What delirium follow-up is routinely offered after elective arthroplasty surgery? A survey of UK and Irish clinicians.

Abstract

Postoperative delirium (POD) is a serious complication occurring after approximately 17% of elective arthroplasty surgeries. However, it is unclear if any routine clinical follow-up services are available to patients post-discharge. This study aims to determine what routine postoperative delirium screening and documentation processes are in place and what follow-up services are currently offered. A brief online survey of multiple-choice and free-text questions was devised for clinicians in the United Kingdom (UK) and Republic of Ireland (ROI). An email invitation to complete the survey was sent to relevant clinicians in the UK and ROI by non-NHS professional bodies. Twitter was used to highlight and disseminate the survey. Of the 43 participating clinicians, 18 (42%) respondents indicated that delirium is routinely screened for after elective arthroplasty and 17 respondents stated that the 4AT tool is used. Most respondents (62%) indicated that delirium is documented upon discharge to patients’ GPs. Only 11 respondents (26%) describe routine clinical follow-up practices. These included a joint arthroplasty clinic, geriatric outpatient department and liaison psychiatry. Results of this survey suggest that a) post-arthroplasty delirium screening and documentation is not widespread and b) clinical follow-up services for delirium in the UK and ROI are neither standardised nor routine.