Study Objective: To determine whether patients with Parkinson disease are at an increased risk for postoperative confusion.
Design: Retrospective chart review of patients with Parkinson disease who remained in the hospital at least 48 hours after their surgery. Current data were compared with published historical controls.
Setting: Recent medical records of a university-affiliated hospital, Veterans Administration hospital, and community hospital.
Patients: Available charts of patients with Parkinson disease who had had surgery in the last 2 years. Patients were excluded if they were disoriented at admission or had serious metabolic disturbances.
Measurements and Main Results: Fifteen of twenty-five postoperative patients with Parkinson disease (60%; CI, 39% to 78%) suffered significant acute confusion, and 9 of these patients had documented hallucinations. Neuropsychiatric changes were frequently delayed after surgery. The acute confusional state lasted an average 2.5 days; several patients, however, were discharged before resolution. These disturbances did not appear to be related to type of antiparkinsonian medication or anesthetic.
Conclusion: In comparison with historical controls, the relative risk of patients with Parkinson disease having an acute postoperative confusional state is between 2. 8 and 8.1. These patients may need environmental supports during the postoperative period.