• Ezinne O Igwe, Jessica Nealon, Mohammed Mohammed, Blake Hickey, Kuei-Ru Chou, Kee-Hsin Chen, and Victoria Traynor.
• Faculty of Science, Medicine and Health, University of Wollongong, NSW 2522, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, NSW 2522, Australia. Electronic address: ekorie@uow.edu.au.
• J Clin Anesth. 2020 Dec 1; 67: 110004.

Study ObjectiveAn 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.MethodsA 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.ResultsThis 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.ConclusionThere 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.Copyright © 2020 Elsevier Inc. All rights reserved.

15 keywords...

hide…