Delirium risk factors: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Delirium}} | {{Delirium}} | ||
{{CMG}}; {{AE}} [[User:Vishal Khurana|Vishal Khurana]], M.B.B.S., M.D. [mailto:vishdoc24@gmail.com] | {{CMG}}; {{AE}} {{Sara.Zand}} {{PB}}; [[User:Vishal Khurana|Vishal Khurana]], M.B.B.S., M.D. [mailto:vishdoc24@gmail.com] | ||
==Overview== | ==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== | ==Risk Factors== | ||
* | Common risk factors associated with [[delirium]] include:<ref name="ZaalDevlin2015">{{cite journal|last1=Zaal|first1=Irene J.|last2=Devlin|first2=John W.|last3=Peelen|first3=Linda M.|last4=Slooter|first4=Arjen J. C.|title=A Systematic Review of Risk Factors for Delirium in the ICU*|journal=Critical Care Medicine|volume=43|issue=1|year=2015|pages=40–47|issn=0090-3493|doi=10.1097/CCM.0000000000000625}}</ref> | ||
* Cognitive | *[[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 <ref>{{Cite web | last = | first = | title = Delirium in elderly adults: diagnosis, prevention and treatment | url = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065676/ | publisher = | date = | accessdate = }}</ref> | |||
==References== | ==References== | ||
Latest revision as of 08:12, 22 April 2021
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Delirium Microchapters |
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Diagnosis |
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Treatment |
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Delirium On the Web |
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American Roentgen Ray Society Images of Delirium |
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".