Eidininkienė Mantė1, Stankevičiūtė Radvilė1, Kazlauskaitė Karolina2, Eidininkas Mantas1, Gudaitytė Jūratė3
1 Lithuanian University of Health Sciences, Faculty of Medicine
2 Medical Center of the Ministry of the Interior of the Republic of Lithuania
3 Lithuanian University of Health Sciences, Medical Academy, Department of Anesthesiology
Background: Postoperative delirium (POD) is one of the most common complications of major surgery that can occur in patients of any age, yet it remains largely underdiagnosed and undertreated, increasing the length of the hospital stay and the risk of death.
Aim: To review the latest studies on POD and provide summarized information regarding its diagnostics, prevention, and treatment in current practice.
Methodology: The search was conducted in “MEDLINE” (“Pubmed”) and “ScienceDirect” databases using predetermined keywords: postoperative delirium, prophylaxis, incidence, prevalence, prevention, management, treatment, precipitating factors, predisposing factors, risk factors, diagnostic tools. 28 articles published since 2007 were included in this literature review.
Results: Many risk factors of POD are non-modifiable, thus early detection is key to improving patient outcomes. Confusion Assessment Method and its adaptations are the best bedside modalities for both screening and diagnosis. There are pharmacological and non-pharmacological prophylactic interventions, however, antipsychotic prophylaxis can significantly reduce not only POD risk, but also its intensity and duration. Additionally, some biomarkers and instruments are emerging as potential tools for detecting and monitoring POD. The treatment of POD is most associated with the use of antipsychotics as well.
Conclusion: There is still a lot to be desired when it comes to evidence-based therapeutic interventions for postoperative delirium, therefore further research is needed to make reliable use of them in everyday practice and standardize care.
Keywords: postoperative delirium, postoperative complication, prediction care.