Recent advances in predicting, preventing, and managing postoperative delirium.

Area of Science:

• Anesthesiology
• Geriatrics
• Critical Care Medicine

Background:

• Postoperative delirium (POD) is a common complication with significant negative patient outcomes.
• Incidence varies widely (5-65%), particularly high in hip and cardiac surgeries.
• POD is linked to increased hospital stay, functional decline, and mortality.

Purpose of the Study:

• To review current understanding of POD predictors, pathophysiology, prevention, and management.
• To highlight areas for future research in POD.

Main Methods:

• Narrative review of existing literature on POD.
• Discussion of predisposing and precipitating factors.
• Evaluation of screening tools and prevention protocols.

Main Results:

• Screening for cognitive impairment and frailty is crucial.
• Prevention strategies include the Hospital Elder Life Program, prehabilitation, and intraoperative monitoring.
• Pharmacologic and non-pharmacologic interventions show potential but require more research.

Conclusions:

• POD management requires a multi-faceted approach.
• Further research is needed to confirm the efficacy of various interventions.
• Anesthesiologists play a key role in mitigating POD risk.