Improving perioperative brain health: an expert consensus review of key actions for the perioperative care team.
Level 5 - mechanism / opinion, no new human data
Expert consensus review and practice guidelines without primary empirical data or systematic review analysis.
PubMed 33413977 · doi:10.1016/j.bja.2020.10.037
What was done
As part of the American Society of Anesthesiologists (ASA) Perioperative Brain Health Initiative, an international multidisciplinary expert group reviewed published best practice statements and clinical guidelines. The panel aimed to establish consensus on practical, feasible recommendations for perioperative care teams to reduce the incidence of delirium and perioperative neurocognitive disorders in patients aged 65 years and older.
What was found
The group selected six consensus action statements focusing on patient and family education, preoperative cognitive screening, postoperative delirium screening, non-pharmacological interventions, tailored pain management, and the avoidance of antipsychotics. The abstract reports no quantitative numerical findings or effect sizes.
Why it matters
Synthesizes broad literature into a prioritized, actionable set of perioperative practices to address the under-recognition and suboptimal prevention of postoperative cognitive impairment in older surgical patients.
Limits
This is an expert consensus statement rather than an empirical trial or systematic review. The abstract provides no primary data, does not detail the formal consensus methodology (e.g., Delphi rounds), and reports no measured clinical outcome improvements.
Cited by
- supports Post-operative cognitive dysfunction (POCD) is a recognized clinical concept by both the American Society of Anesthesiologists and the American Psychological Association.