Postoperative Delirium in Patients Undergoing Total Joint Arthroplasty: A Systematic Review
Section snippets
Eligibility Criteria
Original studies that were conducted on the epidemiology, causative factors, risk profiles and prevention strategies in patients suffering from postoperative delirium following total joint arthroplasty were considered for this review. The American Psychiatric Association’s Diagnostic and Statistical Manual, 4th edition (DSM-IV) definition for delirium was adopted for this study. The DSM-IV lists four key features that characterize delirium [6]: (1) disturbance of consciousness with reduced
Incidence of Postoperative Delirium in Patients Undergoing TJA
The studies included in this systematic review (Table 1) suggest that the incidence of postoperative delirium in patients undergoing TJA of the hip or knee ranges from 0% to 10%. The 3 studies 3., 9., 13. that reported an incidence are prospective cohort studies. The respective incidences reported by these studies are 7%, 10% and 5%. 1 study utilized the mini-mental state examination (MMSE) [16] to determine delirium while 2 studies utilized the confusion assessment model (CAM) [17]. The study
Discussion
Orthopedic surgeons and healthcare institutions continue to strive to improve the efficiency of care associated with TJA as well as to reduce the incidence of perioperative morbidity and mortality. Advances in operative techniques and perioperative anesthetic care have made TJA a safe and reliable procedure to alleviate pain and restore function in patients with arthritis. However, there remain a group of patients, especially elderly ones, who remain at risk of developing postoperative delirium
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2022, KneeCitation Excerpt :However, quite a few postoperative patients suffer from postoperative complications. Postoperative delirium is one of the common complications after TKA, resulting in heavy burdens on individuals and society [1]. Delirium is an acute and fluctuating alteration of mental state characterized by the disturbance of consciousness, cognitive function, or perception.
Postoperative delirium following total joint arthroplasties in a multi-ethnic population – A prospective observational study
2021, KneeCitation Excerpt :While patients in our study did not undergo fast-rack surgery, the opioid-reducing protocol and early mobilization strategies adopted in our institution is in line with the fast-track methodology. As use of opioids is known to be an independent risk factor for POD, the perioperative patient management strategies in our instituted could have mitigated the overall risk [10]. The modality of anaesthesia is another modifiable risk factor that has also been associated with the development of POD [10,29,35].
No author associated with this paper has disclosed any potential or pertinent conflicts which may be perceived to have impending conflict with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2015.03.012.