The PACU functions as a triage center where decisions are made as to whether the patient is ready for discharge, transfer to the floor, or whether continued ICU-level of care is needed. Although the 2013 ASA Practice Guidelines for Postanesthetic Care include mental status assessment as routine perioperative care to detect complications and reduce adverse outcomes in postoperative patients, it often receives less attention compared to other monitored measures such as pain and respiratory or cardiac function (Anesthesiology 2013;118:291-307).

Delirium is a common postoperative complication in older adults. Patients who develop delirium in the PACU are more likely to experience postoperative delirium on the floors and have increased risk of morbidity and mortality. A single incidence of delirium is associated with long-term cognitive decline and 10% increased risk of death (JAMA Intern Med 2023;183:442-50). Delirium specifically identified in the PACU has only recently gained recognition as...

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