Preoperative cognitive testing and depression screening could help healthcare professionals anticipate which older patients are at risk for postoperative delirium, new research suggests. Postoperative delirium is associated with more complications, increased mortality, and prolonged hospital stays.
In the study, 52 older adults ages 51 to 82 completed baseline screening before undergoing major noncardiac surgery requiring general anesthesia. Researchers evaluated them using the Geriatric Depression Scale-Short Form, the Trail Making Test (a measure of executive skill), and the Modified Mini-Mental State Examination-revised (a measure of general cognition). These tests can be administered by nurses before surgery in about 15 minutes.
After surgery, seven patients (13%) developed delirium. Researchers found that depression and performance of an executive task measuring sequencing and cognitive flexibility were independent predictors of postoperative delirium. They hope that their findings lead to more investigation into ways to identify susceptible patients and interventions that would reduce their risk; for example, treating depression before elective surgery.
The researchers presented their findings at an annual meeting of the American Society of Anesthesiologists in Orlando, Fla., in October.