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Preoperative Cognition Screening and Postoperative Delirium in Older Surgical Patients
People 65 years or older are having surgery later in life and are at risk of developing a major postoperative complication, delirium. The Montreal Cognitive Assessment, is a preoperative cognitive screening tool which was used to screen thirty-three older orthopedic surgical patients to reduce the incidence of this serious postoperative complication. Patients who scored below normal were identified as at risk and monitored to ascertain if identification and monitoring influenced their postoperative course. At the first postoperative visit, each patient was evaluated for falls, confusion, and the ability to follow the required postoperative home exercise program to identify an undetected episode of delirium after discharge. Of the patients screened, 34.1% (n = 14) of patients fell below the cutoff for normal cognition. Subsequent monitoring and nursing interventions may have influenced their postoperative course as there were no reported episodes of delirium in the 90-day period. Thus, preoperative screening with the Montreal Cognitive Assessment tool provides a baseline cognitive assessment and early identification of patients at higher risk for postoperative delirium, and therefore, identification of patients at risk for postoperative delirium may allow for early interventions and decrease postoperative delirium....