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Our goal was to determine when postoperative delirium first occurs, and to assess evaluation strategies that reliably detect delirium with lowest frequency of testing'. This was a retrospective study that used a database from a five-center randomized trial. Postoperative cardiothoracic ICU and surgical wards. Adults scheduled for elective coronary artery bypass and/or valve surgery. Postoperative delirium was assessed using CAM-ICU questionnaires twice daily for 5days or until hospital discharge. Data were analyzed using frequency table