Current clinical practice and research are limited by the separate, or dichotomized, use of the terms “encephalopathy” and “delirium.” This separation hinders a unified approach to understanding acute brain dysfunction.

Encephalopathy is the Process, Delirium is the Manifestation: Expert consensus views acute encephalopathy as the underlying pathobiological process in the brain, while delirium is considered a potential phenotypic (observable) manifestation of that process.

A Unified Disorder: The combined “delirium disorder,” encompassing both the clinical symptoms and the underlying brain issue, is a common and serious problem in both the ICU and perioperative settings, leading to significant illness and death.

Monitoring is Essential: Although direct trials on the impact of screening are lacking, strong evidence—especially from studies of the ABCDEF bundle—supports making routine delirium monitoring standard practice.

Standardized Screening: In line with major international guidelines (PADIS 2018 and ESAIC 2024), regular screening is highly recommended to ensure early recognition and prompt intervention for this critical condition.

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