{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:53:57Z","timestamp":1787921637200,"version":"build-2784847793"},"reference-count":37,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T00:00:00Z","timestamp":1673395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University Hospital Bonn","award":["2018-FKS-01\/Grant: O-417.0002"],"award-info":[{"award-number":["2018-FKS-01\/Grant: O-417.0002"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>(1) Background: Postoperative delirium (POD) poses a high risk of worsening outcomes for patients and is also a burden for hospitals. The leading guidelines recommend standardized POD assessment and prevention. The aim of this subgroup analysis of the PRe-Operative Prediction of Postoperative DElirium by Appropriate SCreening (PROPDESC) trial was to compare different delirium assessments and to analyse the frequency of POD on five postoperative days. (2) Methods: This prospective observational trial enrolled 1097 patients in a university hospital from 2018 until 2019. The following POD assessment tools were used for five consecutive days: Confusion Assessment Method for ICU (CAM-ICU) or Confusion Assessment Method for normal ward (CAM), 4 A\u2019s Test (4AT) and Delirium Observation Screening (DOS) scale. (3) Results: In a 5-day visit interval, most new POD developments occurred on the first and second postoperative day. A clear recommendation for a specific POD assessment tool based on our results cannot be given. (4) Conclusions: According to guidelines, a POD assessment should take place on the first five postoperative days, but of these, the first two are those of highest POD occurrence. The POD assessment tool used should at best include direct patient questioning and aspects of patient observation.<\/jats:p>","DOI":"10.3390\/geriatrics8010011","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T02:59:54Z","timestamp":1673405994000},"page":"11","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Occurrence of Postoperative Delirium and the Use of Different Assessment Tools"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3503-4705","authenticated-orcid":false,"given":"Andrea","family":"Kirfel","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Jossen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Menzenbach","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7106-9732","authenticated-orcid":false,"given":"Andreas","family":"Mayr","sequence":"additional","affiliation":[{"name":"Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4786-7712","authenticated-orcid":false,"given":"Maria","family":"Wittmann","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,11]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2015). International Statistical Classification of Disease and Related Health Problems, World Health Organization. 10th Revision."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1001\/jamaneurol.2020.2273","article-title":"Association of Delirium With Long-Term Cognitive Decline: A Meta-Analysis","volume":"77","author":"Goldberg","year":"2020","journal-title":"JAMA Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/S0140-6736(13)60688-1","article-title":"Delirium in Elderly People","volume":"383","author":"Inouye","year":"2014","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2809","DOI":"10.1093\/brain\/aws190","article-title":"Delirium Is a Strong Risk Factor for Dementia in the Oldest-Old: A Population-Based Cohort Study","volume":"135","author":"Davis","year":"2012","journal-title":"Brain"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1097\/EJA.0000000000000594","article-title":"European Society of Anaesthesiology Evidence-Based and Consensus-Based Guideline on Postoperative Delirium","volume":"34","author":"Aldecoa","year":"2017","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2488","DOI":"10.1111\/j.1365-2702.2012.04130.x","article-title":"A Quantitative Exploration of the Subjective Burden Experienced by Nurses When Caring for Patients with Delirium: Subjective Burden","volume":"21","author":"Timmins","year":"2012","journal-title":"J. Clin. Nurs."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1007\/s00540-022-03049-4","article-title":"Postoperative Delirium Is an Independent Factor Influencing the Length of Stay of Elderly Patients in the Intensive Care Unit and in Hospital","volume":"36","author":"Kirfel","year":"2022","journal-title":"J. Anesth."