Related Factors and Treatment of Postoperative Delirium in Old Adult Patients: An Integrative Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Selection Criteria
2.3. Article Selection and Data Abstraction
2.4. Characterisation of Articles
2.5. Evaluation of Methodological Quality
3. Results
3.1. Factors Associated with the Onset and Development of Postoperative Delirium
3.2. Principal Methods of Treatment
3.2.1. Nursing Interventions
- Physiological: Maintain good nutrition and hydration statuses, manage pain adequately, and remove catheters promptly.
- Cognitive: Place clocks and calendars in the patient’s room to aid with temporal reorientation, general reorientation, and cognitive stimulation.
- Behavioural: Reduce preoperative anxiety, give psychosocial support, show concern and empathy, and listen attentively.
- Sensory: Maintain a good level of illumination, facilitate the use of hearing aids at an early stage, facilitate the use of glasses, and avoid excessive noise.
- Sleep and environment: Establish a daily routine in order to prevent disruption of the sleep–wake cycle, avoid the administration of medication or the taking of vital signs during the night where possible, and adjust routines in order to ensure uninterrupted sleep.
- Family involvement: Involve the patient’s family, avoid changes in personnel, and allow family to be present at meal-times.
- Patient safety and skin integrity: Avoid mechanical restraints where possible, and promote early mobility, walking, or directed exercise at least three times daily
3.2.2. Effective Pharmacological Treatments
3.2.3. Ineffective Pharmacological Treatments
4. Discussion
4.1. Study Limitations
4.2. Clinical Implications
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Evered, L.; Silbert, B.; Knopman, D.S.; Scott, D.A.; Dekosky, S.T.; Rasmussen, L.S. Recommendations for the Nomenclature of Cognitive Change Associated with Anaesthesia and Surgery—2018. Anesthesiology 2018, 129, 872–879. [Google Scholar] [CrossRef]
- de las Pozas Abril, J. Postoperative Delirium and factors related in a Unit Care of Cardiac Surgery. Nure Investig. 2011, 8, 567–575. [Google Scholar]
- Honda, S.; Furukawa, K.; Nishiwaki, N.; Fujiya, K.; Omori, H.; Kaji, S.; Makuuchi, R.; Irino, T.; Tanizawa, Y.; Bando, E.; et al. Risk factors for Postoperative Delirium after Gastrectomy in gastric cancer patients. World J. Surg. 2018, 42, 3669–3675. [Google Scholar] [CrossRef] [PubMed]
- Styra, R.; Larsen, E.; Dimas, M.A.; Baston, D.; Elgie-Watson, J.; Flockhart, L.; Lindsay, T.F. The effect of preoperative cognitive impairment and type of vascular surgery procedure on postoperative delirium with associated cost implications. J. Vasc. Surg. 2018, 69, 201–209. [Google Scholar] [CrossRef] [PubMed]
- Shawna Greiner, C.; Kremer, M.J. Clarifying the Confusion of Adult Emergence Delirium. AANA J. 2019, 87, 243–251. [Google Scholar]
- Artuz Diaz, D.E.; Burgos Chaverra, E.L.; Garcia Sanchez, E.M.; Gonzalez Urueta, K.D.; Ortega Dehorta, K.D. Cuidados de Enfermería a Adultos Mayores Con Delirium Postquirúrgico; Una Revisión Sistemática; Universidad de Cartagena: Bolívar, Colombia, 2016. [Google Scholar]
- Card, E.; Pandharipande, P.; Tomes, C.; Lee, C.; Wood, J.; Nelson, D.; Graves, A.; Shintani, A.; Ely, E.; Hughes, C.; et al. Emergence from general anaesthesia and evolution of delirium signs in the post anaesthesia care unit. Br. J. Anaesth. 2014, 115, 411–417. [Google Scholar] [CrossRef] [Green Version]
- Pavone, K.J.; Cacchione, P.Z.; Polomano, R.C.; Winner, L.; Compton, P. Evaluating the use of Dexmedetomidine for the reduction of delirium: An integrative review. Hear Lung 2018, 47, 591–601. [Google Scholar] [CrossRef]
- Wang, Y.; Shen, X. Postoperative delirium in the elderly: The potential neuropathogenesis. Aging Clin. Exp. Res. 2018, 30, 1287–1295. [Google Scholar] [CrossRef]
- Sosa Morales, G.; Alonso Cabrera, E.; Martínez Oquendo, A.; Montes de Oca Montano, J.L.; León Valdivies, Y.J. El Delirio En Ancianos Hospitalizados. Un Estudio en la Unidad de Cuidados Intermedios Quirúrgicos de Cienfuegos. Cuba; Editorial Médica Jims Sl: Barcelona, Spain, 2017. [Google Scholar]
- Rodríguez, J. Delirium Perioperatorio. Rev. Méd. Clín. Condes 2017, 28, 776–784. [Google Scholar] [CrossRef]
- Miller, D.; Lewis, S.; Pritchard, M.; Schofield-robinson, O.; Shelton, C.; Alderson, P.; Smith, A.F. Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non-cardiac surgery. Cochrane Database Syst. Rev. 2018, 8, CD012317. [Google Scholar] [CrossRef]
- Punjasawadwong, Y.; Chau-In, W.; Laopaiboon, M.; Punjasawadwong, S.; Pin-On, P. Processed electroencephalogram and evoked potential techniques for amelioration of postoperative delirium and cognitive dysfunction following non-cardiac and non- neurosurgical procedures in adults. Cochrane Database Syst. Rev. 2018, 5, CD011283. [Google Scholar] [CrossRef]
- Carrera Castro, C. Delirium postoperatorio en cirugía general, el fantasma de nuestros abuelos. Enferm. Glob. 2014, 13, 407–423. [Google Scholar] [CrossRef] [Green Version]
- Dotti, S.; Montes De Oca, O.; Bigalli, D.; Gutierrez, F.; Russo, N.; Pouso, M. Análisis prospectivo sobre incidencia acumulada de delirio en el posoperatorio de cirugía cardíaca. Rev. Urug. Cardiol. 2017, 32, 150–157. [Google Scholar]
- Van Grootven, B.; Detroyer, E.; Devriendt, E.; Sermon, A.; Deschodt, M.; Flamaing, J.; Dubois, C.; Milisen, K. Is preoperative state anxiety a risk factor for postoperative delirium among elderly hip fracture patients? Geriatr. Gerontol. Int. 2015, 16, 948–955. [Google Scholar] [CrossRef] [PubMed]
- Guo, Y.; Fan, Y. A Preoperative, Nurse-Led Intervention Program Reduces Acute Postoperative Delirium. Am. Assoc. Neurosci. Nurse 2016, 48, 229–235. [Google Scholar] [CrossRef] [PubMed]
- Fields, A.; Huang, J.; Schroeder, D.; Sprung, J.; Weingarten, T. Agitation in adults in the post-anaesthesia care unit after general anaesthesia. Br. J. Anaesth. 2018, 121, 1052–1058. [Google Scholar] [CrossRef] [Green Version]
