title: Postoperative delirium and functional decline after noncardiac surgery.
abstract: OBJECTIVE
  To determine whether delirium after noncardiac surgery is associated with functional decline 3 months postoperatively.
  
  
  METHODS
  Secondary analysis of a prospective study.
  
  
  METHODS
  Thirteen hospitals in eight countries.
  
  
  METHODS
  One thousand two hundred eighteen individuals aged 60 and older undergoing noncardiac surgery.
  
  
  METHODS
  Participants were interviewed before surgery and 3 months postoperatively using six items pertaining to social and independent function. Functional decline was determined according to a loss in function in at least one item at the 3-month assessment from baseline. Postoperatively, a trained interviewer assessed delirium daily using a standardized battery. The primary outcome of this analysis was an examination of the risk of functional decline with delirium.
  
  
  RESULTS
  Of the 948 participants who completed functional assessment at 3 months, 20% (n = 189) had a decline in function. In unadjusted analysis, postoperative delirium increased the odds of functional decline (odds ratio (OR) = 2.4, 95% confidence interval (CI) = 1.4-4.2). After adjustment for age, sex, education, cognition, and surgery duration, delirium remained associated with functional decline (OR = 2.1, 95% CI = 1.2-3.8).
  
  
  CONCLUSIONS
  Although considered an acute event, delirium can have lasting functional consequences. Clinicians should give strong consideration to preoperative delirium risk assessment, delirium prevention strategies, and delirium surveillance programs after noncardiac surgery.
authors.affiliation: Geriatric Research, Education, and Clinical Center, Veterans Affairs Boston Healthcare System, Boston, MA 02130, USA.
authors.forename: Nicky
authors.initials: N
authors.lastname: Quinlan
authors.forename: James L
authors.initials: JL
authors.lastname: Rudolph
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003693:Delirium / Q000150:complications*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies