Perioperative Neurocognitive Disorders - Postoperative Prevention Strategies

Abstract

Postoperative delirium (POD) is a common and serious complication after surgery. It is associated with increased morbidity and mortality as well as neurocognitive disorder and associated loss of autonomy and increased need for care. As professionals, it is our duty to treat our patients in a holistic individual concept with the aim to reintegrate our patients into their home and social environment afterwards. In addition to preoperative and intraoperative interventions, postoperative prevention is of particular importance. This article focuses on non-pharmacological prevention strategies to avoid postoperative delirium and neurocognitive disorder in postoperative inpatient care. It is based on the "Evidence-based and consensus-based guideline on postoperative delirium". Thus, risk factors are addressed and non-pharmacological strategies are presented, which include reorientation, mobilization and nutritional support. Interprofessional cooperation plays just as important a role as the implementation of the listed preventive measures. Finally, the modified Hospital Elder Life Program is presented, which presents and applies preventive measures as a system-oriented and interdisciplinary concept, which "prevents functional decline and allows older adults to return home at the maximal level of independence". From our point of view, the training of a professional delirium team is a future-oriented complementary measure in the treatment concept of Perioperative Neurocognitive Disorders (PND), which finds its justification as an interface in the treatment of high-risk patients.