Tom Delbanco, MD. JAMA. 2012;():1-2. doi:10.1001/jama.2012.6857
Ms R is a 76-year-old woman who experienced delirium following complicated surgery for removal of a polyp of the colon. A self-employed, active therapist, she lives alone with children nearby. She has no family history of dementia. She does not smoke and does not abuse alcohol or other substances. She has Medicare and supplemental insurance. For many years, Ms R received care at a hospital-based primary care unit.
Her medical history includes depression, paroxysmal atrial fibrillation, irritable bowel syndrome, and gastrointestinal bleeding due to diverticulosis. She took only vitamins and prophylactic aspirin. She has had long-standing, low-grade anemia, with hemoglobin levels of about 11 g/dL, along with multiple normal creatinine, electrolyte, calcium, and glucose measurements. She received a hip replacement in 2008 for degenerative osteoarthritis, a procedure that was uneventful and was not associated with delirium.
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