- Hesse, S.; Kreuzer, M.; Hight, D.; Gaskell, A.; Devari, P.; Singh, D.; Taylor, N.B.; Whalin, M.K.; Lee, S.; Sleigh, J.W. Association of electroencephalogram trajectories during emergence from anaesthesia with delirium in the post-anaesthesia care unit: An early sign of postoperative complications. Br. J. Anaesth. 2018, 122, 622–634. [Google Scholar] [CrossRef]
- Calderón Delgado, T.B.; Jara Alvarado, J.R. Disfunción Cognitiva Postoperatoria en Pacientes Mayores de 60 Años de Edad Sometidos a Procedimientos de Anestesia General Mediante la Valoración del Test de MOCA en el Hospital San Francisco de Quito Durante el Periodo de Junio-Agosto Del Año 2016; Universidad Central del Ecuador: Quito, Ecuador, 2017. [Google Scholar]
- Peralta-Zamora, E. Estrategias para disminuir la agitación y el delirio postoperatorio en anestesia ambulatoria. Rev. Mex. Anestesiol. 2012, 35 (Suppl. S1), 112–115. [Google Scholar]
- Ocádiz-Carrasco, J.; Gutiérrez-Padilla, R.A.; Páramo-Rivas, F.; Tovar-Serrano, A.; Hernández-Ortega, J.L. Programa preventivo del delirio postoperatorio en ancianos. Cir. Cir. 2013, 81, 181–186. [Google Scholar]
- Chu, C.-S.; Liang, C.-K.; Chou, M.-Y.; Lin, Y.-T.; Hsu, C.-J.; Chou, P.-H.; Chu, C.-L. Short-Form Mini Nutritional Assessment as a useful method of predicting the development of postoperative delirium in elderly patients undergoing orthopedic surgery. Gen. Hosp. Psychiatry 2015, 38, 15–20. [Google Scholar] [CrossRef]
- Aldecoa, C.; Bettelli, G.; Bilotta, F.; Sanders, R.D.; Audisio, R.; Borozdina, A.; Cherubini, A.; Jones, C.; Kehlet, H.; MacLullich, A.; et al. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur. J. Anaesthesiol. 2017, 34, 192–214. [Google Scholar] [CrossRef] [PubMed]
- Riegger, H.; Hollinger, A.; Seifert, B.; Toft, K.; Blum, A.; Zehnder, T.; Siegemund, M. Baden Prevention and Reduction of Incidence of Postoperative Delirium Trial (PRIDe): A phase IV multicenter, blind clinical trial of ketamine versus haloperidol for prevention of postoperative delirium. BMC 2018, 19, 142. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fritz, B.A.; Maybrier, H.R.; Avidan, M.S. Intraoperative electroencephalogram suppression at lower volatile anaesthetic concentrations predicts postoperative delirium occurring in the intensive care unit. Br. J. Anaesth. 2018, 121, 241–248. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mimi, W.; Yongxin, L.; Zhao, D.; Shiduan, W. Perioperative dexmedetomidine reduces delirium after cardiac surgery: A meta-analysis of randomized controlled trials. J. Clin. Anesth. 2018, 50, 33–42. [Google Scholar] [CrossRef]
- MacKenzie, K.K.; Britt-Spells, A.M.; Sands, L.P.; Leung, J.M. Processed Electroencephalogram Monitoring and Postoperative Delirium. Anesthesiology 2018, 3, 417–427. [Google Scholar] [CrossRef] [PubMed]
- Espinosa Calderón, H.P.; Sosa Julia, S.; Mantilla Pinto, X.R. Delirio Posoperatorio En Pacientes Geriátricos Sometidos a Anestesia General versus Neuroaxial, Medido por el Método de Evaluación de la Confusión, en el Hospital Eugenio Espejo y Hospital de la Policía Nacional, Agosto y Septiembre 2016; Universidad Central del Ecuador: Quito, Ecuador, 2017. [Google Scholar]
- Lira, D.; Mar-Meza, M.; Montesinos, R.; Herrera-Pérez, E.; Cuenca, J.; Castro-Suárez, S.; Custodio, N. Una complicación quirúrgica escasamente sospechada: La Disfunción Cognitiva Postoperatoria. Rev. Neuropsiquiatr. 2018, 81, 113–121. [Google Scholar] [CrossRef] [Green Version]
- Guenther, U.; Radtke, F.M. Delirium in the postanaesthesia period. Curr. Opin. Anesthesiol. 2011, 24, 670–675. [Google Scholar] [CrossRef]
- Guenther, U.; Riedel, L.; Radtke, F.M. Patients prone for postoperative delirium: Preoperative assessment, perioperative prophylaxis, postoperative treatment. Curr. Opin. Anesthesiol. 2016, 29, 384–390. [Google Scholar] [CrossRef]
- Sanson, G.; Khlopenyuk, Y.; Milocco, S.; Sartori, M.; Dreas, L.; Fabiani, A. Delirium after cardiac surgery. Incidence, phenotypes, predisposing and precipitating risk factors, and effects. Hear Lung 2018, 47, 408–417. [Google Scholar] [CrossRef]
- Mcdaniel, M.; Brudney, C. Postoperative delirium: Etiology and management. Curr. Opin. Crit. Care 2012, 18, 372–376. [Google Scholar] [CrossRef]
- Bettelli, G.; Neuner, B. Postoperative delirium: A preventable complication in the elderly surgical patient. Monaldi Arch. Chest Dis. 2017, 87, 31–33. [Google Scholar] [CrossRef] [Green Version]
- Celis, E.; Vega Salazar, F.; Torres Marrugo, V. Revisión comparativa de las guías de sedación, analgesia y delirio en pacientes críticos. Acta Colomb. Cuid. Intensiv. 2017, 17, 107–116. Available online: http://linkinghub.elsevier.com/retrieve/pii/S012272621630101X (accessed on 20 August 2021). [CrossRef]
- Li, X.; Yang, J.; Nie, X.L.; Zhang, Y.; Li, X.Y.; Li, L.H.; Wang, D.X.; Ma, D. Impact of dexmedetomidine on the incidence of delirium in elderly patients after cardiac surgery: A randomized controlled trial. PLoS ONE 2017, 12, e0170757. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lee, J.; Jung, J.; Jai Sung, N.; Yoo, S.; You Sun, H. Perioperative Psycho-Educational intervention can reduce postoperative delirium in patients after Cardiac Surgery: A Pilot Study. Psychiatry Med. 2013, 45, 143–158. [Google Scholar] [CrossRef] [PubMed]
- Fok, M.C.; Sepehry, A.A.; Frisch, L.; Sztramko, R.; Van Der Burg, B.L.S.B.; Vochteloo, A.J.H.; Chan, P. Do antipsychotics prevent postoperative delirium? A systematic review and meta-analysis. Int. J. Geriatr. Psychriaty 2015, 30, 333–344. [Google Scholar] [CrossRef]
- Dong, X.; Hailin, X.; Huiyu, T.; Guozhu, X. Preoperative C-Reactive Protein as a risk factor for Postoperative Delirium in elderly patients undergoing Laparoscopic Surgery for Colon Carcinoma. Biomed. Res. Int. 2017, 2017, 5635640. [Google Scholar]
- Marcantonio, A.J.; Pace, M.; Brabeck, D.; Trzaskos, A.; Anderson, R. Team Approach: Management of Postoperative Delirium in the elderly patient with femoral-neck fracture. JBJS Rev. 2017, 5, e8. [Google Scholar] [CrossRef]
- Nuñez Ureña, J.M.; López Carrillo, L.; Hernández Luna, A.; Hardy Pérez, A.E.; Jaimes García, J.; Domínguez Cadena, A.; Vasquez Ceron, J.A. Factores de Riesgo de Delirium Postoperatorio en la Unidad de Cuidados Intensivos; Universidad Autónoma del Estado de México: Toluca, México, 2017. [Google Scholar]
