Zhaosheng Jin1,2, Aktar Rahman1,3, Sudhansu Pattnaik1,4, Maurice Smith1. 1. Departments of Anaesthesia and care of the elderly, Queen's Hospital, Barking Havering and Redbridge NHS Trust, London, UK. 2. Central London School of Anaesthesia, London, UK. 3. Barts and the London School of Anaesthesia, London, UK. 4. Royal College of Anaesthesia, London, UK.
Abstract
BACKGROUND: Delirium is a common postoperative neurocognitive complication in the older population and can lead to significant morbidity and mortality, as well as cognitive and functional impairment. Hypoactive delirium is characterised by drowsiness and inactivity, and expert opinions suggest that it is more likely to be missed and can lead to more complications. Current guidelines and literature evidence both support the use of non-pharmacological management of delirium. METHODS: To investigate the recognition of hyperactive and hypoactive delirium by the surgical multidisciplinary team, and to investigate staff understanding regarding the management and prognosis of postoperative delirium. We conducted a single-centre, multidisciplinary survey on the diagnosis, management and complication of postoperative delirium. RESULTS: We found that hypoactive delirium is significantly less likely to be identified. In contrast, acute psychosis is likely to be misdiagnosed as delirium. Only a small proportion of the respondents had knowledge of the supportive management options for delirium; and the medical complications and higher mortality risk associated with postoperative delirium. DISCUSSION: The finding of the survey demonstrates a need for delirium education. Surveys such as this may be conducted in other centres to identify areas of focus on staff delirium education.
BACKGROUND:Delirium is a common postoperative neurocognitive complication in the older population and can lead to significant morbidity and mortality, as well as cognitive and functional impairment. Hypoactive delirium is characterised by drowsiness and inactivity, and expert opinions suggest that it is more likely to be missed and can lead to more complications. Current guidelines and literature evidence both support the use of non-pharmacological management of delirium. METHODS: To investigate the recognition of hyperactive and hypoactive delirium by the surgical multidisciplinary team, and to investigate staff understanding regarding the management and prognosis of postoperative delirium. We conducted a single-centre, multidisciplinary survey on the diagnosis, management and complication of postoperative delirium. RESULTS: We found that hypoactive delirium is significantly less likely to be identified. In contrast, acute psychosis is likely to be misdiagnosed as delirium. Only a small proportion of the respondents had knowledge of the supportive management options for delirium; and the medical complications and higher mortality risk associated with postoperative delirium. DISCUSSION: The finding of the survey demonstrates a need for delirium education. Surveys such as this may be conducted in other centres to identify areas of focus on staff delirium education.
Authors: Maria I Körber; Matthieu Schäfer; Rakave Vimalathasan; Victor Mauri; Christos Iliadis; Clemens Metze; Henrik Ten Freyhaus; Volker Rudolph; Stephan Baldus; Roman Pfister Journal: Clin Res Cardiol Date: 2021-06-01 Impact factor: 5.460