Postoperative confusion in the elderly

Whitaker, JamesS.

doi:10.1002/gps.930040604

Cited by 9 publications

(6 citation statements)

References 23 publications

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“…Our previous studies 2–4 showed that old age, dementia, regular treatment with drugs having an anticholinergic effect, depression, and cerebrovascular disorders were the main risk factors for post‐operative confusion in elderly patients treated for femoral neck fractures. These ACS risk factors have also been reported after various types of surgery 20–22 …”

supporting

confidence: 54%

A Geriatric‐Anesthesiologic Program To Reduce Acute Confusional States in Elderly Patients Treated for Femoral Neck Fractures

Gustafson

Brännström

Berggren

et al. 1991

J American Geriatrics Society

225

134

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The aim of this study was to evaluate the effect of a geriatric-anesthesiologic intervention program for the prevention and treatment of acute confusional states (ACS) in elderly patients treated for femoral neck fractures. The intervention program was based on the results of previous prospective studies in similar patient populations. The outcome of the intervention, comprising 103 patients, was compared with that of an earlier study comprising 111 patients. The intervention program consisted of pre- and post-operative geriatric assessments, oxygen therapy, early surgery, prevention and treatment of peri-operative blood pressure falls and treatment of post-operative complications. The incidence of ACS was lower, 47.6%, in the intervention study compared with 61.3% (P less than 0.05) in the control study. Furthermore, the ACS that occurred in the intervention study was less severe and of shorter duration than that in the control study. The incidence of post-operative decubital ulcers, severe falls, and urinary retention was also lower. The mean duration of orthopedic ward stay was 17.4 days in the control study and 11.6 days in the intervention study (P less than 0.001). It can be concluded that the intervention program reduced the incidence, severity, and duration of ACS which resulted in a shortened orthopedic ward stay.

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supporting

confidence: 54%

A Geriatric‐Anesthesiologic Program To Reduce Acute Confusional States in Elderly Patients Treated for Femoral Neck Fractures

Gustafson

Brännström

Berggren

et al. 1991

J American Geriatrics Society

225

134

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“…Postoperative delirium may initially manifest as mild, acute confusion and worsen rapidly. Because delirium may delay patient recovery and negatively impact prognosis, the early detection or prevention of delirium is an important aspect of the postoperative nursing management of surgical patients 4 …”

Section: Introductionmentioning

confidence: 99%

An evaluation strategy for the early detection of postoperative delirium

Ohki¹,

Matsushima

Shibuya

et al. 2006

Psychiatry Clin Neurosci

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The aim of the present study was to identify clinical signs detective of the postoperative delirium at the early stage for nursing management. A total of 66 inpatients undergoing cardiac surgery were interviewed using the Delirium Rating Scale (DRS) and NEECHAM Confusion Scale (NCS) preoperatively and on days 1 and 3 postoperatively. The mean onset of delirium occurred on postoperative day 1.3. Development of delirium was detected early by cognitive impairments in the DRS subscales of perceptual disturbance, hallucination, and cognitive status, and the NCS subscales of attention, command, orientation, and verbal skill. These results suggest that assessment of cognitive status on postoperative day is an important strategy in the early detection of postoperative delirium.

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“…Surgery, or anaesthesia, has frequently been implicated in the cause of delirium; general surgery, cardiac surgery and cataract surgery have been particularly studied (Whitaker, 1989). In Millar's (1981) careful pre-and postoperative study of general surgical patients, delirium was positively associated with a number of factorsabnormal electrolytes and urea, cardiovascular problems, respiratory disease, wound infection, opiate analgesia, use of intravenous infusions and insertion of a urinary catheter.…”

Section: Cost Ejfectiveness Of Treatmentmentioning

confidence: 99%

Delirium in the elderly: A review and a suggestion for a research programme

Macdonald

Simpson

Jenkins

1989

Int J Geriat Psychiatry

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SUMMARYDelirium in the elderly attracts sporadic attention in the literature yet constitutes a major challenge to health services, complicating many illnesses and procedures in elderly patients, associated with high rates of mortality, cutting across disciplinary boundaries and posing theoretical difficulties for the organic/ functional distinction that pervades medicine. In this review the importance of delirium in the elderly is emphasized, drawing attention to the suffering caused to the patient and the excess mortality. Problems of nomenclature (why use one word when three will do?) are discussed, the conclusion being that the oldest term is probably the best, provided that the concept of a 'syndrome' is preserved. Difficulties in research assessment are identified, and aetiology and the relationship of the delirium syndrome to dementia syndromes are discussed. Deficiencies in past approaches to management are identified and a definition of delirium is suggested. Finally, a proposal for a research programme is outlined.

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Postoperative confusion in the elderly

Cited by 9 publications

References 23 publications

A Geriatric‐Anesthesiologic Program To Reduce Acute Confusional States in Elderly Patients Treated for Femoral Neck Fractures

A Geriatric‐Anesthesiologic Program To Reduce Acute Confusional States in Elderly Patients Treated for Femoral Neck Fractures

An evaluation strategy for the early detection of postoperative delirium

Delirium in the elderly: A review and a suggestion for a research programme

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