Key result
Preventive strategies for early postoperative cognitive decline lack definitive evidence in emergency settings.
Why the study?
Preoperative cognitive evaluation and proactive interventions are largely impossible in emergency surgery, leaving unclear what preventive strategies for delirium and early postoperative cognitive decline can be implemented in day-to-day practice.
What are the appropriate preventive strategies for early postoperative cognitive decline that can be implemented in day-to-day practice for surgical patients in the emergency setting?
What are the appropriate preventive strategies for early postoperative cognitive decline that can be implemented in day-to-day practice for surgical patients in the emergency setting?
This review highlights recent experimental and clinical strategies to prevent early postoperative cognitive decline in emergency surgical patients.
Answers are grounded in this paper and cite their sources.
Evidence scarcity warrants caution in emergency perioperative care; leaves open rigorous RCTs of multicomponent strategies.
Postoperative neurocognitive impairments following surgery are a growing concern, especially in the elderly population, since it is associated with a significantly increased risk of morbi-mortality in the postoperative period. Among them, delirium or the early postoperative cognitive decline is associated with a further risk of prolonged cognitive dysfunction and it may quicken long-term cognitive impairment or postoperative cognitive dysfunction (POCD). The current knowledge regarding preventive strategies for delirium is not focused anymore only on pharmacological and behavioral management strategies in the postoperative period, but also supports the preoperative cognitive training programs. Since preoperative cognitive evaluation and proactive interventions to optimize surgical patient outcomes are rather impossible in the emergency setting, what are the appropriate preventive strategies that can be implemented in day-to-day practice? In this review, we try to highlight the most recent experimental and clinical strategies, and outline the most relevant recommendations for clinicial practicioners based on the available data.
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Cotae et al. (2024) conducted a review in Early postoperative cognitive decline and delirium. Preventive strategies (pharmacological and non-pharmacological) was evaluated. Current evidence for definitive preventive strategies for early postoperative cognitive decline in emergency settings is scarce, though multicomponent interventions and judicious medication use are advised.
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