scholarly journals Rivastigmine patch (Exelon patch) compared to melatonin patch in prevention of postoperative delirium in the elderly

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Rania Maher Hussien ◽  
Aktham Adel Shoukry
Keyword(s):  
Postoperative Delirium ◽  
The Elderly ◽  
Rivastigmine Patch

scholarly journals Modifications in anesthesia for geriatric patients

2016 ◽  
Vol 84 (2) ◽  
pp. 10-11
Author(s):  
Brandon Chau ◽  
Alexander Levit
Keyword(s):  
Daily Living ◽  
Patient Monitoring ◽  
Postoperative Delirium ◽  
Geriatric Patients ◽  
Postoperative Morbidity ◽  
Perioperative Period ◽  
The Elderly ◽  
Organ Function ◽  
Age Related ◽  
Geriatric Anesthesia

The volume of geriatric surgery is expected to increase dramatically by 2020, requiring a more widespread appreciation of the unique risks and challenges of anesthesia in the elderly. Changes in pharmacokinetics along with age-related changes in organ function have important implications for patient monitoring and dosing of anesthetic, analgesic, and sedative medications. Preoperative screening for risk of postoperative morbidity is improved with an assessment of activities of daily living, and regional anesthesia may be considered to reduce the risk of postoperative delirium, although this remains controversial. Specific homeostatic parameters should be closely monitored in the perioperative period. The approach to anesthesia in geriatric patients should not be merely extrapolated from younger patients, and further evidence specific to geriatric anesthesia will improve surgical outcomes.

scholarly journals Postoperative delirium: A preventable complication in the elderly surgical patient

2017 ◽  
Vol 87 (2) ◽  
Author(s):  
Gabriella Bettelli ◽  
Bruno Neuner
Keyword(s):  
Functional Outcomes ◽  
Postoperative Delirium ◽  
Early Mobilization ◽  
The Elderly ◽  
Cognitive Status ◽  
Surgical Patient ◽  
Surgery Patient ◽  
Disturbance Of Consciousness ◽  
Preventable Complication ◽  
Careful Management

<p>Postoperative delirium (POD) is an acute organic cerebral disturbance of consciousness and attention in combination with additional cognitive symptoms. It usually develops shortly after surgery and lasts for some hours up to some days. It worsens clinical outcomes, prolongs the hospital stay and leads to negative trajectories of cognitive, emotional and functional outcomes up to month if not years after surgery. There are several known predisposing and precipitating factors. Several of them are influenceable. Offering optimal and safe care for an elderly surgery patient requires a team based approach. Strategies for reducing POD incidence include early detection of risk factors, adaptation of surgical and anaesthesiologic techniques, avoiding certain drugs, optimisation of haemostasis, continuously monitoring of the patients’ cognitive status as well as early mobilization and careful management of eventual early signs of POD. If POD is prevented, it’s negative trajectories may be likewise anticipated. </p>

scholarly journals Incidence and risk factors of postoperative delirium in the elderly patients with hip fracture

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Chen-guang Wang ◽  
Ya-fei Qin ◽  
Xin Wan ◽  
Li-cheng Song ◽  
Zhi-jun Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
The Elderly

scholarly journals Elevated Procalcitonin as a Risk Factor for Postoperative Delirium in the Elderly after Cardiac Surgery—A Prospective Observational Study

2020 ◽  
Vol 9 (12) ◽  
pp. 3837
Author(s):  
Anna Kupiec ◽  
Barbara Adamik ◽  
Natalia Kozera ◽  
Waldemar Gozdzik
Keyword(s):  
Cardiac Surgery ◽  
Depressive Symptoms ◽  
Elderly Patients ◽  
Odds Ratio ◽  
Postoperative Delirium ◽  
Prospective Observational Study ◽  
Reference Range ◽  
The Elderly ◽  
Daily Functioning ◽  
Multivariable Logistic Regression Model

One of the most common complications after cardiac surgery with cardiopulmonary bypass (CBP) is delirium. The purpose of this study was to prospectively investigate the risk of developing postoperative delirium in a group of elderly patients using a multivariate assessment of preoperative and intraoperative risk factors. A total of 149 elderly patients were included. Thirty patients (20%) developed post-operative delirium. Preoperative procalcitonin (PCT) above the reference range (>0.05 ng/mL) was recorded more often in patients who postoperatively developed delirium than in the non-delirium group (50% vs. 27%, p = 0.019). After surgery, PCT was significantly higher in the delirium than the non-delirium group: ICU admission after surgery: 0.08 ng/mL vs. 0.05 ng/mL p = 0.011), and for consecutive days (day 1: 0.59 ng/mL vs. 0.25 ng/mL, p = 0.003; day 2: 1.21 ng/mL vs. 0.36 ng/mL, p = 0.006; day 3: 0.76 ng/mL vs. 0.34 ng/mL, p = 0.001). Patients with delirium were older (74 vs. 69 years, p = 0.038), more often had impaired daily functioning (47% vs. 28%, p = 0.041), depressive symptoms (40% vs. 17%, p = 0.005), and anemia (43% vs. 19%, p = 0.006). In a multivariable logistic regression model, preoperative procalcitonin (odds ratio (OR) = 3.05), depressive symptoms (OR = 5.02), age (OR = 1.14), impaired daily functioning (OR = 0.76) along with CPB time (OR = 1.04) were significant predictors of postoperative delirium.

scholarly journals Postoperative Course After Emergency Colorectal Surgery for Secondary Peritonitis in the Elderly Is Often Complicated by Delirium

2012 ◽  
Vol 97 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Stephan Engelberger ◽  
Manuel Zürcher ◽  
Jochen Schuld ◽  
Carsten Thomas Viehl ◽  
Christoph Kettelhack
Keyword(s):  
Postoperative Delirium ◽  
Statistical Significance ◽  
The Elderly ◽  
Morbidity And Mortality ◽  
University Hospital ◽  
Colorectal Origin ◽  
American Society ◽  
Emergency Colorectal Surgery ◽  
American Society Of Anesthesiologists ◽  
The University

Abstract Postoperative delirium, morbidity, and mortality in our elderly patients with secondary perionitis of colorectal origin is described. This is a chart-based retrospective analysis of 63 patients who were operated on at the University Hospital Basel from April 2001 to May 2004. Postoperative delirium occurred in 33%. Overall morbidity was 71.4%. Surgery-related morbidity was 43.4%. Mortality was 14.4%. There was no statistical significance between delirium, morbidity and mortality (P  =  0.279 and P  =  0.364). There was no statistically significant correlation between the analyzed scores (American Society of Anesthesiologists classification, Mannheimer Peritonitis Index, Acute Physiology and Chronic Health Evaluation score II, physiological and operative surgical severity and enumeration of morbidity and mortality score‚ or short ‚cr-POSSUM’) and postoperative delirium, morbidity or mortality. Postoperative delirium occurred in one-third of the patients, who seem to have a trend to higher morbidity. Even if the different scores already had proven to be predictive in terms of morbidity and mortality, they do not help the risk stratification of postoperative delirium, morbidity, or mortality in our collective population.

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