未经证实:术后谵妄是老年手术后发病率最高、危及生命的并发症。根据通常在麻醉后护理单元开始并持续到手术后5天的手术类型,住院手术患者的总发病率从5%到52%不等。术后谵妄表现为不活跃,过度活跃和混合亚型。谵妄的发病机制尚不明确,但人们公认,谵妄是患者潜在的脆弱性或危险因素与感染或手术等外部压力源相结合的结果。
UNASSIGNED:为了制定基于证据的预防建议,诊断,术后谵妄的治疗。
未经授权:从PubMed搜索文献,CINAH,谷歌学者,以及2010年至2021年通过制定纳入和排除标准发布的Cochrane数据库。过滤是根据方法学质量进行的,结果,和人口数据。最后,11元分析,11个系统审查,7项介入研究,11项观察性研究,本综述包括美国和欧洲以前制定的临床实践指南的建议。
未经评估:本次评估共考虑了43项研究。该指南的制定基于9项关于术后谵妄风险分层的研究,18项关于术后谵妄风险最小化和预防的研究,关于术后谵妄诊断的五项研究,11项关于术后谵妄治疗的研究。
未经评估:术后谵妄管理可分为风险评估,风险最小化,早期诊断,和治疗。早期诊断对于触发集中和有效的治疗至关重要。非药物干预措施是术后活跃和过度活跃的一线管理,同时考虑了促成因素和根本原因。抗精神病药物只能用于试图伤害自己的过度活跃的谵妄个体。目前的证据表明右美托咪定可作为术后谵妄的治疗选择。
UNASSIGNED: Postoperative delirium is the highest prevalence and life-threatening complication following geriatric surgery. The overall incidence rate varies from 5% to 52% of hospitalized surgical patients based on the type of surgery that often began in the postanesthesia care unit and continues up to 5 days post-surgery. Postoperative delirium manifests as a hypoactive, hyperactive and mixed subtype. The mechanism of delirium development is not clear, but it is accepted that delirium is a result of the patient\'s underlying vulnerabilities or risk factors combined with an outside stressor such as infection or surgery.
UNASSIGNED: To develop evidence-based recommendations for the prevention, diagnosis, and treatment of postoperative delirium.
UNASSIGNED: Literature was searched from PubMed, CINAH, Google Scholar, and Cochrane databases that are published from 2010 to 2021 by formulating inclusion and exclusion criteria. Filtering was made depending on methodological quality, outcome, and data on population. Finally, 11 meta-analysis, 11 systematic reviews, 7 interventional studies, 11 observational studies, and recommendations of the previous clinical practice
guideline developed by the American and European are included in this review.
UNASSIGNED: A total of 43 studies were considered in this evaluation. The development of this
guideline was based on nine studies on risk stratification for postoperative delirium, eighteen studies on risk minimization and prevention for postoperative delirium, five studies on diagnosis for postoperative delirium, and eleven studies on treatments for postoperative delirium.
UNASSIGNED: Postoperative delirium management can be categorized into risk assessment, risk minimization, early diagnosis, and treatment. Early diagnosis is critical to trigger focused and effective treatment. Non-pharmacological interventions are the first-line management for both hypoactive and hyperactive postoperative with considering contributory factors and underlying causes. Antipsychotics should only be used for hyperactive delirium individuals who try to harm themselves. Current evidence suggested that dexmedetomidine can be used as a treatment option for postoperative delirium.