Background Factors of Postoperative Psychiatric Disorder

Postoperative psychiatric disorder (PPD) is a common problem in general surgery. We reviewed the clinical records of 1057 patients who underwent our operation under general anesthesia, and examined the background factors of PPD. One hundred and forty-five (13.7% of all) patients presented some symptoms of PPD, such as delirium. Their onset was about 2.7 days on an average, postoperatively. PPD occurred more frequently in older patients, men, and those with a longer operation time, longer ICU stay, shorter Ccr time, higher ICG level, longer preoperative fasting period, those who had a past history of brain disease, and those who were not informed definitively about their malignancy. However, no significant difference in the incidence rate between emergency and no-emergency cases. PPD was more common in patients who did not informed about their malignancy. The informed consent may decrease the occurrence of PPD. We have to consider some total management for PPD. For example, we give some information to a patient and his family about PPD during a preoperative hospitalization, and cope with his or her disease together. The problem of PPD will be more important in the near future, because the number of elderly patients will increase.