Key result
Risk factors for post-operative delirium, which affects up to 47% of surgical patients, include age, cognitive impairment, frailty, and the rapidity and severity of the surgical insult.
Identifying risk factors for post-operative delirium, such as frailty and cognitive impairment, can help target specialist geriatrician input to high-risk patients.
May guide targeted geriatric input for high-risk surgical patients; leaves open prospective trials to confirm benefit.
The number of people over 65 is increasing and those over 65 requiring surgery will likewise increase. Post-operative delirium (POD) affects up to 47% of patients undergoing surgery and is more prevalent in older people. Importantly, POD is associated with increased morbidity, mortality, length of stay and care home placement. There is evidence that specialist geriatrician input reduces POD but to be cost effective, needs to target patients with increased risk for POD. Many factors have been associated with increased risk of POD, including age, cognitive impairment, gender, depression, alcohol, drug use, smoking, co-morbidity, functional status, ASA score and pre-operative biochemical and haematological abnormalities. This article reviews the literature associated with the above factors, considers frailty as a factor and also suggests that POD may be associated with rapidity of onset and severity of the insult to the patient.
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Dean J. Noimark (2009) conducted a review in Post-operative delirium. Risk factors (age, cognitive impairment, frailty, etc.) was evaluated on Onset of post-operative delirium. Risk factors for post-operative delirium, which affects up to 47% of surgical patients, include age, cognitive impairment, frailty, and the rapidity and severity of the surgical insult.
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