​A small, single-facility study found that not only does delirium affect half of cardiac surgery patients, its effects may last for a year postoperatively. These findings are published in the September 2018 issue of Anesthesiology. Of the 142 patients followed, 76 were diagnosed with delirium. Researchers identified no age differences between those who developed delirium and those who did not. One month postoperatively, patients with delirium had decreased cognition and poorer scores in visuoconstruction and processing speed compared with patients who did not develop delirium. However, by one year postoperatively, the only remaining finding was decreased processing speed in those who had had postoperative delirium. One limitation of the study, the researchers note, is that they did not measure cognitive function preoperatively to more accurately assess postoperative decline. However, they also note that "preservation of cognitive status . . . after cognitive surgery is an important patient-centered goal to facilitate prompt return to presurgical function status, such as living independently with normal social engagement." A related editorial examines the relationship of postoperative delirium and cognitive dysfunction.

HRC Recommends: Delirium is a serious, acute condition that is linked to cognitive and functional decline and is associated with morbidity and mortality. Delirium is often caused by underlying clinical issues and is usually reversible. It is fairly common among older adults undergoing procedures and can be mistaken for dementia, depression, or psychosis. Risk managers should evaluate the effectiveness of their organization's processes for preventing, identifying, and treating delirium.