Quality of recovery in elderly patients with postoperative delirium

Cristelo, Daniela; Ferreira, Mariana; Castro, João Sarmento e; Teles, Ana Rita; Campos, Marta G.; Abelha, Fernando

doi:10.4103/sja.sja_747_18

Cited by 6 publications

(8 citation statements)

References 18 publications

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“…159,174 POD further impacted on ICU length of stay (LoS) in cardiac surgery patients [175][176][177][178][179] (Fig. 10 the corresponding Funnel plots is Supplement Figure S13, http://links.lww.com/EJA/A851) and hospital LoS for both cardiac and noncardiac surgical patients 167,168,174,[180][181][182][183][184][185][186][187][188][189] (Figs. 11 and 12, the corresponding Funnel plots are Supplement Figure S14, http://links.…”

Section: Discussionmentioning

confidence: 99%

Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients

Aldecoa,

Bettelli,

Bilotta

et al. 2023

European Journal of Anaesthesiology

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Postoperative delirium (POD) remains a common, dangerous and resource-consuming adverse event but is often preventable. The whole peri-operative team can play a key role in its management. This update to the 2017 ESAIC Guideline on the prevention of POD is evidence-based and consensus-based and considers the literature between 01 April 2015, and 28 February 2022. The search terms of the broad literature search were identical to those used in the first version of the guideline published in 2017. POD was defined in accordance with the DSM-5 criteria. POD had to be measured with a validated POD screening tool, at least once per day for at least 3 days starting in the recovery room or postanaesthesia care unit on the day of surgery or, at latest, on postoperative day 1. Recent literature confirmed the pathogenic role of surgery-induced inflammation, and this concept reinforces the positive role of multicomponent strategies aimed to reduce the surgical stress response. Although some putative precipitating risk factors are not modifiable (length of surgery, surgical site), others (such as depth of anaesthesia, appropriate analgesia and haemodynamic stability) are under the control of the anaesthesiologists. Multicomponent preoperative, intra-operative and postoperative preventive measures showed potential to reduce the incidence and duration of POD, confirming the pivotal role of a comprehensive and team-based approach to improve patients’ clinical and functional status.

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Section: Discussionmentioning

confidence: 99%

Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients

Aldecoa,

Bettelli,

Bilotta

et al. 2023

European Journal of Anaesthesiology

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“…Length of stay (LOS) has been shown to be longer in the elderly who undergo surgery. There is a positive correlation with LOS and delirium in aged patient [65,66]. In a study highlighting the incidence of delirium in the elderly, it was found that patients with advanced age had a higher rate of post-operative delirium (POD) and postoperative cognitive dysfunction (POCD) [67,68].…”

Section: Post-operative Assessmentmentioning

confidence: 99%

Glioblastoma in Elderly Population

Santiago¹,

Borghei-Razavi²,

Mandel³

et al. 2023

Glioblastoma - Current Evidence

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Glioblastoma (GBM) is the third most common primary intracranial tumor and the commonest primary malignant brain tumor in adults. The peak incidence is between 65 and 84 years old. The incidence of GBM increases starkly with age—from 1.3/100,000 between the ages of 35–44 to 15.3/100,000 between the ages of 75–84 years. Elderly patients with GBM have increased comorbidities, lower functional status, aggressive tumor biology, and an overall worse outcome as compared with their younger counterparts. Age is an independent and powerful prognosticator of GBM outcomes, even if the performance status is controlled. Elderly patients with GBM represent a vulnerable heterogeneous cohort. Surgical resection in elderly patients offers a better outcome and improved quality of life as compared with biopsy alone and nowadays can be safely tolerated by elderly patients in specialized centers. The standard of care treatment of glioblastoma based on the Stupp’s protocol excluded patients over the age of 70. Thus, the standard of care treatment in elderly patients with GBM remains controversial. Selected elderly patients with excellent performance status may be treated with Stupp’s protocol. Elderly patients with lower functional status may be treated with a hypofractionated treatment regimen with concomitant and adjuvant temozolomide. Frail patients with MGMT methylated tumor can be treated with temozolomide monotherapy alone. It is also not unreasonable to treat elderly frail patients with MGMT unmethylated GBM with hypofractionated RT alone. Thus, treatment of elderly patients with GBM needs a multidisciplinary approach based on the extent of the tumor, MGMT methylation status, performance status, and even the social situation unique to the elderly patient. This chapter seeks to bring a comprehensive and updated review on the treatment of glioblastoma in the elderly population.

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“…Moreover, Cristelo et al . [ 10 ] observed in their study that elderly patients had inadequate early postoperative recovery due to a low Richmond Agitation and Sedation Scale (RASS) measured until 15 minutes postoperatively. In addition, elderly patients exhibit poorer psychomotor recovery postoperatively.…”

Section: The Trajectory Of Recovery From Anesthesia In the Elderlymentioning

confidence: 99%

The elderly in the post-anesthesia care unit

Alghamdi,

Almuzayyen,

Chowdhury

2023

Saudi J Anaesth

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It is increasingly conceivable that elderly patients will be treated in perioperative settings as the world’s population shifts toward an older age distribution. They are more prone to a variety of unfavorable outcomes as a consequence of the physiological changes that accompany aging and the coexistence of multiple medical conditions. Postoperative complications in elderly patients are linked to a large increase in morbidity and mortality and the burden placed on the healthcare system. Our goal is to determine how elderly patients’ recovery after anesthesia differs from that of younger patients. In addition, we will discuss the main postoperative complications experienced by elderly patients and the measures that are utilized to limit the risk of these complications developing.

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Quality of recovery in elderly patients with postoperative delirium

Cited by 6 publications

References 18 publications

Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients

Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients

Glioblastoma in Elderly Population

The elderly in the post-anesthesia care unit

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