Content uploaded by V. Franklin Sechriest II
All content in this area was uploaded by V. Franklin Sechriest II on Jun 19, 2021
Content may be subject to copyright.
TEMPLATE DESIGN © 2008
David Supinski BA 1, Kelsey L. Wise MD 1, 2, Shanon Harper DNP 2, V.F. Sechriest MD 1, 2,
1 Minneapolis VA Department of Orthopeadic Surgery1, University of Minnesota Department of Orthopeadic Surgery2
•Postoperative delirium is a common complication
in the elderly.1
•Risk factors include age, cognitive impairment,
psychotropic medications, and sensory
impairment, all of which are common in the
•Little is known about the incidence of delirium after
patients undergo ambulatory surgery.
•Investigate prevalence of risk factors for
postoperative delirium in patients undergoing
ambulatory orthopedic surgery in a VA setting.
•Establish protocols for screening, education, and
prevention of postoperative delirium for patients
undergoing ambulatory orthopedic surgery.
Investigation of Postoperative Delirium in the Setting of
Ambulatory Surgery in a US Veteran Population
Brittney Betcher and Emily Grimshaw for their help with enrolling patients and
providing education materials prior to surgery.
•73% of patients had at least 1 risk factor, 51%
have 2 or more, 38% have 3 or more.
•The most common risk factors were depression,
antidepressants, sleep deprivation/disturbance,
antihistamines, and hearing impairment.
•Preoperative screening may identify at risk
patients, as well as help inform surgical planning
(choice of anesthesia, overnight stay, etc.) while
family counseling about delirium helps to
maximize awareness and minimize negative
outcomes of postoperative delirium.
•Novel education materials were created to
educate the patient’s family members, the most
likely people to recognize postoperative delirium.
1. Schenning KJ, Deiner SG. Postoperative Delirium in the Geriatric Patient. Anesthesiol Clin. 2015
Sep;33(3):505-16. doi: 10.1016/j.anclin.2015.05.007. Epub 2015 Jul 7. PMID: 26315635; PMCID:
2. Olenick M, Flowers M, Diaz VJ. US veterans and their unique issues: enhancing health care professional
awareness. Adv Med Educ Pract. 2015 Dec 1;6:635-9. doi: 10.2147/AMEP.S89479. PMID: 26664252;
3. Eibner et al. Current and Projected Characteristics and Unique Health Care Needs of the Patient
Population Served by the Department of Veterans Affairs. Rand Health Q. 2016 May 9;5(4):13. PMID:
28083423; PMCID: PMC5158228.
•We better understand the amount of risk our patients
possess. More study is needed to correlate these
risk factors with incidence of postoperative delirium,
measured with the FAM-CAM tool (Figure 2).
•Design a system to organize ambulatory surgery
patients into risk categories for postoperative
delirium (Low, Medium, High) based on patient-
Table 1: Patient Characteristics
•All patients undergoing ambulatory orthopedic
shoulder surgery at the Minneapolis VAMC.
•Patient demographics and known risk factors
for postoperative delirium.
•Quantify risk, design education materials on
delirium to provide to patients and their families.
•A total of 100 patients who underwent outpatient
shoulder surgery at the Minneapolis VAMC in 2019
were reviewed (Table 1).
•16 risk factors for delirium were identified (Table 2).
•Over half of patients had at least 2 delirium risk
factors, and over one third of patients had at least 3
risk factors (Figure 1).
Table 2. Risk Factors for Delirium
Sleep deprivation or disturbance
History of postoperative delirium
History of stroke
Current Hip Fracture
0 1 2 3 4 ≥5
Delirium Risk Factors
Figure 1. Number of delirium risk factors
at risk for
with the patients’
•Delirium education materials were designed for
patient’s families (Image 1).