- Hempenius, L.; Slaets, J.P.J.; Asselt, D.Z.B.; Van Schukking, J.; De Bock, G.H.; Wiggers, T.; van Leeuwen, B.L. Interventions to prevent postoperative delirium in elderly cancer patients should be targeted at those undergoing nonsuperficial surgery with special attention to the cognitive impaired patients. Eur. J. Surg. Oncol. 2014, 41, 28–33. [Google Scholar] [CrossRef]
- Dan, L.; Jie, L.; Huiying, Z.; Youzhong, A. The influence of analgesic-based sedation protocols on delirium and outcomes in critically ill patients: A randomized controlled trial. PLoS ONE 2017, 12, e0184310. [Google Scholar]
- Cheol, L.; Cheol Hyeong, L.; Gilho, L.; Jongmyeong, L.; Jihyo, H. The effect of the timing and dose of dexmedetomidine on postoperative delirium in elderly patients after laparoscopic major non-cardiac surgery: A double blind randomized controlled study. J. Clin. Anesth. 2018, 47, 27–32. [Google Scholar] [CrossRef]
- Nadler, J.W.; Evans, J.L.; Fang, E.; Preud’Homme, X.A.; Daughtry, R.L.; Chapman, J.B.; Bolognesi, M.P.; Attarian, D.E.; Wellman, S.S.; Krystal, A.D. A randomised trial of peri operative positive airway pressure for postoperative delirium in patients at risk for obstructive sleep apnoea after regional anaesthesia with sedation or general anaesthesia for joint arthroplasty. Anesthesia 2017, 72, 729–736. [Google Scholar] [CrossRef] [Green Version]
- Van Der Sluis, F.J.; Buisman, P.L.; Meerdink, M.; Wouter, B.; van Etten, B.; de Bock, G.H.; van Leeuwen, B.L.; Pol, R.A. Risk factors for postoperative delirium after colorectal operation. Surgery 2016, 161, 704–711. [Google Scholar] [CrossRef]
- Kang, S.Y.; Sang Won, S.; Joo Yong, K. Comprehensive risk factor evaluation of postoperative delirium following major surgery: Clinical data warehouse analysis. Neurol. Sci. 2019, 40, 793–800. [Google Scholar] [CrossRef]
- Xin, J.; Dong, C.; Yahao, L.; Zhongshi, L. Risk factors for postoperative delirium after spine surgery in middle- and old-aged patients. Aging Clin. Exp. Res. 2016, 29, 1039–1044. [Google Scholar]
- Deiner, S.; Luo, X.; Lin, H.-M.; Sessler, D.I.; Saager, L.; Sieber, F.E.; Lee, H.B.; Sano, M.; Jankowski, C.; Bergese, S.; et al. Intraoperative infusion of Dexmedetomidine for prevention of Postoperative Delirium and Cognitive Dysfunction in elderly patients undergoing major elective Noncardiac Surgery. JAMA Surg. 2017, 152, e171505. [Google Scholar] [CrossRef]
- Chevillon, C.; Hellyar, M.; Madani, C.; Kerr, K.; Kim, S.C. Preoperative education on Postoperative Delirium, anxiety, and knowledge in Pulmonary Thromboendarterectomy patients. Am. J. Crit. Care. 2015, 24, 164–171. [Google Scholar] [CrossRef] [Green Version]
- Guo, Y.; Jia, P.; Zhang, J.; Wang, X.; Jiang, H.; Jiang, W. Prevalence and risk factors of postoperative delirium in elderly hip fracture patients. J. Int. Med. Res. 2016, 44, 317–327. [Google Scholar] [CrossRef] [Green Version]
- Chacón Zamora, M. Delirio postquirúrgico en fractura de cadera del paciente adulto mayor. Rev. Clín. Esc. Med. 2014, 4, 6–10. [Google Scholar]
- Romero Luna, D.I.; Cuitláhuac Márquez, Z.; González Hidalgo, E. Frecuencia de la Disfunción Cognitiva Posoperatoria (DCPO) en Adultos, Sometidos a Colecistectomía Laparoscópica Programada Bajo Anestesia General Balanceada, En Pacientes Premedicados Con Midazolam; Universidad Autónoma del Estado de México, Facultad de Medicina: Toluca, México, 2014. [Google Scholar]
- Jiménez Ardila, Y.B.; Marténez Castro, J.; Peña Aguirre, Y.V. Guía De Enfermería Para La Prevención Y Manejo No Farmacológico del Delirium en Pacientes en Postoperatorio de Cirugía Cardiovascular en la Unidad Cardiovascular de la Fundación Cardioinfantil de Bogotá; Universidad de la Sabana: Cundinamarca, Colombia, 2013; Available online: https://intellectum.unisabana.edu.co/handle/10818/11544 (accessed on 20 August 2021).
- Van Meenen, L.C.C.; Van Meenen, D.M.P.; De Rooij, S.E.; ter Riet, G. Risk Prediction Models for Postoperative Delirium: A Systematic Review and Meta-Analysis. Aging Surg. 2014, 62, 2383–2390. [Google Scholar] [CrossRef]
- Ogawa, M.; Izawa, K.P.; Satomi-Kobayashi, S.; Kitamura, A.; Tsuboi, Y.; Komaki, K.; Ono, R.; Sakai, Y.; Tanaka, H.; Okita, Y. Preoperative exercise capacity is associated with the prevalence of postoperative delirium in elective cardiac surgery. Aging Clin. Exp. Res. 2017, 30, 27–34. [Google Scholar] [CrossRef]
- Duan, X.; Coburn, M.; Rossaint, R.; Sanders, R.D.; Waesberghe, J.V.; Kowark, A. Efficacy of perioperative dexmedetomidine on postoperative delirium: Systematic review and meta-analysis with trial sequential analysis of randomised controlled trials. Br. J. Anaesth. 2018, 121, 384–397. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Langer, T.; Santini, A.; Zadek, F.; Chiodi, M.; Pugni, P.; Cordolcini, V.; Bonanomi, B.; Rosini, F.; Marcucci, M.; Valenza, F.; et al. Intraoperative hypotension is not associated with postoperative cognitive dysfunction in elderly patients undergoing general anesthesia for surgery: Results of a randomized controlled pilot trial. J. Clin. Anesth. 2019, 52, 111–118. [Google Scholar] [CrossRef]
- Popp, J.; Arlt, S. Prevention and treatment options for postoperative delirium in the elderly. Curr. Opin. Psychiatry 2012, 25, 515–521. [Google Scholar] [CrossRef]
- An, Y.; Jin, Y.; Jin, T.; Hur, E.Y.; Lee, S. Operative and Anesthetic Factors Influencing on Delirium in the Intensive Care Unit: An analysis of Electronic Health Records. J. Clin. Nurs. 2018, 28, 1327–1335. [Google Scholar] [CrossRef]
- Chung-Sik, O.; Ka Young, R.; Tae-Gyoon, Y.; Nam-Sik, W.; Seung Wan, H.; Seong-Hyop, K. Postoperative Delirium in Elderly Patients Undergoing Hip Fracture Surgery in the Sugammadex Era: A Retrospective Study. Biomed. Res. Int. 2016, 2016, 1054597. [Google Scholar]
- Rodríguez Soto, Y. Delirium Postoperatorio: Implicación clínica y manejo. Rev. Med. Costa Rica Centroam. 2013, 605, 19–23. Available online: http://www.medigraphic.com/pdfs/revmedcoscen/rmc-2013/rmc131e.pdf (accessed on 20 August 2021).
