Perioperative Brain Health Centre

Delirium:

• Disturbance in consciousness with reduced ability to focus, sustain, or shift attention
• Change in memory, language or orientation, or development ofa perceptual disturbance not explained bya pre-existing, established, or evolving dementia
• Disturbance develops over a short period of time (usually hours to days) and tends to fluctuate during the day
• Caused by direct physiological consequences of a general medical condition

Delirium by the numbers:

• 12-51% post-operative
• 19-82% intensive care
• 20-56% nursing home
• 47% palliative care
• 27% stroke units
• 8-17% emergency room

Risks

Delirium increases:

• odds of dying in hospital by 2-4X
• odds of dying within 6 months by 2.5-5X
• length of hospital stay by 2X
• risk of being re-admitted to the hospital by 2X
• rates of cognitive decline and dementia up to 41X

Delirium is expensive:

• it costs one Toronto hospital an estimated $17 million dollars a year from 'increased length of stay' alone

Delirium can be prevented:

• 30-40% of delirium cases can be prevented

Using the CHASM care plan for the prevention and management of delirium, a series of interventions in the following areas:

C - Cognition and perception

H - Hydration

A - Agitation

S - Sleep-wake cycle

M - Mobility

Brought to you by the:

Perioperative Brain Health Centre at Sunnybrook