},{"key":"ref_9","unstructured":"DAS-Taskforce 2015, Baron, R., Binder, A., Biniek, R., Braune, S., Buerkle, H., Dall, P., Demirakca, S., Eckardt, R., and Eggers, V. (2015). Evidence and Consensus Based Guideline for the Management of Delirium, Analgesia, and Sedation in Intensive Care Medicine. Revision 2015 (DAS-Guideline 2015)\u2014Short Version. GMS Ger. Med. Sci., 13, Doc19."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"110233","DOI":"10.1016\/j.jclinane.2021.110233","article-title":"Optimal Interval and Duration of CAM-ICU Assessments for Delirium Detection after Cardiac Surgery","volume":"71","author":"Hamadnalla","year":"2021","journal-title":"J. Clin. Anesth."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/ALN.0b013e318190b4d9","article-title":"Preoperative Use of Statins Is Associated with Reduced Early Delirium Rates after Cardiac Surgery","volume":"110","author":"Katznelson","year":"2009","journal-title":"Anesthesiology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1007\/s12630-010-9355-8","article-title":"Hospital Administrative Database Underestimates Delirium Rate after Cardiac Surgery","volume":"57","author":"Katznelson","year":"2010","journal-title":"Can. J. Anesth.\/J. Can. Anesth."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1111\/ggi.12592","article-title":"Evaluating Attention in Delirium: A Comparison of Bedside Tests of Attention","volume":"16","author":"Adamis","year":"2016","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s00391-021-02003-5","article-title":"Comparison of Delirium Detection Tools in Acute Care: A Rapid Review","volume":"55","author":"Brefka","year":"2022","journal-title":"Z. Gerontol. Geriat."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1002\/gps.4441","article-title":"Psychometric Properties and Feasibility of Instruments for the Detection of Delirium in Older Hospitalized Patients: A Systematic Review: Review of Delirium Scales for Hospitalized Elderly","volume":"31","author":"Zwakhalen","year":"2016","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"(2015). The American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults American Geriatrics Society Abstracted Clinical Practice Guideline for Postoperative Delirium in Older Adults. J. Am. Geriatr. Soc., 63, 142\u2013150.","DOI":"10.1111\/jgs.13281"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s40520-015-0323-6","article-title":"Under-Recognition of Delirium in Older Adults by Nurses in the Intensive Care Unit Setting","volume":"27","author":"Panitchote","year":"2015","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1053\/j.jvca.2011.05.004","article-title":"Hypoactive Delirium After Cardiac Surgery as an Independent Risk Factor for Prolonged Mechanical Ventilation","volume":"25","author":"Stransky","year":"2011","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.jpsychores.2011.11.013","article-title":"A Longitudinal Study of Motor Subtypes in Delirium: Frequency and Stability during Episodes","volume":"72","author":"Meagher","year":"2012","journal-title":"J. Psychosom. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1176\/appi.psy.50.3.248","article-title":"Phenomenological Subtypes of Delirium in Older Persons: Patterns, Prevalence, and Prognosis","volume":"50","author":"Yang","year":"2009","journal-title":"Psychosomatics"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"100501","DOI":"10.1016\/j.conctc.2019.100501","article-title":"Estimating Patients\u2019 Risk for Postoperative Delirium from Preoperative Routine Data\u2014Trial Design of the PRe-Operative Prediction of Postoperative DElirium by Appropriate SCreening (PROPDESC) Study\u2014A Monocentre Prospective Observational Trial","volume":"17","author":"Menzenbach","year":"2020","journal-title":"Contemp. Clin. Trials Commun."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"110684","DOI":"10.1016\/j.jclinane.2022.110684","article-title":"PRe-Operative Prediction of Postoperative DElirium by Appropriate SCreening (PROPDESC) Development and Validation of a Pragmatic POD Risk Screening Score Based on Routine Preoperative Data","volume":"78","author":"Menzenbach","year":"2022","journal-title":"J. Clin. Anesth."},{"key":"ref_23","first-page":"592","article-title":"Confusion Assessment Method for Intensive Care Unit zur routinem\u00e4\u00dfigen Kontrolle des Delirs auf Intensivstation","volume":"50","author":"Wrigge","year":"2009","journal-title":"An\u00e4sth Intensiv."