- Alcoba Pérez, Á.; Ciria Poza, S.; Carracedo Catalán, C.; García Fernández, A.; Marcos Vidal, J.M. Valoración de la concordancia entre la escala CAM-ICU y la nursing delirium screening scale en el postoperatorio de cirugía cardiaca en una unidad de críticos. Enferm. Intensiv. 2014, 25, 100–106. [Google Scholar] [CrossRef]
- Duarte Martínez, D.M. Factores de Riesgo en Pacientes Adultos Para el Desarrollo de Delirium Una Perspectiva Desde el Cuidado de Enfermería; Universidad de Ciencias Aplicadas y Ambientales, U.D.C.A.: Bogotá, Colombia, 2018. [Google Scholar]
- Dearholt, S.L.; Dang, D. Evidence-Based Practice: Model and Guidelines Johns Hopkins Nursing, 2nd ed.; Sigma Publication: Indianapolis, IN, USA, 2012; p. 29. [Google Scholar]
- Ewan, S.; Noel-Storr, A.; William, C. The Impact of General and Regional Anesthesia on the Incidence of Post- Operative Cognitive Dysfunction and Post-Operative Delirium: A Systematic Review with Meta-Analysis. J. Alzheimers Dis. 2010, 22, S67–S79. [Google Scholar]
- Koster, S.; Hensens, A.G.; Schuurmans, M.J.; Van Der Palen, J. Risk factors of delirium after cardiac surgery A systematic review. Eur. J. Cardiovasc. Nurs. 2010, 10, 197–204. [Google Scholar] [CrossRef]
- Vásquez-márquez, I.; Castellanos-Olivares, A. Alteraciones cognitivas y postoperatorias en el paciente geriátrico. Rev. Mex. Anestesiol. 2011, 34, 183–189. [Google Scholar]
- Steiner, L.A. Postoperative delirium. Part 1: Pathophysiology and risk factors. Eur. J. Anesthesiol. 2011, 28, 628–636. [Google Scholar] [CrossRef]
- Rengel, K.F.; Pandharipande, P.P.; Hughes, C.G. Postoperative delirium. Presse Med. 2018, 27, e53–e64. [Google Scholar] [CrossRef] [PubMed]
- Gräsner, J.-T.; Lefering, R.; Koster, R.W.; Masterson, S.; Böttiger, B.W.; Herlitz, J.; Wnent, J.; Tjelmeland, I.B.; Ortiz, F.R.; Maurer, H.; et al. EuReCa ONE 27 Nations, ONE Europe, ONE Registry. Resuscitation 2016, 105, 188–195. Available online: http://linkinghub.elsevier.com/retrieve/pii/S0300957216300995 (accessed on 20 August 2021). [CrossRef] [PubMed] [Green Version]
- Huang, J.; Qi, H.; Lv, K.; Chen, X.; Zhuang, Y.; Yang, L. Emergence Delirium in Elderly Patients as a Potential Predictor of Subsequent Postoperative Delirium: A Descriptive Correlational Study. J. PeriAnesth. Nurs. 2019, 35, 478–483. [Google Scholar] [CrossRef]
- Mei, X.; Tong, J. The plasma levels of brain-derived neurotrophic factor are positively associated with emergence agitation in the elderly after gastrointestinal surgery. J. Anesth. 2016, 30, 811–816. [Google Scholar] [CrossRef]
- Inouye, S.K.; Robinson, T.; Blaum, C.; Boustani, M.; Busby-Whitehead, J.; Chalian, A. The American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults. Postoperative Delirium in Older Adults: Best Practice Statement from the American Geriatrics Society. J. Am. Coll. Surg. 2015, 220, 136–148. [Google Scholar] [CrossRef] [Green Version]
- Vásquez Márquez, I.; Castellanos Olivares, A. Delirio postoperatorio en el paciente geriátrico. Rev. Mex. Anestesiol. 2011, 34, 190–194. [Google Scholar]
- Jia, Y.; Jin, G.; Guo, S.; Gu, B.; Zujian, J.; Xing, G.; Li, Z. Fast-track surgery decreases the incidence of postoperative delirium and other complications in elderly patients with colorectal carcinoma. Langenbeck’s Arch. Surg. 2014, 399, 77–84. [Google Scholar] [CrossRef] [Green Version]
- Mosk, C.A.; van Vugt, J.L.; de Jonge, H.; Witjes, C.D.; Buettner, S.; Ijzermans, J.N.; van der Laan, L. Low skeletal muscle mass as a risk factor for postoperative delirium in elderly patients undergoing colorectal cancer surgery. Clin. Interv. Aging 2018, 13, 2097–2106. [Google Scholar] [CrossRef] [Green Version]
- Read, M.D.; Maani, C.V.; Blackwell, S. Dexmedetomidine as a Rescue Therapy for Emergence Delirium in Adults: A Case Series. Case Rep. 2017, 9, 20–23. [Google Scholar] [CrossRef]
- Borozdina, A.; Qeva, E.; Cinicola, M.; Bilotta, F. Perioperative cognitive evaluation. Curr. Opin. Anesthesiol. 2018, 31, 756–761. [Google Scholar] [CrossRef] [PubMed]
- Luo, C.; Zou, W. Cerebral monitoring of anaesthesia on reducing cognitive dysfunction and postoperative delirium: A systematic review. J. Int. Med. Res. 2018, 46, 4100–4110. [Google Scholar] [CrossRef] [PubMed]
- Jee, Y.S.; You, H.J.; Sung, T.Y.; Cho, C.K. Effects of nefopam on emergence agitation after general anesthesia for nasal surgery. Medicine 2017, 96, e8843. [Google Scholar] [CrossRef]
- Munk, L.; Peter, L.; Andersen, H.; Gögenur, I. Emergence delirium. Clin. Featur. 2013, 23, 251–255. [Google Scholar] [CrossRef]
- Goins, A.E.; Smeltz, A.; Ramm, C.; Strassle, P.D.; Teeter, E.G.; Vavalle, J.P.; Kolarczyk, L. General Anesthesia for transcatheter Aortic Valve replacement: Total Intravenous Anesthesia is associated with less Delirium as compared to volatile agent technique. J. Cardiothorac. Vasc. Anesth. 2018, 32, 1570–1577. [Google Scholar] [CrossRef] [PubMed]
- Kassie, G.M.; Nguyen, T.A.; Ellett, L.M.K.; Pratt, N.L.; Roughead, E.E. Preoperative medication use and postoperative delirium: A systematic review. BMC Geriatr. 2017, 17, 298. [Google Scholar] [CrossRef] [Green Version]
- Soto Martin, V.; Ojeda González, J.J.; Dávila Cabo de Villa, E. Síndrome confusional agudo posanestesia en el paciente geriátrico de urgencia. Rev. Cuba. Anestesiol. Reanim. 2015, 14, 29–43. [Google Scholar]
- Li, T.; Yeung, J.; Li, J.; Zhang, Y.; Melody, T.; Gao, Y.; Wang, Y.; Lian, Q.; Gao, F. Comparison of regional with general anaesthesia on postoperative delirium (RAGA-delirium) in the older patients undergoing hip fracture surgery: Study protocol for a multicentre randomised controlled trial. BMJ Open 2017, 7, 1–8. [Google Scholar] [CrossRef] [Green Version]
- González Masis, J.R.; Cordero Escobar, I.; Rassi Llanes, D.; Mora Díaz, I. Utilidad del Minimental State en el diagnóstico de disfunción cognitiva posoperatoria del anciano. Rev. Cuba. Anestesiol. Reanim. 2014, 13, 115–126. Available online: http://scielo.sld.cu/scielo.php?script=sci%7B_%7Darttext%7B&%7Dpid=S1726-67182014000200003%7B&%7Dlang=pt (accessed on 20 August 2021).
