Prevention of postoperative delirium through the avoidance of potentially inappropriate medications in a geriatric surgical patient

Kevin G. Burfeind, Andrés A.Tirado Navales, Brandon Michael Togioka, Katie Schenning

Research output: Contribution to journalArticlepeer-review

Abstract

We demonstrate the utility of risk stratification for postoperative delirium in geriatric patients and show that postoperative delirium can be prevented in high-risk patients when potentially inappropriate medications (PIMs) (medications that are best avoided in older adults) are avoided. In this case, a 65-year-old woman underwent two debridement procedures with similar presurgical risk for postoperative delirium. There was no risk stratification or preoperative cognitive assessment in the first procedure, she received PIMs and developed postoperative delirium. In the second procedure, PIMs were intentionally avoided and postoperative delirium did not occur. This case supports recent recommendations from the European Society of Anaesthesiology, the American Society of Anesthesiologists and the American Geriatrics Society that providers assess a patient's cognitive function and delirium risk profile preoperatively to appropriately guide perioperative management.

Original languageEnglish (US)
Article numbere240403
JournalBMJ Case Reports
Volume14
Issue number4
DOIs
StatePublished - Apr 19 2021

Keywords

  • adverse reactions
  • anaesthesia
  • delirium
  • geriatric medicine
  • surgery
  • unwanted effects

ASJC Scopus subject areas

  • Medicine(all)

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