Anika Müller1, Gunnar Lachmann, Alissa Wolf, Rudolf Mörgeli, Björn Weiss, Claudia Spies. 1. Department of Anesthesiology and Intensive Care Medicine Campus Charité Mitte and Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany *Anika Müller and Gunnar Lachmann contributed equally to this work.
Abstract
PURPOSE OF REVIEW: From an elderly patient's perspective, acute and chronic cognitive disturbances are among the most harmful complications that can occur following surgery. For elderly patients, these complications often mean the end of an independent life. This article focuses on this serious aspect, which is increasingly prevalent in our aging society. Cognitive disturbances are associated with severe outcome impairments and increased mortality. This article aims to provide a current overview regarding the diagnosis, pathophysiology, prevention, and treatment of this severe social problem. RECENT FINDINGS: The current knowledge of risk factors, diagnosis, prevention, and treatment of postoperative delirium and postoperative cognitive dysfunction should help to raise awareness and improve the outcome of delirious patients, particularly in the elderly population. SUMMARY: Especially in elderly patients, postoperative delirium constitutes a common, severe complication. Early diagnosis and supportive treatment are essential to improve outcome. To date, no pharmacological treatment strategy was effective, so that further research about the underlying pathophysiology and the development of treatment strategies are urgently required.
PURPOSE OF REVIEW: From an elderly patient's perspective, acute and chronic cognitive disturbances are among the most harmful complications that can occur following surgery. For elderly patients, these complications often mean the end of an independent life. This article focuses on this serious aspect, which is increasingly prevalent in our aging society. Cognitive disturbances are associated with severe outcome impairments and increased mortality. This article aims to provide a current overview regarding the diagnosis, pathophysiology, prevention, and treatment of this severe social problem. RECENT FINDINGS: The current knowledge of risk factors, diagnosis, prevention, and treatment of postoperative delirium and postoperative cognitive dysfunction should help to raise awareness and improve the outcome of delirious patients, particularly in the elderly population. SUMMARY: Especially in elderly patients, postoperative delirium constitutes a common, severe complication. Early diagnosis and supportive treatment are essential to improve outcome. To date, no pharmacological treatment strategy was effective, so that further research about the underlying pathophysiology and the development of treatment strategies are urgently required.
Authors: Stacie Deiner; Xiaodong Luo; Hung-Mo Lin; Daniel I Sessler; Leif Saager; Frederick E Sieber; Hochang B Lee; Mary Sano; Christopher Jankowski; Sergio D Bergese; Keith Candiotti; Joseph H Flaherty; Harendra Arora; Aryeh Shander; Peter Rock Journal: JAMA Surg Date: 2017-08-16 Impact factor: 14.766
Authors: Gunnar Lachmann; Ilse Kant; Florian Lammers; Victoria Windmann; Claudia Spies; Saya Speidel; Friedrich Borchers; Daniel Hadzidiakos; Jeroen Hendrikse; Georg Winterer; Jeroen de Bresser Journal: PLoS One Date: 2019-06-14 Impact factor: 3.240