Evidence map›Paper›PMID 41962161›Full record

Observational studyJournal of neurosurgery. Spine2026

Costs associated with delirium among older patients undergoing complex spine surgeries.

Odmara L Barreto Chang, Niti Pawar, Rebecca T Brown, Alekos A Theologis, Arati Patel, Praveen V Mummaneni, Bruce Miller, Mervyn Maze, Katherine L Possin

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of neurosurgery. Spine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Odmara L Barreto Chang1Department of Anesthesia and Perioperative Care, University of California, San Francisco.
Niti Pawar1Department of Anesthesia and Perioperative Care, University of California, San Francisco.
Rebecca T Brown3Division of Geriatric Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Alekos A Theologis5Department of Orthopaedic Surgery, University of California, San Francisco.
Arati Patel6Department of Neurological Surgery, University of California, San Francisco.
Praveen V Mummaneni6Department of Neurological Surgery, University of California, San Francisco.
Bruce Miller7Memory and Aging Center, Department of Neurology, University of California, San Francisco; and.
Mervyn Maze1Department of Anesthesia and Perioperative Care, University of California, San Francisco.
Katherine L Possin7Memory and Aging Center, Department of Neurology, University of California, San Francisco; and.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAs the number of older adults undergoing spine surgery grows, it is important to better understand the risks of this procedure, including associated costs. The authors recently reported that undergoing more complex spine surgeries is strongly associated with postoperative delirium (POD). The goal of this study was to examine the costs associated with POD among patients undergoing spine surgeries of varying complexity.

methodsData from a prospective observational cohort study of 256 adults aged ≥ 65 years who underwent spine surgery were analyzed. Preoperative, intraoperative, and postoperative variables were collected. The primary outcome of POD was defined as a positive score on any of three measures (Confusion Assessment Method for the Intensive Care Unit, Nursing Delirium Screening Scale, and chart review). The authors conducted univariable and multivariable analyses to examine factors associated with POD and estimated costs of POD stratified by tier of surgery.

resultsRisk factors associated with POD included age, lower education level, baseline cognitive impairment, American Society of Anesthesiologists class ≥ III, tier 4 surgery, high estimated blood loss, intensive care unit admission, postoperative complications, and hospital length of stay. In multivariable analyses, age, baseline cognitive impairment, postoperative complications, and length of hospitalization remained significantly associated with POD. The mean total costs were significantly higher in the group with delirium versus without delirium ($99,543 vs $67,892). Additionally, more patients who developed delirium required discharge to an acute rehabilitation facility (47.0% vs 21.5%, p < 0.001). In analyses stratified by tier of surgery, the greatest difference in mean costs between those with delirium versus without delirium was observed in tier 4 ($164,902 vs $116,579, p < 0.001).

conclusionsSpine surgeries with greater complexity are associated with an increased risk of POD, with higher costs and rates of intensive care unit admissions, more postoperative complications, and discharge to acute rehabilitation facilities. Delirium prevention interventions targeted to older adults at high risk for POD have the potential to optimize outcomes and decrease healthcare costs.

Indexed as

DeliriumPostoperative ComplicationsSpineAgedAged, 80 and overFemaleHealth Care CostsHumansLength of StayMaleProspective StudiesRisk Factorscervicalhealthcare costlumbarolder adultsPODpostoperative deliriumpostoperative outcomesspine surgerythoracic

Identifiers

PMID41962161
PMCPMC13244318

What OpenQuestion holds

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Registered trials

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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.