This post hoc analysis of a randomized trial included 195 cardiac-surgery patients aged 65 years or older at one Swedish tertiary hospital. Postoperative delirium occurred in 36% (70/195), with postoperative assessments on days 1 and 3. Relative plasma hyperosmolality on postoperative day 3 was identified as a potentially independent correlate of delirium in multivariable analysis. More than two concurrent perioperative factors were reported to be associated with an eightfold greater likelihood of delirium, although the abstract provided neither confidence intervals nor a numerical effect estimate for hyperosmolality.
These exploratory findings link postoperative hyperosmolality and accumulated perioperative factors with delirium after cardiac surgery. They do not establish causality or demonstrate that modifying osmolality prevents delirium.
Study limitation: Single-centre post hoc associations, without reported confidence intervals or clear temporal ordering, limit causal interpretation and precision.
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