Occurrence of Postoperative Delirium and the Use of Different Assessment Tools.
Andrea KirfelDiane JossenJan MenzenbachAndreas MayrWittmann MariaPublished in: Geriatrics (Basel, Switzerland) (2023)
(1) Background: Postoperative delirium (POD) poses a high risk of worsening outcomes for patients and is also a burden for hospitals. The leading guidelines recommend standardized POD assessment and prevention. The aim of this subgroup analysis of the PRe-Operative Prediction of Postoperative DElirium by Appropriate SCreening (PROPDESC) trial was to compare different delirium assessments and to analyse the frequency of POD on five postoperative days. (2) Methods: This prospective observational trial enrolled 1097 patients in a university hospital from 2018 until 2019. The following POD assessment tools were used for five consecutive days: Confusion Assessment Method for ICU (CAM-ICU) or Confusion Assessment Method for normal ward (CAM), 4 A's Test (4AT) and Delirium Observation Screening (DOS) scale. (3) Results: In a 5-day visit interval, most new POD developments occurred on the first and second postoperative day. A clear recommendation for a specific POD assessment tool based on our results cannot be given. (4) Conclusions: According to guidelines, a POD assessment should take place on the first five postoperative days, but of these, the first two are those of highest POD occurrence. The POD assessment tool used should at best include direct patient questioning and aspects of patient observation.
Keyphrases
- patients undergoing
- end stage renal disease
- cardiac surgery
- ejection fraction
- newly diagnosed
- clinical trial
- intensive care unit
- chronic kidney disease
- healthcare
- study protocol
- hip fracture
- randomized controlled trial
- peritoneal dialysis
- case report
- phase ii
- metabolic syndrome
- acute kidney injury
- adipose tissue
- extracorporeal membrane oxygenation
- phase iii
- open label
- clinical practice
- mechanical ventilation
- skeletal muscle
- patient reported
- acute respiratory distress syndrome