Diagnosis of POD and POCD

Postoperative delirium (POD) is a subtype of delirium that is often observed in elderly patients after surgery. Delirium is defined as an acute and fluctuating disturbance in both attention and awareness. For early diagnosis and treatment of POD, it is important to evaluate at-risk postoperative patients routinely using diagnostic tools, such as the Confusion Assessment Method (CAM), the Confusion Assessment Method for the ICU (CAM-ICU), or the Intensive Care Delirium Screening Checklist (ICDSC). The differential diagnosis of POD includes dementia, emergence delirium, and postoperative cognitive dysfunction (POCD). POCD is defined as a decline in postoperative cognitive functions as compared with preoperative functions that are evaluated by a battery of neuropsychological tests, which should be performed by trained examiners. However, there is, as yet, no consensus concerning the selection of tests, timing of postoperative testing, and diagnostic definition of decline in test scores. It is important to recognize the risk factors of both POD and POCD for prevention and early treatment of these postoperative complications that can lead to poor outcomes.