)

214 (1.87%)

Other transurethral excision or destruction of lesion or tissue of bladder

112 (1.39%)

38 (1.43%)

150 (1.38%)

Partial nephrectomy

39 (1.27%)

33 (1.49%)

72 (1.31%)

Gastrointestinal

Other partial resection of small intestine

404 (3.82%)

472 (3.86%)

877 (3.8%)

Open and other right hemicolectomy

405 (4.16%)

385 (3.39%)

790 (3.7%)

Open and other sigmoidectomy

324 (3.41%)

300 (3.05%)

624 (3.18%)

Other lysis of peritoneal adhesions

249 (3.09%)

289 (2.31%)

540 (2.59%)

Cholecystectomy

224 (2.40%)

142 (1.43%)

366 (1.87%)

Open and other left hemicolectomy

129 (3.71%)

129 (3.51%)

258 (3.58%)

Radical pancreaticoduodenectomy

112 (6.01%)

84 (5.14%)

196 (5.56%)

Partial gastrectomy with anastomosis to jejunum

92 (5.51%)

50 (3.16%)

142 (4.33%)

Other

Unilateral lung transplantation

18 (13.85%)

6 (5.61%)

24 (10.13%)

Bilateral lung transplantation

30 (11.28%)

16 (7.84%)

46 (9.79%)

Combined heart-lung transplantation

17.65%^a

18.18%^a

17.95%^a

Heart transplantation

35 (4.69%)

11 (3.93%)

46 (4.47%)

Other transplant of liver

124 (7.22%)

67 (6.71%)

191 (7.02%)