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1164\/rccm.2107138","article-title":"The Richmond Agitation\u2013Sedation Scale: Validity and Reliability in Adult Intensive Care Unit Patients","volume":"166","author":"Sessler","year":"2002","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1891\/rtnp.17.1.31.53169","article-title":"The Delirium Observation Screening Scale: A Screening Instrument for Delirium","volume":"17","author":"Schuurmans","year":"2003","journal-title":"Res. Theory Nurs. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"941","DOI":"10.7326\/0003-4819-113-12-941","article-title":"Clarifying Confusion: The Confusion Assessment Method: A New Method for Detection of Delirium","volume":"113","author":"Inouye","year":"1990","journal-title":"Ann. Intern. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1093\/ageing\/afu021","article-title":"Validation of the 4AT, a New Instrument for Rapid Delirium Screening: A Study in 234 Hospitalised Older People","volume":"43","author":"Bellelli","year":"2014","journal-title":"Age Ageing"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.1097\/00003246-200107000-00012","article-title":"Evaluation of Delirium in Critically Ill Patients: Validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU): Crit","volume":"29","author":"Ely","year":"2001","journal-title":"Care Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1111\/jocn.14324","article-title":"Delirium in ICU Patients Following Cardiac Surgery: An Observational Study","volume":"27","author":"Simeone","year":"2018","journal-title":"J. Clin. Nurs."},{"key":"ref_30","first-page":"150","article-title":"Delirium Post-cardiac Surgery: Incidence and Associated Factors","volume":"26","author":"Alshraideh","year":"2019","journal-title":"Nurs. Crit. Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1016\/j.athoracsur.2015.12.074","article-title":"The Impact of Delirium After Cardiac Surgical Procedures on Postoperative Resource Use","volume":"101","author":"Brown","year":"2016","journal-title":"Ann. Thorac. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1002\/bjs.6843","article-title":"Risk Factors and Incidence of Postoperative Delirium in Elderly Patients after Elective and Emergency Surgery","volume":"97","author":"Ansaloni","year":"2010","journal-title":"Br. J. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s00391-015-0871-6","article-title":"What Does Delirium Cost?: An Economic Evaluation of Hyperactive Delirium","volume":"49","author":"Weinrebe","year":"2016","journal-title":"Z. Gerontol. Geriat."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1001\/jama.2010.1182","article-title":"Does This Patient Have Delirium?: Value of Bedside Instruments","volume":"304","author":"Wong","year":"2010","journal-title":"JAMA"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Shenkin, S.D., Fox, C., Godfrey, M., Siddiqi, N., Goodacre, S., Young, J., Anand, A., Gray, A., Hanley, J., and MacRaild, A. (2019). Delirium Detection in Older Acute Medical Inpatients: A Multicentre Prospective Comparative Diagnostic Test Accuracy Study of the 4AT and the Confusion Assessment Method. BMC Med., 17.","DOI":"10.1186\/s12916-019-1367-9"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1111\/j.1532-5415.2008.01674.x","article-title":"The Confusion Assessment Method: A Systematic Review of Current Usage: CAM: A Systematic Review of Current Usage","volume":"56","author":"Wei","year":"2008","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"554","DOI":"10.7326\/M14-0865","article-title":"3D-CAM: Derivation and Validation of a 3-Minute Diagnostic Interview for CAM-Defined Delirium: A Cross-Sectional Diagnostic Test Study","volume":"161","author":"Marcantonio","year":"2014","journal-title":"Ann. Intern. Med."}],"container-title":["Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3417\/8\/1\/11\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:06:41Z","timestamp":1760119601000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3417\/8\/1\/11"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,11]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["geriatrics8010011"],"URL":"https:\/\/doi.org\/10.3390\/geriatrics8010011","relation":{},"ISSN":["2308-3417"],"issn-type":[{"value":"2308-3417","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,11]]}}}