Perioperative Multidisciplinary Delirium Prevention: A Longitudinal Case Report.
Perioperative Multidisciplinary Delirium Prevention: A Longitudinal Case Report.
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围手术期多学科谵妄预防：一项纵向病例报告
DOI：
10.1213/xaa.0000000000001364
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发表时间：
2021-01-14
期刊：
影响因子：
--
通讯作者：
Price CC
中科院分区：
文献类型：
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作者：
Hamlet KM;Pasternak E;Rabai F;Mufti M;Hernaiz Alonso C;Price CC
术后谵妄与认知能力加速下降、死亡率以及高昂的医疗费用相关。围手术期风险识别的重要性日益受到认可，但最佳预防策略仍在不断发展。我们回顾了一位79岁高危患者的病例，该患者在一年内进行了三次腰椎手术，其中两次术后出现谵妄，一次未出现。我们讨论了全面的术前认知评估如何成功地为围手术期决策提供信息，包括麻醉管理以及老年医学的术后多模式谵妄预防策略。该病例例证了跨学科团队的协调管理如何能够减少高危个体的术后谵妄。
Postoperative delirium is associated with accelerated cognitive decline, mortality and high healthcare costs. The importance of perioperative risk identification is increasingly recognized but optimal prevention strategies are still evolving. We review the case of an at-risk 79-year-old who had three lumbar spine surgeries within a year, two of which were complicated by postoperative delirium and one which was not. We discuss how a comprehensive preoperative cognitive assessment successfully informed perioperative decision making, including anesthetic management and postoperative multimodal delirium prevention strategies by geriatric medicine. The case exemplifies how coordinated interdisciplinary team management may reduce postoperative delirium in high risk individuals.