- Kratz, T.; Heinrich, M.; Schlauß, E.; Diefenbacher, A. Preventing Postoperative Delirium. Dtsch. Ärztebl. Int. 2015, 112, 289. [Google Scholar] [CrossRef] [Green Version]
- Smulter, N.; Lingehall, H.C.; Yngve, G.; Olofsson, B.; Gunnar, K.; Appelblad, M.; Svenmarker, S. Disturbances in oxygen balance during Cardiopulmonary Bypass: A risk factor for Postoperative Delirium. J. Cardiothorac. Vasc. Anesth. 2017, 32, 684–690. [Google Scholar] [CrossRef]
- Lee, D.S.; Lee, M.Y.; Park, C.M.; Kim, D.I.; Kim, Y.W.; Park, Y.J. Preoperative statins are associated with a reduced risk of postoperative delirium following vascular surgery. PLoS ONE 2018, 13, e0192841. [Google Scholar] [CrossRef] [Green Version]
- Chan, B.; Aneman, A. A prospective, observational study of cerebrovascular autoregulation and its association with delirium following cardiac surgery. Anesthesia 2018, 74, 33–44. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Shin, J.E.; Kyeong, S.; Lee, J.S.; Park, J.Y.; Lee, W.S.; Kim, J.J.; Yang, K.H. A personality trait contributes to the occurrence of postoperative delirium: A prospective study. BMC Psychiatry 2016, 16, 371. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sánchez, A.; Thomas, C.; Deeken, F.; Wagner, S.; Klöppel, S.; Kentischer, F. Quality of life: Reduction of delirium risk and postoperative cognitive dysfunction after elective procedures in older adults—study protocol for a stepped-wedge cluster randomized trial (PAWEL Study). Trials 2019, 20, 71. [Google Scholar] [CrossRef] [Green Version]
- Munk, L.; Andersen, G.; Møller, A.M. Post-anaesthetic emergence delirium in adults: Incidence, predictors and consequences. Acta Anaesthesiol. Scand. 2016, 60, 1059–1066. [Google Scholar] [CrossRef] [PubMed]
- Esteve, N.; Valdivia, J.; Ferrer, A.; Mora, C.; Ribera, H.; Garrido, P. Influyen las técnicas anestésicas en los resultados postoperatorios? Parte, I. Rev. Esp. Anestesiol. Reanim. 2013, 60, 93–102. [Google Scholar] [CrossRef]
- Smulter, N.; Lingehall, H.C.; Gustafson, Y.; Olofsson, B.; Engström, G.K. The use of a screening scale improves the recognition of delirium in older patients after cardiac surgery–a retrospective observational study. J. Clin. Nurs. 2019, 28, 2309–2318. [Google Scholar] [CrossRef] [PubMed]
- Lee, S.; Choi, S.J.; In, C.B.; Sung, T. Effects of tramadol on emergence agitation after general anesthesia for nasal surgery. Medicine 2019, 98, e14763. [Google Scholar] [CrossRef] [PubMed]
- Carranza Salas, E. Revisión Crítica: Efectividad de la Intervención de Enfermería en el Preoperatorio Para Reducir el Delirio en Pacientes de Cirugía Mayor; Universidad Católica Santo Toribio de Mogrovejo: Chiclayo, Peru, 2017. [Google Scholar]
- Wen, J.; Zeng, H.; Li, Z.; He, G.; Jin, Y. Pharmacologic interventions for preventing delirium in adult patients after cardiac surgery. Medicine 2018, 97, 1–3. [Google Scholar] [CrossRef]
- Subramaniam, B.; Shankar, P.; Shaefi, S.; Mueller, A.; O’Gara, B.; Banner-Goodspeed, V.; Gallagher, J.; Gasangwa, D.; Patxot, M.; Packiasabapathy, S.; et al. Effect of intravenous Acetaminophen vs Placebo combined with Propofol or Dexmedetomidine on Postoperative Delirium among older patients following Cardiac Surgery. JAMA 2019, 321, 686–696. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Veiga, D.; Luis, C.; Parente, D.; Fernandes, V.; Botelho, M.; Santos, P.; Abelha, F. Postoperative Delirium in Intensive Care Patients: Risk Factors and Outcome. Braz. J. Anesthesiol. 2012, 62, 469–483. [Google Scholar] [CrossRef] [Green Version]
- Wang, C.G.; Qin, Y.F.; Wan, X.; Song, L.C.; Li, Z.J.; Li, H. Incidence and risk factors of postoperative delirium in the elderly patients with hip fracture. J. Orthop. Surg. Res. 2018, 13, 186. [Google Scholar] [CrossRef] [Green Version]
- Aitken, S.J.; Blyth, F.M.; Naganathan, V. Incidence, prognostic factors and impact of postoperative delirium after major vascular surgery: A meta-analysis and systematic review. Vasc. Med. 2017, 22, 387–397. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Alvarez-Bastidas, L.; Morales-Vera, E.; Valle-Leal, J.G.; Marroquín González, J. Delirio en el adulto mayor sometido a anestesia: Factores asociados. Colomb. J. Anesthesiol. 2018, 46, 273–278. [Google Scholar]
- Nazemi, A.K.; Gowd, A.K.; Carmouche, J.J.; Kates, S.L.; Albert, T.J.; Behrend, C.J. Prevention and management of Postoperative Delirium in elderly patients following elective Spinal Surgery. Clin. Spine Surg. 2017, 30, 112–119. [Google Scholar] [CrossRef] [PubMed]
- Ha, A.; Krasnow, R.E.; Mossanen, M.; Nagle, R.; Hshieh, T.T.; Rudolph, J.L.; Chang, S.L. A contemporary population-based analysis of the incidence, cost, and outcomes of postoperative delirium following major urologic cancer surgeries. Urol. Oncol. Semin. Orig. Investig. 2018, 36, 341.e15–341.e22. [Google Scholar] [CrossRef]
- Calderón Rodríguez, A.; Rodríguez Castaño, R.; Alonso Marín, A. Delirio En El Paciente Anciano Ingresado En Una Unidad De Cuidados Intensivos: Una Complicación Frecuente; Asunivep: Almería, Spain, 2018; pp. 17–24. [Google Scholar]
- Steiner, L.A. Postoperative delirium. Part 2: Detection, prevention and treatment. Eur. J. Anesthesiol. 2011, 28, 723–732. [Google Scholar] [CrossRef]
- Fukata, S.; Kawabata, Y.; Fujishiro, K.; Kitagawa, Y.; Kuroiwa, K.; Akiyama, H.; Takemura, M.; Ando, M.; Hattori, H. Haloperidol prophylaxis for preventing aggravation of postoperative delirium in elderly patients: A randomized, open label prospective trial. Surg. Today 2016, 47, 815–826. [Google Scholar] [CrossRef]
