Preoperative discussion with patients about delirium risk: are we doing enough?
Postoperative delirium is a common complication in the older surgical population, occurring in 10-50 % of cases. It is thought to be more common if an individual is identified as frail. Postoperative delirium is associated with poor outcome including higher mortality rates, prolonged length of hospital stay, increased care needs on discharge and longer term post-traumatic stress disorder. Guidelines from the American Geriatric Society and the National Institute for Health and Care Excellence highlight the importance of risk assessment at the time of the preoperative visit. This enables the perioperative team to plan a care pathway that minimises the risk of delirium occurring postoperatively. Risk assessment also informs a discussion with patient and family regarding their risk, as part of a process of informed patient consent. This is an essential step in conforming to current legal and General Medical Council guidance on the process of consent.
Department of Critical Care, University College Hospital, T03, 3RD floor, 235 Euston Road, London, NW1 2BU UK.
Judith H
JH
Tomlinson
Proactive care of Older People undergoing Surgery (POPS), Department of Ageing and Health, St Thomas' Hospital, 9th Floor North Wing, Westminster Bridge Road, London, SE1 7EH UK.
Judith S L
JS
Partridge
Delirium; Informed consent; Postoperative complications; Preoperative risk assessment; Shared decision-making