Evidence map›Paper›PMID 40844240›Full record

ArticleEuropean journal of anaesthesiology2025

Patient-reported outcomes as drivers of postoperative delirium in the postanaesthesia care unit: Data from a one-year prospective cohort study.

Joana Berger-Estilita, Isabel Marcolino, Mia Gisselbaek, Christian Seidl, Thomas W Buehrer, Ines Fortuna, Basak C Meco, Finn M Radtke, Sarah Saxena

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In one paragraph

Article in European journal of anaesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Joana Berger-EstilitaFrom the Department of Anaesthesiology and Intensive Care, Salem-Spital, Hirslanden Hospital Group, Bern, Switzerland (JB-A, CS, TWB), Institute for Medical Education, University of Bern, Bern, Switzerland (JB-E), RISE-Health, Centre for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal (JB-E), Institute of Anaesthesiology and Intensive Care, Spital Limmattal, Schlieren, Switzerland (IM), Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland (MG), Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland (MG), Faculdade de Medicina, Universidade do Porto, Porto, Portugal (IF), Department of Anaesthesia and Intensive Care, Ankara University Faculty of Medicine, Ankara, Turkey (BCM), Ankara University Brain Research Center (BAUM), Ankara, Turkey (BCM), Department of Anaesthesia and Intensive Care, Hospital of Nykøbing Falster, University of Southern Denmark, Odense, Denmark (FMR), Department of Anesthesiology, Helora, Mons, Belgium (SS), Department of Surgery, UMons, Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium (SS).ORCID 0000-0002-8695-4264
Isabel Marcolino
Mia Gisselbaek
Christian Seidl
Thomas W Buehrer
Ines Fortuna
Basak C Meco
Finn M Radtke
Sarah Saxena

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundValue-based healthcare emphasises patient-centred outcomes. However, Patient-Reported Outcomes Measures (PROMs) and Patient-Reported Experience Measures (PREMs) remain underused in peri-operative care. Postoperative delirium (POD) is a common and serious complication associated with increased morbidity and healthcare costs. Understanding the prognostic value of PROMs and PREMs may support identification and prevention of POD in the postoperative anaesthesia care unit (PACU).

objectivesWe assessed the association between peri-operative patient-reported symptoms and PACU POD using systematically collected PROMs and PREMs (including pain, anxiety, thirst, stress, and satisfaction), following the implementation of a brain protection care bundle.

designProspective cohort study.

settingA single-centre study in a secondary-care private hospital in Switzerland from January 2023 to January 2024. PATIENTS: 1419 adults undergoing elective or urgent surgery. Exclusion criteria included age <18 years, inability to provide consent, language barriers, need for postoperative mechanical ventilation, or pre-operative Nursing Delirium Screening Scale (Nu-DESC > or equal to 2).

interventionsImplementation of the Safe Brain Initiative (SBI) care bundle, incorporating 18 multidisciplinary, nonpharmacologic strategies to optimise peri-operative brain health.

main outcome measuresThe primary outcome was PACU POD incidence, assessed using the Nu-DESC at emergence and PACU discharge. Secondary outcomes included associations between PACU POD and pre-operative PROMs (pain, anxiety, stress, nausea) and PREMs (satisfaction, well being).

resultsPACU POD occurred in 19.6% of patients. Pre-operative anxiety (NRS > 7) was an independent predictor of POD ( P  = 0.012). Pre-operative PROMs showed increasing trends, while postoperative symptoms (pain, anxiety, nausea) significantly decreased. Patients with POD reported lower well being scores despite high satisfaction in other PREM domains.

conclusionsPre-operative anxiety and stress strongly predict PACU POD, supporting early risk stratification and targeted interventions. Integrating PROMs and PREMs into peri-operative workflows enhances patient-centred care.

Indexed as

DeliriumEmergence DeliriumPatient Reported Outcome MeasuresPostoperative ComplicationsAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesSwitzerland

Identifiers

PMID40844240
PMCPMC12517719

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.