A reliable pre-surgical risk assessment is urgently needed to improve preventive measures, consequent surgical outcomes and thus patients’ quality of life.
POCD & PODMore than 30% of patients aged over 60 suffer from cognitive impairment due to surgical complications [1].
Disorientation, memory loss, difficulty in speech, and behavioral changes are among the symptoms experienced by patients affected by Post-Operative Delirium (POD) and Post-Operative Cognitive Decline/Dysfunction (POCD). These cognitive disorders result in a longer post-surgical recovery time, with increased hospital stays and associated costs [2]. In addition, the most severe forms of perioperative cognitive disorders can lead to the admission in nursing homes due to significant functional and cognitive decline. Today, there is no effective POD and POCD treatment currently available. It is therefore crucial to prevent the onset of these disorders. |
PIPRA'S SURVEY
Out of 108 anesthesiologists: - 80% believe that POCD is a problem - 70% claimed the utility of a patient risk score for POCD - 80% thinks patients should be informed about their risk of POCD |
PREVENTION IS KEY
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As of today, no precise tool for patient screening and risk determination is yet available in the current clinical practice.
Preventive strategies could help reduce POD incidence and thus improve patient’s quality of life. For instance, finding the high-risk patients preoperatively would allow for the adoption of tailored and protective perioperative measures.
In parallel, it would also be crucial to properly inform patients about their risk of suffering from cognitive impairment after undergoing any surgery, under general anesthesia. |
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The impact of post-operative delirium on patients is enourmous.
Dr. med. Rebecca von Haken from the University Hospital Mannheim and member of the Delir Network, Heidelberg has much experience with patients who end up with POD. What impact has a post-operative delirium in older people? And what are she and her team doing to help patients with a high risk of post-operative delirium? |
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[1] Inouye, S.K. et al. Postoperative Delirium in Older Adults : Best Practice Statement from the American Geriatrics Society. 2015. JACS, 220. 2: 16-148.
[2] Inouye, S.K. Delirium in Older Persons. 2006. N Engl J Med. 354:1157-1165
[2] Inouye, S.K. Delirium in Older Persons. 2006. N Engl J Med. 354:1157-1165