Preoperative Cognitive Assessment Recommendations for the Older Adult.

Purpose: The purpose of this project was to identify the need for and to improve the preoperative cognitive assessment of the older adult.

Design: A retrospective chart review was used to explore the incidence of postoperative delirium (PD) and characteristics associated with it.

Methods: A retrospective chart review was used to identify the incidence of PD in a community hospital. The data were analyzed using descriptive statistics for trends in demographic and physiological characteristics of older adults undergoing elective hip or knee surgery.

Findings: The incidence of PD was found to be 11%. Older adults with PD had an increased mean age and comorbid conditions. PD was associated with a mean increase in hospital stay, postoperative complications, and 30-day readmission.

Conclusions: Preoperative cognitive assessment can identify high-risk patients, stratify care, medically optimize the older adult before surgery, and improve perioperative outcomes.