Toronto clinic looks to prevent delirium in high-risk patients

If you’re looking for a model to handle the devastating but all-too-common complication of postoperative neurocognitive disorders (P-NCD, popularly known as delirium) experienced by your patients, some friends to our north have created a program that might be of interest.

Toronto’s Sunnybrook Health Sciences Centre this month welcomed the first patient to its new Perioperative Cognition Clinic, which it has established in partnership with its Hurvitz Brain Sciences Program, Integrated Surgical Program, Harquail Centre for Neuromodulation and Perioperative Brain Health Centre. Sunnybrook says the clinic is the first of its kind in Canada.

Sunnybrook says that while P-NCDs can impact anyone who has had a surgery, the patient’s age and the type of surgery can increase the risk. “P-NCDs can occur due to a sudden change to an individual’s mental state that can include confusion, agitation, or complete withdrawal, which can happen after surgery,” it explains about the condition, which it says is frequently missed of misdiagnosed by providers, and can lead to “reduced quality of life, prolonged hospital stays and loss of independence.”

Sunnybrook says its Perioperative Cognition Clinic will care for “high-risk perioperative patients from the beginning to end of their surgical journey, in hopes of faster recovery and preventing complications from P-NCDs.”

Howard Meng, MD, FRCPC, director of pain and anesthesiologist at Sunnybrook’s Department of Anesthesiology and Pain Medicine, and the co-leader of the Perioperative Cognition Clinic, says the facility will support patients by using “established prevention strategies and necessary follow-up care” to provide “holistic care to promote better physical and cognitive health.”

The clinic’s integrated-care approach is modelled after the Sunnybrook-led Redesigning the Surgical Pathway (PROMoTE) Study, which is testing if “participation in a delirium-reduction program during the perioperative period will reduce delirium in older surgical patients.”

Learn more about the program here.