Zipser CM Deuel J Ernst J Schubert M von Känel R Böttger S 2019 BACKGROUND Delirium is the most common neuropsychiatric presentation during hospitalization. In neurosurgery, studies on predisposing and precipitating risk factors for the development of delirium are rare but required for the individual risk estimation. METHODS Prospective cohort study in a tertiary university center. In total, 949 neurosurgical patients, 307 with and 642 without delirium, were included. Demographic factors, neurosurgery-related, neurological, and medical clusters were tested as predictors of delirium in multiple logistic regression analyses. RESULTS The incidence of delirium in this cohort of neurosurgical patients was 32.4%. Compared to patients without delirium, those with delirium were significantly older, more cognitively and neurologically impaired, transferred from hospitals and nursing homes, admitted as emergencies, longer hospitalized (16.2 vs. 9.5 days; p < 0.001), in greater need of intensive care management, and more frequently transferred to rehabilitation. Predisposing factors of delirium were stroke (OR 5.45, CI 2.12-14.0, p < 0.001), cardiac insufficiency (OR 4.59, CI 1.09-19.26, p = 0.038), cerebral neoplasm (OR 1.53, CI 0.92-2.54, p = 0.019), and age ≥ 65 years (OR 1.47, CI 1.03-2.09, p = 0.030). Precipitating factors of delirium were acute cerebral injury (OR 3.91, CI 2.24-6.83, p < 0.001), hydrocephalus (OR 3.10, CI 1.98-4.87, p < 0.001), and intracranial hemorrhage (OR 1.90, CI 1.23-2.94, p = 0.004). CONCLUSIONS Delirium in acute neurosurgical patients was associated with longer hospitalization. Whereas common etiologies of delirium like infections and dementia, did not predict delirium, pre-existing neurovascular and traumatic diseases, as well as surgery-related events seem important risk factors contributing to delirium in neurosurgery. https://sonar.ch/global/documents/47682 eng info:eu-repo/semantics/altIdentifier/doi/10.1007/s00701-019-03927-z info:eu-repo/semantics/altIdentifier/pmid/31106393 Acta neurochirurgica. - 2019 Delirium Impact Interaction Neurosurgery Precipitating factors Predisposing factors Risk factors Age Factors Aged Aged, 80 and over Brain Neoplasms Delirium Female Hospitalization Humans Hydrocephalus Incidence Male Middle Aged Neurosurgical Procedures Precipitating Factors Prospective Studies Risk Factors Stroke The predisposing and precipitating risk factors for delirium in neurosurgery: a prospective cohort study of 949 patients. http://purl.org/coar/resource_type/c_6501