Postoperative Delirium in Elderly Patients

Postoperative Delirium is defined as an "acute confusional state characterised by inattention, abnormal level of consciousness, thought disorganisation, and a fluctuating course".¹ The incidence of postoperative delirium in clinical trials varies from 4-66%.^2,3 Patient-specific and iatrogenic factors may place patients at greater risk.⁴

Common complications of perioperative care are neurobehavioural disturbances, which can occur in three distinct forms:

• Emergence Delirium: occurs on emergence from anaesthesia and sedation, with no lucid interval for approximately 30 minutes;
• Postoperative Cognitive Decline: subtle cognitive impairment of attention and memory;
• Postoperative Delirium: which is the most severe occurs on emergence from anaesthesia and sedation, with or without lucidintervals, for approximately a couple of hours or longer.

Patients suffering postoperative delirium have a 2 to 4 times greater odds of dying in the hospital,^5,6 2 times greater odds of dying within 3 months,⁷ and 2.5 to 5 times greater odds of dying within 6 months compared to patients without postoperative delirium.^5,6,8

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