A Narrative Review Study On Post-Operative Delirium In Geriatric Patients, Causes, Diagnosis, Prevention, And Its Treatment

Abstract:

Background:

Delirium is characterized as an intense confusion state with a decrease in attention and comprehension. The reason isn’t known but almost certainly, many factors contribute to postoperative delirium such as hypotension, the patient having age greater than 65 years, chronic mental impairment or dementia, poor eyesight or Auditory perception, severer disease, Infectious diseases, cognitive impairment, poor visual or other sensory impairment, self-reported excess of alcohol use, and specific electrolytes variation from the normal range.

Objective:

To review recent findings and developments in post-operative delirium in geriatric patients causes diagnosis, prevention, and treatment. An estimated 80% of older people undergoing surgery develop postoperative delirium (POD) making them a high-risk group.

Methods and Material:

Studies were considered relevant if all three of the following criteria were met, they were primary data-collection studies the study population included elders, and the operations studied were elective or urgent cases. Articles that addressed sub-acute or chronic cognitive changes not associated with surgery were not considered relevant to this review. Brain surgery articles were excluded since the central nervous system complications of neurosurgery can produce confounding results. The Electronics data basis and sources used to conduct the literature search included PubMed, Google Scholar, Sci-Hub, and Web General.  words used for the literature search were postoperative delirium, postoperative delirium in older adults, postoperative delirium geriatrics society, Postoperative delirium in elderly, and Postoperative delirium in elderly patients.

Conclusion

The development of delirium is a poor prognostic indicator. Preventive methods have the possibility in many patients with efforts preoperatively and attention to detail postoperatively. Delirium is costly not only to the patients but also expensive to the hospitals. Despite encouraging recent findings, further studies in patients with various risk factors are expected to assess whether pharmacological therapy prophylaxis of postoperative delirium may be recommended. Apart from identifying and addressing causing components, delirium treatment may include nonpharmacological ways to deal with decreasing delirium seriousness, length, and related complications. Whereas administration of antipsychotics may represent a possibility for symptomatic management. Antipsychotics might only be used for short-term symptomatic treatment starting at the most reduced dose of it, as per the clinical response, and observing potential unfavorable impacts, for example, QT interval prolongation and extrapyramidal manifestations.