The cost of delirium in the surgical patient

The authors identified the added cost attributable to postoperative deliriu m in patients undergoing elective surgery. The authors evaluated patients ( n = 500) before their elective surgery, assessing cognitive functioning, me dical conditions, medication usage, and other information regarding their h ealth status. Using DSM-IV criteria, the authors assessed patients for deli rium on Postoperative Days 1-4. Medical record review provided laboratory, radiological, and pharmaceutical information. The authors analyzed length o f stay (LOS), comprehensive cost data collected through the hospital, and a group practice financial database to determine differences among those dev eloping delirium. Of the 500 patients assessed, 57 (11.4%) developed deliri um during the study. Delirium is an extremely costly disorder both to the p atient in terms of morbidity and mortality and to the medical facility. A p rolonged LOS increases charges to third parry payers and reduces return to physicians and hospitals when delirium develops. Careful presurgical screen ing and targeted postoperative interventions may help contain LOS and costs while affording greater physical, emotional, and cognitive health to patie nts hospitalized for elective surgery.