As mentioned in our colleagues’ impressive article, such a concept has been in place at our hospital for years and we have succeeded in permanently integrating interdisciplinary measures into standard care. Prompted by the experiences we had gathered since 2001 and knowing that the awareness of the importance of these measures among all healthcare professionals involved is not given at all times, a “Department of Perioperative Geriatric Medicine“ was established (1).
The insight that the number of patients experiencing postoperative delirium can be reduced with appropriate measures is not new and the health care professionals working with these patients are familiar with it. However, what is missing is the awareness of how much these measures can contribute to a better quality of life for these patients. If not enough awareness has been raised among the healthcare professionals involved, their acceptance of these measures will be low, and it does not come as a surprise that attempts to establish these essentially simple measures universally in the daily hospital routine often fail.
This article shows that our success is by no means a welcome development in just a single hospital, but can definitely be reproduced at other hospitals.
Thankfully, the authors mention the fact that delirium prolongs the length of hospital stays. Apart from conflict-ridden hospital courses (patients with delirium are at risk for further complications), delirium is a cost factor in itself—the increased demand on resources is not paid for. There is good evidence to support the cost effectiveness of the measures established at our hospital—maybe this is another incentive to dive deeper into the topic of “delirium“.
In addition, this topic is increasingly covered by the media, and patients confront us with their concerns about cognitive deficits. This should encourage all healthcare professionals involved in the perioperative management of these high-risk patients to test and rigorously pursue the establishment of such measures where they work.
Dr. med. Simone Gurlit
Abteilung für Perioperative Altersmedizin; Simone.email@example.com
Prof. Dr. med. Michael Möllmann, Klinik für Anästhesie und operative Intensivmedizin
Dipl.-Kfm. Burkhard Nolte, St. Franziskus-Hospital Münster
Conflict of interest statement
Dr. Gurlit has received fees for conference participation and reimbursement of travel and accommodation expenses from Orion. She has received payment for preparing continuing medical education events from Abbvie.
Prof. Möllmann and Dipl.-Kfm. Nolte declare that no conflict of interest exists.
|1.||Ministerium für Gesundheit, Emanzipation, Pflege und Alter NRW: Der alte Mensch im OP. Praktische Anregungen zur besseren Versorgung und Verhinderung eines perioperativen Altersdelirs. Broschüre zu beziehen über www.mgepa.nrw.de.|
|2.||Kratz T, Heinrich M, Schlauß E, Diefenbacher A: The prevention of postoperative delirium—a prospective intervention with psychogeriatric liaison on surgical wards in a general hospital. Dtsch Arztebl Int 2015; 112: 289–96 VOLLTEXT|