title: Recognizing encephalopathy and delirium in the cardiopulmonary rehabilitation setting.
abstract: OBJECTIVE
  This article reviews the prevalence, underlying mechanisms, and challenges of treating encephalopathy and delirium in the postsurgical and medically compromised cardiopulmonary patient receiving services on an acute inpatient rehabilitation unit. Additionally, pertinent information is provided on conducting an evaluation to assess for neurocognitive sequelae of the above-mentioned conditions to help achieve better treatment outcomes.
  
  
  METHODS
  Review of the medical and neuropsychology literature is provided along with 2 case reports to illustrate evaluation of a persisting toxic-metabolic encephalopathy and a resolving delirium and the treatment team's effectiveness in producing a more optimal treatment outcome. The unique role of the rehabilitation psychologist, special treatment considerations, and the importance of integrated follow-up neurorehabilitation services for the cardiopulmonary patient and caregivers also are emphasized.
  
  
  RESULTS
  Encephalopathy and delirium are 2 related, but somewhat different, conditions that can emerge postoperatively, any time during acute care hospitalization, and often enough, during impatient or subacute-care rehabilitation. Their association with long-term harm and poor outcome warrant early identification and immediate medical intervention.
  
  
  CONCLUSIONS
  Encephalopathy and delirium can significantly affect rehabilitation outcomes and, as such, rehabilitation psychologists are encouraged to systematically screen for the presence of delirium and encephalopathy in the cardiopulmonary rehabilitation setting so to enhance treatment efficacy and quality of life in affected individuals.
authors.affiliation: Rusk Rehabilitation.
authors.forename: William J
authors.initials: WJ
authors.lastname: Waked
authors.affiliation: Rusk Rehabilitation.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Gordon
authors.affiliation: Rusk Rehabilitation.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Whiteson
authors.affiliation: Department of Psychology, Pace University.
authors.forename: Erika M
authors.initials: EM
authors.lastname: Baron
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D003693:Delirium / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D007297:Inpatients; D011183:Postoperative Complications / Q000175:diagnosis* / Q000523:psychology