Impaired peripheral perfusion during anesthesia is associated with postoperative delirium in older patients undergoing minimally invasive colorectal surgery: a retrospective observational study

The study investigated the relationship between peripheral perfusion during anesthesia and postoperative delirium in patients aged over 65 years undergoing laparoscopic or robot-assisted colorectal surgery. Ninety-eight patients were included, of whom 11 developed postoperative delirium. Patients with delirium had a lower mean perfusion index during anesthesia (1.5 versus 2.3; P = 0.0069). The perfusion index demonstrated moderate predictive value for postoperative delirium with an optimal cut-off value of 1.83, achieving 82% sensitivity and 70% specificity. Lower intraoperative mean perfusion index remained significantly associated with postoperative delirium even after adjusting for serum albumin and hemoglobin concentrations. The results suggest that perfusion index could complement standard monitoring for assessing postoperative delirium risk.