{Reference Type}: Case Reports {Title}: How a single perioperative delirium case can make the difference. {Author}: Juarez-Sanchez A;Heras Hernando V;Brunete Jimenez T;Molina Mendoza CR;Arnal Velasco D;Fernández Téllez L; {Journal}: Rev Esp Anestesiol Reanim (Engl Ed) {Volume}: 71 {Issue}: 7 {Year}: 2024 Aug-Sep 12 暂无{DOI}: 10.1016/j.redare.2024.04.003 {Abstract}: This report describes how postoperative delirium in an elderly man during COVID-19 pandemic led to a serious event involving a central venous catheter. Delirium is a common cause of perioperative morbidity and mortality, and is characterised by an alteration in consciousness and perception and a reduced ability to focus, sustain or shift attention. The event was analysed by a multidisciplinary committee which developed a risk stratification delirium protocol in order to prevent similar events in the future.