Postoperative delirium: A preventable complication in the elderly surgical patient

Monaldi Arch Chest Dis. 2017 Jul 18;87(2):842. doi: 10.4081/monaldi.2017.842.

Abstract

Postoperative delirium (POD) is an acute organic cerebral disturbance of consciousness and attention in combination with additional cognitive symptoms. It usually develops shortly after surgery and lasts for some hours up to some days. It worsens clinical outcomes, prolongs the hospital stay and leads to negative trajectories of cognitive, emotional and functional outcomes up to month if not years after surgery. There are several known predisposing and precipitating factors. Several of them are influenceable. Offering optimal and safe care for an elderly surgery patient requires a team based approach. Strategies for reducing POD incidence include early detection of risk factors, adaptation of surgical and anaesthesiologic techniques, avoiding certain drugs, optimisation of haemostasis, continuously monitoring of the patients' cognitive status as well as early mobilization and careful management of eventual early signs of POD. If POD is prevented, it's negative trajectories may be likewise anticipated.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition / physiology*
  • Delirium / diagnosis
  • Delirium / epidemiology
  • Delirium / prevention & control*
  • Early Ambulation / adverse effects
  • Early Ambulation / methods
  • Early Diagnosis
  • Humans
  • Incidence
  • Intraoperative Care / standards
  • Length of Stay
  • Postoperative Care / standards
  • Postoperative Complications / epidemiology
  • Postoperative Complications / psychology*
  • Preoperative Care / standards*
  • Risk Factors