Tackling Post Operative Delerium (POD)

Delirium in the first week after surgery

Quick FAQs: Post Operative Delirium

  • Postoperative delirium; largest unaddressed disorder of aging

  • 2023: 5.5 million major surgery US patients ≥65

  • 25% (1.4 million patients) will have postoperative delirium this year

  • Associated costs ≥$32.9 billion, yet no approved drugs

  • Competition: No approved drugs, no industry pipeline

What is Post Operative Delirium?

Postoperative delirium is a common yet often overlooked complication that can occur after surgery. It is characterized by confusion, disorientation, and altered mental status. This condition affects many patients, especially older adults, and can have serious consequences on their recovery and overall well-being. Apart from its impact on patients’ well-being, postoperative delirium also poses a significant economic burden on healthcare systems. The lack of effective treatments for postoperative delirium is a major unmet need in healthcare today.

Prevalence and Impact

Postoperative delirium affects a substantial number of surgical patients, particularly older adults. Studies have shown that its prevalence can range from 10% to 60%, depending on various factors such as age, type of surgery, and pre-existing cognitive impairment. This high prevalence highlights the need to address the health and economic consequences associated with this condition.

Direct Healthcare Costs

Postoperative delirium increases the length and intensivity (e.g., admission to an intensive care unit) of hospital stays, leading to higher healthcare costs. Patients experiencing delirium often require extended monitoring, additional medical interventions, and specialized care. These factors contribute to increased medication usage, laboratory tests, imaging studies, and consultations with healthcare professionals. The cumulative effect of these interventions significantly amplifies the direct healthcare costs associated with postoperative delirium.

Indirect Costs

In addition to direct healthcare costs, postoperative delirium also generates substantial indirect costs. Patients with delirium often experience complications, such as falls, pressure ulcers, or infections, which require further medical attention and treatment. These complications prolong hospital stays and necessitate additional resources, further contributing to the economic burden. Moreover, postoperative delirium can lead to functional decline and cognitive impairment, resulting in the need for long-term care facilities, rehabilitation services, and increased healthcare utilization even after discharge.

Long-Term Consequences

Postoperative delirium can have long-term consequences on patients’ cognitive function and quality of life. Cognitive impairment following delirium may persist for months or even years, leading to reduced functional independence and increased dependency on healthcare services. These long-term consequences further contribute to the economic burden by necessitating ongoing care and support.

Current efforts in Mitigating Economic Healthcare Costs

Efforts to mitigate the economic healthcare costs associated with postoperative delirium are multifaceted. Here are a few current strategies:

  1. Prevention: Implementing preoperative assessments, optimizing patients’ medical conditions, and managing medications can reduce the incidence of postoperative delirium, subsequently lowering healthcare costs.

  2. Early Detection and Intervention: Timely recognition and management of delirium can help prevent complications and reduce the length of hospital stays, leading to cost savings.

  3. Multidisciplinary Care: Collaborative efforts involving healthcare professionals from various disciplines, including geriatricians, anesthesiologists, and nurses, can improve patient outcomes and potentially reduce healthcare costs.

  4. Rehabilitation and Support: Providing appropriate rehabilitation services and support to patients with postoperative delirium can help minimize long-term cognitive impairment and reduce the need for long-term care facilities.

The Unmet need:

Even with current efforts, postoperative delirium remains a significant unmet need in healthcare today. The lack of effective treatments for this condition is a major barrier to improving patient outcomes and reducing healthcare costs. There are currently no approved drugs for postoperative delirium, and no industry pipeline (beyond Cogmotos efforts) exists for this indication. This lack of treatment options highlights the need for innovative approaches. Cogmotos addresses this unmet need by developing a novel intervention for postoperative delirium with a safe, well-studied drug (intranasal insulin) and a unique delivery platform. The combination of insulin and our proprietary device delivers insulin directly to the brain, circumventing the blood-brain barrier that prevents most candidate drugs from helping in neurological disease. This approach has the potential to improve patient outcomes and reduce healthcare costs associated with postoperative delirium.