• Paim Strapasson Atahualpa Cauê AC Department of Neurosurgery, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Ápio Cláudio Martins Antunes, Petry Oppitz Paulo P Department of Neurosurgery, HCPA, Porto Alegre, Brazil., Marcos Dalsin, and de Mello Rieder Carlos Roberto CR Department of Neurology, HCPA, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil..
• Department of Neurosurgery, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. Electronic address: drstrapasson@gmail.com.
• World Neurosurg. 2019 May 1; 125: e966-e971.

BackgroundDeep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established treatment for patients with Parkinson disease. One adverse event is the development of postoperative confusion. The aim of this study was to report the incidence and associated factors of postoperative confusion after STN DBS surgery.MethodsThis was a retrospective cohort study by chart review of patients with Parkinson disease who underwent STN DBS in a Brazilian public academic hospital from January 2013 to October 2017. The primary outcome was the incidence of postoperative confusion. The association of the outcome and imaging and clinical variables was evaluated.ResultsAmong 49 patients who underwent STN DBS for Parkinson disease, the incidence of postoperative confusion was 26.5% (95% confidence interval 15%-41.1%). Univariate analysis identified the following variables associated with development of confusion: age (63.2 ± 7.8 years vs. 55.4 ± 9.1 years, P = 0.009), disease duration (16.5 ± 5.1 years vs. 13.2 ± 4.2 years, P = 0.027), Charlson comorbidity index (2 [interquartile range 1-3] vs. 1 [0-1 interquartile range], P = 0.002), width of the third ventricle (5.4 ± 2.1 mm vs. 4 ± 1.6 mm, P = 0.018), and cella media index (5 ± 1 vs. 5.6 ± 0.8, P = 0.018). After adjustment, Charlson comorbidity index remained significant (adjusted relative risk 1.64, 95% confidence interval 1.17-2.3, P = 0.004).ConclusionsThe incidence of postoperative confusion in this cohort was 26.5%. After analysis of confounding factors, the Charlson comorbidity index was significantly associated with postoperative confusion.Copyright © 2019 Elsevier Inc. All rights reserved.

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