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Age and Ageing Advance Access originally published online on March 18, 2009
Age and Ageing 2009 38(4):368-373; doi:10.1093/ageing/afp024
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© The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Review

Predicting the onset of delirium in the post-operative patient

Dean Noimark

Elderly Medicine, Royal Free Hospital, Pond Street, London, NW3 2QG, UK

Address correspondence to: D. Noimark. Tel: (+44) 0207 830 2050; Fax: (+44) 0207 830 2598. Email: zcham11{at}hotmail.com

The number of people over 65 is increasing and those over 65 requiring surgery will likewise increase. Post-operative delirium (POD) affects up to 47% of patients undergoing surgery and is more prevalent in older people. Importantly, POD is associated with increased morbidity, mortality, length of stay and care home placement. There is evidence that specialist geriatrician input reduces POD but to be cost effective, needs to target patients with increased risk for POD. Many factors have been associated with increased risk of POD, including age, cognitive impairment, gender, depression, alcohol, drug use, smoking, co-morbidity, functional status, ASA score and pre-operative biochemical and haematological abnormalities. This article reviews the literature associated with the above factors, considers frailty as a factor and also suggests that POD may be associated with rapidity of onset and severity of the insult to the patient.

Keywords: elderly, predicting, delirium, confused, surgery

Received 15 August 2008; accepted in revised form 30 January 2009.


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