Delirium in Geriatric Patients Undergoing Emergency General Surgery: A Call to Action

We would like to thank the editor for the opportunity to reply to the comments raised in the letter to the editor. Despite all unified efforts to streamline multidisciplinary care, delirium remains a prevalent postoperative complication in the older adult surgical population. Our understanding of the natural history of this complication continues to evolve. Frailty and delirium may be manifestations of a shared vulnerability to illness and reduced physiologic reserve in older adults. 1 Saljuqi A.T. Hanna K. Asmar S. et al. Prospective evaluation of delirium in geriatric patients undergoing emergency general surgery. J Am Coll Surg. 2020 Feb 21; ([Epub ahead of print]) Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar It is evident that the occurrence of delirium is dependent on a complex interaction between predisposing patient-related factors and precipitating factors during the patient's in-hospital stay. 2 Zenilman M.E. Delirium: an important postoperative complication. JAMA. 2017; 317: 77-78 Crossref PubMed Google Scholar ,3 Quinlan N. Marcantonio E.R. Inouye S.K. et al. Vulnerability: the crossroads of frailty and delirium. J Am Geriatr Soc. 2011; 59: S262-S268 Crossref PubMed Scopus (93) Google Scholar Multiple reports identify various reversible risk factors that can be addressed on the patient level and on a system-wide level. Postoperative Delirium in Geriatric Patients after Emergency General SurgeryJournal of the American College of SurgeonsVol. 231Issue 1PreviewPostoperative delirium (POD) is associated with severe obstacles related to increased lengths of hospital stay, costs, morbidity, and mortality in elderly patients.1 The most important management of POD is based primarily on prevention and early recognition.2 Therefore, a more complete understanding of potential risk factors for POD in elderly patients undergoing surgery is needed. However, there has been little research aimed at finding the risk factors for POD. I have carefully read the article published in the Journal of the American College of Surgeons by Saljuqi and colleagues,3 and his findings and conclusions are indeed interesting.