Postoperative Delirium in the Older Patient

Abstract

R T t p d f n s w o a d o d ostoperative delirium, an acute disorder of cognition nd attention after an operation, is among the most ommon and potentially devastating psychiatric comlications of hospitalized postoperative elderly patients. lthough possible at any time in the perioperative peiod, delirium most commonly occurs during the posturgical period and complicates hospital stays for more han 2 million older people every year. Studies show a pattern of underdiagnosis of this ondition. A survey by Ely and colleagues of more han 912 healthcare professionals, including 753 physiians, found that delirium was considered an underdiagosed condition by 78%. Despite this finding, only 0% reported that they routinely screen for delirium nd less than half of those who routinely screen indiated using a specific tool for assessment. This survey ound incongruence between the perceived significance f delirium as a serious medical problem and current ractices of assessing for this condition. In the postoperative setting, delirium has been asociated with poor cognitive and functional recovery, onger hospital stays, and greater hospital costs. In ddition, delirium in the elderly is a risk factor for nstitutionalization and morbidity. Fortunately, isks of postoperative delirium can be reduced and ecovery from delirium can be enhanced by early dentification, assessment, and treatment. This article ill review postoperative delirium with emphasis on anagement. Although evidence is scarce on treatent of delirium in postoperative older adults, several linical trials about prevention and treatment of this ondition will be included.