J Anesth Perioper Med. 2017;4(4):179-185. https://doi.org/10.24015/ebcmed.japm.2017.0052

Post-Operative Delirium in the Elderly: Diagnosis, Risk Factors and Prevention

Zhen Liu1 and Jing Zhao1,2

From the 1Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China; 2Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China.

Correspondence to Dr. Jing Zhao at Zhaojing1009@aliyun.com.

EBCMED ID: ebcmed.japm.2017.0052 DOI: 10.24015/ebcmed.japm.2017.0052


Aim of review
Delirium is a common postoperative complication after major surgery especially in elderly patients. Postoperative delirium (POD) is related to increased perioperative morbidity and mortality. Avoiding risk factors and performing early interventions can decrease the incidence of POD. Aim of this article is to review progresses in diagnosis, risk factors and prevention of POD in old patients.

We review recent studies on delirium in the past 2 decades. We focus on the diagnosis, risk factors and prevention of POD.

Recent findings
Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) are reliable methods for the diagnosis of delirium in critically ill patients. Risk factors for POD can be divided into pre-operative risk factors, operation-related risk factors and anesthesia related risk factors. Old age, preoperative cognitive impairment and current smoking have been proven to be independent risk factors of POD. Multiple non-pharmacological interventions are recommended in highrisk patients of POD. Dexmedetomidine, melatonin, antipsychotics and statins can be used as pharmacological prevention or treatment interventions in POD.

Avoiding risk factors and early interventions can reduce the incidence of POD. Finding early indicators of POD will help to perform early interventions and reduce medical expenses. (Funded by Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China.)

Article Type
Original Article

Declaration of Interests
The authors declare no conflicts of interest.

This work was supported by the Department of Anesthesiology, Peking Union Medical College Hospital, Beijing, China.

This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.