Preventing Postoperative Delirium: Low-Cost Strategies to Protect Brain Health

A recent large-scale study highlights that postoperative delirium, a sudden state of confusion following surgery, is both preventable and impactful. Driven by factors such as patient frailty and surgical stress, this condition often affects older adults and can lead to long-term cognitive decline, increased risk of complications, and higher healthcare costs, estimated between $26 to $42 billion annually in the U.S.

The study, published in JAMA Network Open, analyzed over 5.5 million hospitalizations of adults aged 65 and older undergoing major non-cardiac surgeries. It found delirium in approximately 3.6% of cases, with affected patients experiencing significantly worse outcomes, including 3.5 times higher odds of death or major complications, nearly three times the risk of death within 30 days, and a fourfold likelihood of discharge to a healthcare facility instead of home.

Experts emphasize that postoperative delirium should be regarded as a medical emergency—akin to acute brain failure—that requires prompt recognition and intervention. Importantly, the findings suggest that straightforward, low-cost interventions can dramatically improve patient outcomes.

Key preventative measures include ensuring good sleep hygiene by minimizing nighttime disturbances through coordinated vital sign checks and medication schedules, providing sensory aids like glasses and hearing aids to reduce disorientation, scheduling surgeries early in the day for high-risk patients to reduce fasting and circadian disruption, and involving geriatric or hospital medicine specialists to optimize medical and functional health before and after surgery.

Patient and family education is also vital. Informing them about delirium risk factors and prevention tactics—such as maintaining familiar surroundings and normal sleep patterns—can empower them to recognize early signs and advocate for timely care.

The study underscores that implementing these cost-effective strategies can significantly reduce the incidence of postoperative delirium, thereby enhancing recovery, decreasing healthcare costs, and improving the quality of life for older adults.

For more details, see the original publication: DOI: 10.1001/jamanetworkopen.2025.19467. Source: https://medicalxpress.com/news/2025-07-postoperative-delirium-acute-brain-failure.html