Postoperative Delirium

The incidence of postoperative delirium (POD) is high, and the prevalence increases with the severity of the surgical effort. Many risk factors are implicated in the genesis of postoperative delirium, and among these, an important role is given by age, associated comorbidities, the use of drugs with a high anticholinergic burden, and the presence of an underlying cognitive frailty. Some studies have also associated postoperative delirium with an increased risk of developing even severe dementia disease, up to 5 years after the postoperative delirium episode with consequent need for hospitalization in nursing home and a reduction in quality of life. Many studies and clinical practice show that delirium is a condition frequent and associated with surgery in older people. Specific clinical conditions and multiple factors (e.g., comorbidities, cognitive frailty, environment, drugs, etc.) predispose older patients at the onset of delirium. It is therefore fundamental identify and correct these elements to reduce the occurrence of the delirium and improve patient outcomes.