Outpatient Surgery Magazine - Subscribers

Running on Empty - Outpatient Surgery Magazine - August 2019

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://magazine.outpatientsurgery.net/i/1153559

Contents of this Issue


Page 108 of 116

post-op delirium. You can use that information to bolster their health before surgery and ensure post-op actions (like reorientation and mobi- lization) are prioritized to prevent delirium. Let's take a quick look at these screening tools. • NSQIP risk calculator. This free online tool estimates a patient's risk of suffering surgical complications based on several baseline vari- ables, including age, sex, BMI, physical function and comorbidities (riskcalculator.facs.org). The calculator combines a patient's base- line risk with the anticipated physical insult of specific surgeries, and calculates an overall risk percentage score for serious complications. Patients with NSQIP risk scores of 21% or greater are at risk of experi- encing moderate to severe delirium, with higher numbers associated with more severe forms of the condition. • TMT Part B. There's a proven association between pre-op execu- tive function — a measure of attention level and problem-solving abil- ities — and incidence of post-op delirium. This test, which measures executive function, consists of 25 circles containing numbers (1 to 13) and letters (A to L). Patients must draw a line connecting the circles in ascending order, alternating between numbers and letters. (1-A-2-B- 3-C and so on). The longer it takes patients to complete the test, the worse their executive function; an average score is 75 seconds and a deficient score is longer than 273 seconds. The screening tool is avail- able as an easy-to-administer iPad app (osmag.net/QKJwG7). The higher the scores of the 2 tests, the higher the risk of the patient experiencing severe delirium after surgery. Using the tests in combination is not a perfect predictor of how severe post-op delirium will be, but it's an improvement over current screening methods, which focus on older adults with dementia-level cognitive impairment. Those patients are indeed at the highest risk of suffer- ing severe post-op delirium, but focusing on those individuals A U G U S T 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • < # >

Articles in this issue

Links on this page

Archives of this issue

view archives of Outpatient Surgery Magazine - Subscribers - Running on Empty - Outpatient Surgery Magazine - August 2019