- Rincón Franco, I.; Cortés Pomar, J.F. Utilidad del Índice Biespectral (BIS) en Delirio Posoperatorio en Pacientes Con Déficit Neurocognositivo de la Fundación Cardioinfantil; Universidad del Rosario, Fundación Cardioinfantil-Instituto de Cardiología: Bogotá, Colombia, 2017. [Google Scholar]
- Shankar, P.; Mueller, A.; Packiasabapathy, S.; Gasangwa, D.; Patxot, M.; Gara, B.O.; Shaefi, S.; Marcantonio, E.R.; Subramaniam, B. Dexmedetomidine and intravenous acetaminophen for the prevention of postoperative delirium following cardiac surgery (Dexacet trial): Protocol for a prospective randomized controlled trial. Trials 2018, 19, 326. [Google Scholar] [CrossRef] [Green Version]
- Koskderelioglu, A.; Onder, O.; Gucuyener, M.; Altay, T.; Kayali, C.; Gedizlioglu, M. Screening for postoperative delirium in patients with acute hip fracture: Assessment of predictive factors. Geriatr. Gerontol. Int. 2017, 17, 919–924. [Google Scholar] [CrossRef]
- Winter, A.; Steurer, M.P.; Dullenkopf, A. Postoperative delirium assessed by post anesthesia care unit staff utilizing the Nursing Delirium Screening Scale: A prospective observational study of 1000 patients in a single Swiss institution. BMC Anesthesiol. 2015, 15, 184. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- JSmith, P.; K Attix, D.; Weldon, B.C.G.; Monk, T. Depressive Symptoms and Risk of Postoperative Delirium. Am. J. Geriatr. Psychiatry 2016, 24, 232–238. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hernandez, B.A.; Lindroth, H.; Rowley, P.; Boncyk, C.; Raz, A.; Gaskell, A.; García, P.S.; Sleigh, J.; Sanders, R.D. Post-anaesthesia care unit delirium: Incidence, risk factors and associated adverse outcomes. Br. J. Anaesth. 2012, 119, 288–290. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Järvelä, K.; Porkkala, H.; Karlsson, S.; Martikainen, T.; Selander, T.; Bendel, S. Postoperative Delirium in Cardiac Surgery Patients. J. Cardiothorac. Vasc. Anesth. 2017, 32, 1597–1602. [Google Scholar] [CrossRef] [PubMed]
- Vilchis-Rentería, J.S.; Zaragoza-Lemus, G. Déficit cognitivo en artroplastía de cadera y rodilla. Rev. Mex. Anestesiol. 2012, 35, 83–86. [Google Scholar]
- Stephani Hernández, A.; Sánchez, J. Factores anestésicos asociados con el deterioro cognitivo postoperatorio en el paciente geriátrico. Rev. Mex. Anestesiol. 2014, 37 (Suppl. S1), 349–351. [Google Scholar]
- Kassie, G.M.; Nguyen, T.A.; Kalisch, L.M.; Nicole, E.; Roughead, E.E. Do risk prediction Models for Postoperative Delirium consider patients’ preoperative medication use? Drugs Aging 2018, 35, 213–222. [Google Scholar] [CrossRef]
- Saller, T.; Hofmann-Kiefer, K.F.; Saller, I.; Zwissler, B.; Von Dossow, V. Implementation of strategies to prevent and treat postoperative delirium in the post-anesthesia caring unit A German survey of current practice. J. Clin. Monit. Comput. 2021, 35, 599–605. [Google Scholar] [CrossRef]
- González-Vaquero, M.; Carriedo-Ule, D.; Domínguez-Berrot, A.M.; González-Luengo, R.; Jiménez-García, P. Complicaciones de la reanimación cardiopulmonar asistida telefónicamente Complications of cardiopulmonary resuscitation telephone assisted. Med. Intensiv. 2015, 39, 127–129. [Google Scholar] [CrossRef]
Predisposing Factors | ||
---|---|---|
Advanced age [1,2,3,4,8,14,16,17,18,19,24,26,30,31,32,38,40,42,44,45,47,49,50,51,53,54,58,59,61,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109] Pre-existing cognitive deterioration [1,3,8,9,14,16,18,31,32,40,45,46,54,60,67,76,78,79,80,81,91,94,97,110,111,112,113,114,115,116] Pain [2,4,14,30,31,32,34,69,70,71,75,79,80,91,100,104,111,117,118,119,120,121,122] Elevated ASA score [14,19,31,38,40,42,48,49,75,84,88,118] Alcohol abuse [16,23,30,32,44,67,81,90,91,97,101,121] Hypoxemia [23,30,67,70,76,80,91] Male sex [14,18,32,39,49,51,58,87,88,101,103,122] Metabolic disturbances, Water–electrolyte imbalance [16,30,31,75,76,80,81,94] Vision impairment [8,23,32,54,78,89,97] Auditory impairment [3,32,54,78,83,89,97] Disrupted sleep patterns [2,9,16,32,70,75,76,81,91] Depression [3,32,70,78,80,89,90,91,97] Previous episodes of delirium [14,32,80,81,88,95,97] Dehydration [2,16,32,76,80,81,91] Cerebrovascular disease [26,51,57,80,81,100] Intraoperative hypotension [19,59,75,80,120] | Sepsis [16,75,76,80,81] Reduced cerebral SaO2 [14,81,90,101] Renal insufficiency [32,75,81,84,91] Intraoperative haemorrhage [19,31,32,74] Low mini-mental state score [18,29,39,56,62] Dementia [3,58,70,78,97] Diabetes Mellitus type [19,29,40,44,80,88] Low level of education [4,9,28,58,67] Hypertension [75,80,87,88] Hypotension [14,16,23,76,81] High creatinine level [29,84,100] Immobilisation [30,32,75,91] Anaemia [44,70,81,83,91] Arterial fibrillation [17,26,44,83,90] Abnormally high albumin level [3,44,60,74,100] Cerebral aging [16,81,95] Functional deficit [29,78,89,91] Malnutrition [2,3,19,91] Sensory impairments [8,70,78] Parkinson’s disease [57,95] Smoking [38,44,83,87,90,101] Haematocrit < 30% [57,81] High PCR [29,84,100] Functional dependence [32,70] Drug use [80,97] Endocrine disorders [16,94] Urinary tract infections [81,95] | Hepatic insufficiency [32,113] Respiratory infection [81,95] Hyperglycaemia [23,100] Poor nutrition [80,81] Elevated APACHE II score [25] Low Barthel index [21] Low BMI [18] Low pre-op NEECAM score [39] High Bilirubin level [101] High postoperative level of Lactic acid [83] Social isolation [95] Myocardial ischemia [81,108] Neurotransmitter/receptor dysfunction [94] Preoperative anxiety [104] Lack of familiar environment [95] Emotional stress [32] Infection of the surgical wound [81] Shock [80] Cardiopulmonary disorder [108] Gastrointestinal disorder [81] Sleep apnoea [38] Hypercapnia [76] Hyperthermia [75] Thrombocytopenia [81] COPD [81] Hypothyroidism [80] HIV [32] |
