Delirium risk factors
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Pratik Bahekar, MBBS [3]; Vishal Khurana, M.B.B.S., M.D. [4]
Overview
Common risk factors associated with delirium include older age, dementia, hypertension, emergency surgery or trauma before ICU admission, mechanical ventilation, metabolic acidosis, delirium on the prior day , coma.
Risk Factors
Common risk factors associated with delirium include:[1]
- Older age
- Dementia
- Hypertension
- Emergency surgery or trauma before ICU admission
- Acute Physiology and Chronic Health Evaluation II (APACHE-II) score
- Mechanical ventilation
- Metabolic acidosis
- Delirium on the prior day of admission
- Coma
Modifiable Risk Factors
- Impaired sensation (vision, hearing)
- Urinary catheters insertion or physical restraints
- Medications such as sedative hypnotics, narcotics, anticholinergic drugs, corticosteroid, polypharmacy
- Withdrawal of alcohol or other drugs
- Acute neurological impairment such as acute stroke (right parietal), intracranial hemorrhage, meningitis, encephalitis
- Infectious disease, iatrogenic complications, severe acute illness, anemia, dehydration, poor nutritional status, fracture, trauma, HIV infection
- Metabolic impairment
- Surgery
- Intensive care unit admission
- Pain
- Emotional stress
- Lack of sleep
Non-Modifiable Risk Factors
- Cognitive impairment
- Older age (>65 years)
- History of delirium, stroke, neurological disease, falling or gait disorder
- Multiple medical disorders
- Male
- Presence of underlying renal or hepatic disorders [2]
References
- ↑ Zaal, Irene J.; Devlin, John W.; Peelen, Linda M.; Slooter, Arjen J. C. (2015). “A Systematic Review of Risk Factors for Delirium in the ICU*”. Critical Care Medicine. 43 (1): 40–47. doi:10.1097/CCM.0000000000000625. ISSN 0090-3493.
- ↑ “Delirium in elderly adults: diagnosis, prevention and treatment”.
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