The increasing focus on postoperative delirium (POD) in oral and maxillofacial surgery reflects the expanding treatment options available for elderly and frail patients. As medical technology advances, the need to understand the correlation between POD and these surgeries becomes more critical. A scoping review conducted recently offers a comprehensive overview of the screening and management protocols for POD, highlighting the importance of identifying risk factors and implementing preventive measures.
Methodology and Scope
Following the Scoping Review extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR), researchers conducted an extensive literature search on POD in oral and maxillofacial surgery. The review spanned articles published from 2002 to 2023, emphasizing the need to understand the occurrence and management of delirium in this specialized field. Registered with the Open Science Framework, the review applied stringent inclusion criteria, narrowing down from 644 articles to 68 that met the requirements.
Key Findings
The review uncovered significant heterogeneity in the methods used to diagnose POD. Multiple risk factors influencing POD were identified across different phases of surgery—preoperative, intraoperative, and postoperative. These findings resulted in the creation of a clinical prediction list, which is crucial for medical professionals to preoperatively identify at-risk patients. Moreover, the review stressed the need for modifying these risks throughout the patient’s hospital stay.
The analysis also highlighted the importance of nonpharmacological preventive measures. These strategies, tailored for patients susceptible to delirium, aim to reduce the incidence of POD significantly. This focus on nonpharmacological interventions underscores the need for a holistic approach in managing at-risk patients, emphasizing the role of comprehensive care in improving patient outcomes.
Market Access Insights
Several valuable inferences can be drawn from the review, particularly regarding market access:
- Standardizing screening and management protocols can enhance the marketability of medical devices and pharmaceuticals aimed at preventing POD.
- Identifying risk factors and integrating them into clinical practice may lead to the development of specialized tools and software, creating new market opportunities.
- Nonpharmacological interventions can be commercialized as part of comprehensive care packages, appealing to hospitals and care facilities focusing on elderly and frail patients.
The research points to the critical role of developing standardized specialty-specific protocols. These protocols should incorporate validated assessment tools, addressing a broad spectrum of risk factors associated with POD. Future studies are encouraged to delve deeper into this area to create robust guidelines that medical professionals can rely on, ultimately improving patient care in oral and maxillofacial surgery.
Original Article:
Head Face Med. 2024 Jul 23;20(1):39. doi: 10.1186/s13005-024-00439-9.
ABSTRACT
BACKGROUND: Postoperative delirium (POD) in the oral and maxillofacial settings has gained more attention in recent decades. Due to advances in medical technology, treatment possibilities have expanded treatment for elderly and frail patients. This scoping review explores the correlation between POD and oral and maxillofacial surgery, summarizing screening and management protocols and identifying risk factors in this surgical field.
METHODS: This review follows the Scoping Review extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR). A comprehensive literature search was performed using multiple databases, focusing on articles published from 2002 to 2023 that discuss delirium in oral and maxillofacial surgery settings. The review was registered beforehand in the Open Science Framework ( https://osf.io/r2ebc ).
RESULTS: From the initial 644 articles, 68 met the inclusion criteria. These studies highlighted the significant heterogeneity in POD diagnosis methods. The review identifies multiple risk factors across the preoperative, intraoperative, and postoperative phases that influence the occurrence of POD. Significant and independent risk factors in multiple regression analysis were highlighted, creating a clinical prediction list for the occurrence of POD.
CONCLUSION: It is crucial to preoperatively identify patients at risk for POD and actively modify these risks throughout the patient’s hospital stay. Implementing nonpharmacological preventive measures for at-risk patients is recommended to decrease the incidence of POD. Future research should focus on creating standardized specialty-specific protocols incorporating validated assessment tools and addressing the full spectrum of risk factors associated with POD.
PMID:39044223 | DOI:10.1186/s13005-024-00439-9
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