PURPOSE: To determine if there is an association between perioperative 
administration of beta-blockers and postoperative delirium in patients 
undergoing vascular surgery.
METHODS: After Institutional Review Board approval, data were retrospectively 
collected on patients who underwent vascular surgery in an academic hospital 
during the period January 2006 to January 2007. Patients with preoperative 
altered level of consciousness, carotid endarterectomy, or discharge within 24 h 
of surgery were excluded from the study. Identification of delirium was based on 
evaluation of the level of consciousness with the NEECHAM Confusion Scale and/or 
a chart-based instrument for delirium. Multivariable logistic regression 
analysis was used to identify independent perioperative predictors of 
postoperative delirium. Beta-blockers were tested for a potential effect.
RESULTS: The incidence of postoperative delirium was 128/582 (22%). Independent 
predictors included age (OR 1.04, 95% CI [1.02-1.07]), history of 
cerebrovascular accident/transient ischemic attack (OR 2.64, 95% CI 
[1.57-4.55]), and depression (OR 3.56, 95% CI [1.53-8.28]). Open aortic 
reconstruction was associated with an OR of 5.34, 95% CI (2.54-11.2) and 
amputation with an OR of 4.66, 95% CI (1.96-11.09). Preoperative beta-blocker 
administration increased the odds of postoperative delirium 2.06 times (95% CI 
[1.18-3.6]). Statin administration reduced the odds of delirium by 44% (95% CI 
[0.37-0.88]). The model was reliable (Hosmer-Lemeshow test, P = 0.72) and 
discriminative (area under the receiver operating characteristic [ROC] curve = 
0.729).
CONCLUSIONS: Preoperative administration of beta-blockers is associated with an 
increased risk of postoperative delirium after vascular surgery. Conversely, 
preoperative statin administration is associated with a lower risk of 
postoperative delirium. A randomized prospective controlled trial is required to 
validate these findings.