• Kevin G Burfeind, Andrés A Tirado Navales, Brandon Michael Togioka, and Katie Schenning.
• Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, Oregon, USA.
• BMJ Case Rep. 2021 Apr 19; 14 (4).

AbstractWe demonstrate the utility of risk stratification for postoperative delirium in geriatric patients and show that postoperative delirium can be prevented in high-risk patients when potentially inappropriate medications (PIMs) (medications that are best avoided in older adults) are avoided. In this case, a 65-year-old woman underwent two debridement procedures with similar presurgical risk for postoperative delirium. There was no risk stratification or preoperative cognitive assessment in the first procedure, she received PIMs and developed postoperative delirium. In the second procedure, PIMs were intentionally avoided and postoperative delirium did not occur. This case supports recent recommendations from the European Society of Anaesthesiology, the American Society of Anesthesiologists and the American Geriatrics Society that providers assess a patient's cognitive function and delirium risk profile preoperatively to appropriately guide perioperative management.© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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