Rengel Kimberly F, Pandharipande Pratik P, Hughes Christopher G
Department of Anesthesiology, Division of Anesthesiology Critical Care Medicine, Vanderbilt University School of Medicine, 1211 21st Avenue South, 422 MAB, Nashville, TN 37212, USA.
Department of Anesthesiology, Division of Anesthesiology Critical Care Medicine, Vanderbilt University School of Medicine, 1211 21st Avenue South, 422 MAB, Nashville, TN 37212, USA.
Anesthesiol Clin. 2019 Sep;37(3):521-536. doi: 10.1016/j.anclin.2019.04.010. Epub 2019 Jun 17.
Postoperative delirium and postoperative cognitive dysfunction (POCD) occur commonly in older adults after surgery and are frequently underrecognized. Delirium has been associated with worse outcomes, and both delirium and cognitive dysfunction increase the risk of long-term cognitive decline. Although the pathophysiology of delirium and POCD have not been clearly defined, risk factors for both include increasing age, lower levels of education, and baseline cognitive impairment. In addition, developing delirium increases the risk of POCD. This article examines interventions that may reduce the risk of developing delirium and POCD and improve long-term recovery and outcomes in the vulnerable older population.
术后谵妄和术后认知功能障碍（POCD）在老年人术后很常见，且常常未得到充分认识。谵妄与更差的预后相关，谵妄和认知功能障碍都会增加长期认知衰退的风险。尽管谵妄和POCD的病理生理学尚未明确界定，但两者的风险因素都包括年龄增长、教育程度较低和基线认知障碍。此外，发生谵妄会增加POCD的风险。本文探讨了一些干预措施，这些措施可能会降低发生谵妄和POCD的风险，并改善脆弱老年人群的长期康复和预后。
