[Delirium in geriatric urology patients]

Area of Science:

• Geriatric Medicine
• Anesthesiology
• Critical Care Medicine

Background:

• Delirium is a frequent, often undiagnosed complication in geriatric patients post-operation, affecting 14-56% of those over 70.
• Antimuscarinic medications are known to contribute to cognitive disturbances.
• Postoperative delirium presents a significant challenge in hospital settings, particularly for the elderly population.

Purpose of the Study:

• To outline diagnostic criteria for identifying delirium in clinical practice.
• To describe non-pharmacologic treatment strategies for reducing postoperative delirium.
• To enhance clinician ability in detecting and managing this complication.

Main Methods:

• Focus on recognizing delirium symptoms, including fluctuating attention and awareness.
• Utilizing validated screening tools such as the Clinical Assessment Method (CAM) and Nurses Delirium Screening Scale (Nu-DESC).
• Considering organic causes and specific surgical risks like Transurethral Resection (TUR) of the prostate and bladder.

Main Results:

• Typical delirium symptoms include sudden, fluctuating decreases in attentiveness, awareness, and thinking.
• TUR procedures can elevate risks of bleeding, delirium, and TUR syndrome.
• CAM and Nu-DESC are effective instruments for assessing delirium signs in clinical settings.

Conclusions:

• Preoperative geriatric assessment can identify vulnerable elderly patients, aiding in complication reduction.
• Regular delirium screening pre-, post-, and perioperatively is crucial for minimizing complications.
• Early detection and management strategies are key to improving outcomes for elderly surgical patients.