Delirium risk factors

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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:

• 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