OBESITY AND POSTOPERATIVE DELIRIUM IN A MIDDLE-AGE SURGICAL PATIEN

Abstract

The literature for bladder cancer patients outlines the role of malnutrition as one of the key factors for postoperative outcomes, including postoperative delirium (POD). However, there is still a debated question whether obesity has a protective, or etiology role in the process of occurrence of POD. Here, we present a case of a 56-years-old man with obese class 1 admitted to City General Hospital “8th of September”, Skopje, Macedonia, for an elective major surgical procedure, radical cystectomy, presenting with postoperative delirium (POD). Anthropometric measurements (weight, high) and nutrition screening tools (body mass index, NRS-2002) verified his nutrition status. We additionally performed The Confusion Assessment Method and Mini-Mental Status Examination on admission and days 1, 2, 3, and 7 to evaluate signs of POD and his cognition level. Clinical presentation and radiographic imaging confirm the diagnosis of POD. We faced a few challenges writing this case report, including the impact of older age, selection of appropriate and available laboratory markers, examination of how body mass index affects POD, and identification of precipitated factors for POD.

We determined that hypoxia could be a key link that connects inflammation, nutrition status, and POD in our patient.