Precipitating Factors | ||
---|---|---|
Benzodiazepines [15,16,19,30,32,40,44,49,56,58,70,76,79,83,87,89,91,101,104] Cardiac surgery [32,55,70,75,76,91] Heart-lung bypass [17,84,113,116] Duration of surgery [9,16,24,28,31,44,67,79,83,100,101,103] Emergency surgery [24,55,70,75,80,96] Orthopaedic surgery [28,32,39,55,57,70,76,81,88,98] Type of surgery [18,49,67,83,95,103,104] Major transfusion [17,18,19,38,47,49,60,75,100] Admission to UCI [16,25,32,47,55,57,76,82,118] Psychotropics [46,56,58,78,90] Inhalational anaesthetic [49,65,94,101,103] | Opioids [12,49,69,75,83] Anticholinergics [32,73,76,79,81,117] Foley catheterization or other invasive procedures [16,30,32,76,91,101] General anaesthetic [58,94,119] Duration of anaesthesia [58,67,75] Loneliness [4,14,47] Analgesics [58,87] Pharmacological suppression, physical restriction [32,70] Mechanical ventilation [2,79] Duration of orotracheal intubation [17,26] Institutionalisation [78,114] | Poor family support [16,76] Fresh frozen plasma [49,96] Length of stay [14] Abdominal surgery [75] Neurovascular surgery [75] Polypharmacy [45] Balloon counter-pulsation [80] delay in emergence from anaesthesia [25] Hospitalisation [30] Urological surgery [28] GABA [73] Adrenaline [26] |
Nursing Interventions | |
---|---|
Physiological Maintain good nutrition and hydration [3,9,16,33,44,69,81,83,94,119] Manage pain adequately [7,9,10,33,34,55,59,69,82] Remove catheters promptly [3,7,9,55,79,82] Ensure adequate oxygenation [2] Manage bladder and bowel care [94] Minimize the risk of aspiration pneumonia [94] Avoid prolonged hypotension [107] Cognitive Place clocks and calendars in the patient’s room to aid in temporal reorientation [3,7,8,13,55,62,76,81,94,119] General reorientation [55,64,82,119] Cognitive stimulation [7,44,76,81,94,119] Read letters or books to the patient or show the patient family photographs [13,55] Implement strategies to help the patient differentiate between day and night by, for example, showing them pictures of the sun or moon [7,55] Use music [7,55] Give the patient access to objects that will help them orient themselves [119] Encourage reading, watching TV, and listening to music [7,55] Place objects such as photographs where they are easily visible to the patient [55] Avoid excessive perioperative and postoperative sedation [2] Behavioural Reduce preoperative anxiety [107] Give psychosocial support [16] Show concern and empathy; listen attentively [55] Do not dismiss concerns expressed by the patient [107] Offer realistic solutions and avoid threats [55] Use open questions and try to discover the source of patient concerns Be assertive; use sentences that are short and clear [107] Use acupuncture and acupressure (at the “Shenmen” and “Point Zero” auricular acupuncture points) [107] | Sensory Maintain a good level of illumination [7,13,55,62,70,76,79,94,119] Facilitate the use of hearing aids at an early stage [3,7,33,55,62,69,76,79,102,119] Facilitate the use of glasses [3,7,11,13,62,69,79,102] Avoid excessive noise [3,7,33,55,81,95,119] Facilitate the use of dentures [10,13,50] Visual and auditory stimulation [76,81] Avoid artificial lighting [81,82] Sleep and Environment Establish a daily routine in order to prevent disruption of the sleep–wake cycle [13,81,95] Where possible, avoid the administration of medication or the taking of vital signs during the night [55,64,81] Adjust routines in order to ensure uninterrupted sleep [119] Back massage [46,119] Enable the patient to obtain adequate rest [11,35] Give the patient peace and quiet and maintain a pleasant environment (without unwanted noise or visits) [55,95] Enquire as to whether the patient was already taking medication to aid sleep [119] Allow a warm milky drink to be taken before sleep [46] Provide warm drinks for the patient [119] Family involvement Involve the patient’s family [10,55,62,64,69] Avoid changes in personnel [13,62,94] Allow the family to be present at meal-times [7,55] It may be necessary to require a family member or someone who is close to accompany the elderly patient [95] Use carers’ names [119] Patient Safety and Skin Integrity Where possible, avoid mechanical restraints [2,16,55,64,79,81,95,119] Promote early mobility [3,7,10,33,34,44,55,59,69,76,82,95] Walking or directed exercise at least three times daily [7,55,76,119] Protect the patient from falls [94] Care of pressure points [2,94] |
Effective Pharmacological Treatments | ||
---|---|---|
Haloperidol [8,9,11,15,16,33,47,54,64,70,74,78,81,89,92,94,97,102] Dexmedetomidine [8,10,11,15,16,33,37,47,54,64,70,78,81,89,94,97,102] Benzodiazepines [3,10,87,89,91] Olanzapine [9,10,11,15,47,75,82,97,115] Quetiapine [11,47,64,70,74,75,78,81,97,115] Risperidone [9,11,43,47,64,75,81,82,89,97] Clonidine [3,107] | Chlorpromazine [87,115] Propofol [107] Melatonin [9,70,78] Hydroxyzine + Midazolam [107] Acetaminophen [117] Antipsychotics [82] Aprotinin [94,112] Peripheral nerve blocks [119] | Ziprasidone [10,82] Statins [79,97] Fentanyl [107] Ketamine [33] Levomepromazine [87] Nefopam [101] Rivastigmine [97] Sufentanil [107] |
Ineffective Pharmacological Treatments | ||
---|---|---|
Benzodiazepines [2,9,10,15,44,69,91] Melatonin [2,42,79] GABA agonists [94,112] Glutamate blockers [95,112] Haloperidol [2,64] Membrane stabilizers [95,112] Donepezil [78,79] | Dexmedetomidine [28] NMDA agonists [106] Antioxidants [15] Barbiturates [41] Ca++ or Na+ blockers [112] Gabapentin [66] Ganglioside GM1 [112] | Leukocyte adhesion inhibitors or growth factor [95] Ketamine [7] Nimodipine [2] Remacemide [112] Rivastigmine [79] Tryptophan [111] |
