ABSTRACT
BACKGROUND: Postoperative delirium in the elderly is associated with increased morbidity and risk of injury. However, the opinion of attending surgeons and anes- thesiologists regarding postoperative delirium is uncer- tain, as is the prevention and treatment of the condi- tion, in Japanese hospitals. METHODS: We conducted a multicenter questionnaire survey about postoperative delirium. Survey sheets were sent to 40 hospitals belonging to the National Hospital Organization. RESULTS: Wide variation in the answers from 26 hospitals revealed no common understanding regarding the diagnosis and management of postoperative delir- ium. The incidence of postoperative delirium was reported as 20-30%. It developed on postoperative day 2, with recovery within 1 month. Age, postoperative complications, alcohol abuse, cognitive impairment, sex, and depth of anesthesia were considered to be risk fac- tors. Prevention and treatment strategies included pain control, encouraging normal sleep-wake cycles, and avoiding postoperative complications. Although phar- macologic management with haloperidol or risperidone was also adopted in many facilities, the effect was thought to be uncertain. All respondents agreed that an enormous effort was required in caring for patients with postoperative delirium. CONCLUSIONS: Prospective clinical studies are neces- sary for improving the management of elderly patients with postoperative delirium.
