Multi-disciplinary and pharmacological interventions to reduce post-operative delirium in elderly patients: A systematic review and meta-analysis

Ezinne O. Igwe, Jessica Nealon, Mohammed Mohammed, Blake Hickey, Kuei Ru Chou, Joyce K. Chen, Victoria Traynor

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)

Abstract

Study objective: An estimated 80% of older people undergoing surgery develop postoperative delirium (POD) making them a high-risk group. Research in this area is growing fast but there is no established consensus on strategies for POD prevention or management. A systematic review and meta-analysis were conducted to synthesise data on clinical interventions used to reduce POD among older people undergoing elective and emergency surgery. Methods: A range of database searches generated 336 papers. A total of 25 studies met the inclusion criteria and were assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The studies were undertaken across the world. Results: This review identified a range of intervention approaches: comparisons between anaesthetic and sedatives agents, medication-specific interventions and multidisciplinary models of care. Results found more consistencies across multidisciplinary interventions than the pharmacological interventions. In pooled analyses, haloperidol (OR 0.74; 95% CI (confidence interval) 0.44, 1.26) was not statistically significantly associated with reduced POD incidence any more than a placebo. Conclusion: There is a need to implement multidisciplinary interventions, as well as collaboration between clinicians on pre- and postoperative care practices regarding pharmacological interventions to more effectively reduce and manage POD in older people.

Original languageEnglish
Article number110004
JournalJournal of Clinical Anesthesia
Volume67
DOIs
Publication statusPublished - Dec 2020

Keywords

  • Guidelines
  • Meta-analysis
  • Office-based anaesthesia
  • Pharmacology in older people
  • Postoperative delirium

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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