Number | Authors | Year | Evidence and Quality | Number | Authors | Year | Evidence and Quality |
---|---|---|---|---|---|---|---|
1 | Evered et al. | 2018 | I A | 61 | An et al. | 2018 | II A |
2 | De las Pozas Abril et al. | 2011 | I A | 62 | Chung-Sik et al. | 2016 | III A |
3 | Honda et al. | 2018 | III A | 63 | Rodríguez Soto et al. | 2015 | V C |
4 | Styra et al. | 2018 | III A | 64 | Alcoba Pérez et al. | 2014 | III A |
5 | Shawna Greiner et al. | 2019 | I A | 65 | Duarte Martinez et al. | 2018 | V A |
6 | Artuz Diaz et al. | 2016 | II A | 66 | Dearholt et al. | 2012 | I A |
7 | Card et al. | 2014 | III A | 67 | Ewan et al. | 2010 | I A |
8 | Pavone et al. | 2018 | III A | 68 | Koster et al. | 2010 | I A |
9 | Wang et al. | 2018 | III A | 69 | Vásquez-Marquez et al. | 2011 | V B |
10 | Sosa Morales et al. | 2017 | III A | 70 | Steiner et al. | 2011 | V A |
11 | Rodríguez et al. | 2017 | III A | 71 | Renger et al. | 2018 | III B |
12 | Miller et al. | 2018 | I A | 72 | Gräsner et al. | 2016 | I A |
13 | Punjasawadwong et al. | 2018 | I A | 73 | Huang et al. | 2019 | I A |
14 | Carrera Castro et al. | 2014 | IV A | 74 | Mei et al. | 2016 | III B |
15 | Dotti et al. | 2017 | III B | 75 | The American Geriatrics Society. | 2015 | II A |
16 | Van Grootven et al. | 2015 | III B | 76 | Vásquez-Marquez et al. | 2012 | V B |
17 | Guo et al. | 2016 | II A | 77 | Jia et al. | 2014 | I A |
18 | Fields et al. | 2018 | III A | 78 | Mosk et al. | 2018 | III A |
19 | Hesse et al. | 2018 | III A | 79 | Read et al. | 2017 | V C |
20 | Calderón Delgado et al. | 2017 | III A | 80 | Borozdina et al. | 2018 | I B |
21 | Peralta-Zamora et al. | 2012 | V B | 81 | Luo et al. | 2018 | II A |
22 | Ocádiz-Carrasco | 2013 | III A | 82 | Jee et al. | 2017 | I A |
23 | Chu et al. | 2015 | II A | 83 | Munk et al. | 2013 | III A |
24 | Aldecoa et al. | 2017 | IV A | 84 | Goins et al. | 2018 | III B |
25 | Riegger et al. | 2018 | I B | 85 | Kassie et al. | 2017 | I A |
26 | Fritz et al. | 2018 | III A | 86 | Soto Martín | 2015 | III B |
27 | Mimi et al. | 2018 | I A | 87 | Li et al. | 2017 | I A |
28 | MacKenzie et al. | 2018 | I A | 88 | González Masís et al. | 2014 | III A |
29 | Espinosa Calderón et al. | 2017 | III B | 89 | Kratz et al. | 2015 | III A |
30 | Lira et al. | 2018 | V B | 90 | Smulter et al. | 2017 | III A |
31 | Guenther et al. | 2011 | III A | 91 | Lee et al. | 2018 | III A |
32 | Guenther et al. | 2016 | III A | 92 | Chan et al. | 2018 | III A |
33 | Sanson et al. | 2018 | III A | 93 | Shin et al. | 2016 | I A |
34 | Mcdaniel et al. | 2012 | V B | 94 | Sánchez et al. | 2019 | I A |
35 | Bettelli et al. | 2017 | V B | 95 | Munk et al. | 2016 | I A |
36 | Celis et al. | 2017 | V A | 96 | Esteve et al. | 2013 | V A |
37 | Li et a. | 2017 | III A | 97 | Smulter et al. | 2019 | III B |
38 | Lee et al. | 2013 | III B | 98 | Lee et al. | 2019 | I A |
39 | Fok et al. | 2015 | I A | 99 | Carranza Salas et al. | 2017 | III A |
40 | Dong et al. | 2017 | III A | 100 | Wen et al. | 2018 | II A |
41 | Marcantonio et al. | 2017 | V A | 101 | Subramaniam et al. | 2019 | I A |
42 | Nuñez Ureña et al. | 2017 | III B | 102 | Veiga et al. | 2012 | III A |
43 | Hempenius et al. | 2014 | III A | 103 | Wang et al. | 2018 | I A |
44 | Dan et al. | 2017 | I B | 104 | Aitken et al. | 2017 | II A |
45 | Cheol et al. | 2018 | I A | 105 | Alvarez-bastidas et al. | 2018 | III C |
46 | Nadler et al. | 2017 | I B | 106 | Nazemi et al. | 2017 | I B |
47 | Van Der Sluis et al. | 2016 | IIA | 107 | Ha et al. | 2018 | III A |
48 | Kang et al. | 2019 | III A | 108 | Calderón Rodríguez et al. | 2018 | V B |
49 | Xing et al. | 2016 | III A | 109 | Steiner et al. | 2012 | V A |
50 | Deiner et al. | 2017 | I A | 110 | Fukata et al. | 2016 | II A |
51 | Chevillon et al. | 2015 | I A | 111 | Rincon Franco et al. | 2017 | I A |
52 | Guo et al. | 2016 | IIA | 112 | Shankar et al. | 2018 | I A |
53 | Chacón Zamora et al. | 2014 | V C | 113 | Koskderelioglu et al. | 2017 | III A |
54 | Romero Luna et al. | 2014 | III B | 114 | Winter et al. | 2015 | III A |
55 | Jimenez Ardila et al. | 2013 | IV A | 115 | J. Smith et al. | 2016 | III C |
56 | Van Meenen et al. | 2014 | II A | 116 | Hernández et al. | 2012 | III C |
57 | Ogawa et al. | 2017 | III A | 117 | Järvelä et al. | 2017 | III B |
58 | Duan et al. | 2018 | I A | 118 | Vilchis-rentería et al. | 2012 | V B |
59 | Langer et al. | 2019 | I A | 119 | Stephani Hernández et al. | 2014 | III A |
60 | Popp et al. | 2012 | V A | 120 | Kassie et al. | 2018 | II A |
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Méndez-Martínez, C.; Fernández-Martínez, M.N.; García-Suárez, M.; Martínez-Isasi, S.; Fernández-Fernández, J.A.; Fernández-García, D. Related Factors and Treatment of Postoperative Delirium in Old Adult Patients: An Integrative Review. Healthcare 2021, 9, 1103. https://doi.org/10.3390/healthcare9091103
Méndez-Martínez C, Fernández-Martínez MN, García-Suárez M, Martínez-Isasi S, Fernández-Fernández JA, Fernández-García D. Related Factors and Treatment of Postoperative Delirium in Old Adult Patients: An Integrative Review. Healthcare. 2021; 9(9):1103. https://doi.org/10.3390/healthcare9091103
Chicago/Turabian StyleMéndez-Martínez, Carlos, María Nélida Fernández-Martínez, Mario García-Suárez, Santiago Martínez-Isasi, Jesús Antonio Fernández-Fernández, and Daniel Fernández-García. 2021. "Related Factors and Treatment of Postoperative Delirium in Old Adult Patients: An Integrative Review" Healthcare 9, no. 9: 1103. https://doi.org/10.3390/healthcare9091103