There are two groups of risk factors related to delirium: predisposing and precipitant factors. Multifactorial models have been accepted, describing delirium as an interaction of a vulnerable patient with predisposing factors exposed to noxious insults or precipitant factors. Multiple theories describe potential pathophysiologic causes of delirium, and any single case of delirium probably involves one or more of these theories in a complex and interconnected process. The pathophysiology is not fully understood, and there is likely no single etiology. This activity reviews the evaluation and management of delirium and the role of interprofessional team members in collaborating to provide well-coordinated care and improve patient outcomes.ĭelirium is a manifestation of stress on the function of the central nervous system in a vulnerable patient. Efforts should focus on prevention, early detection, and treatment of the underlying cause. ĭelirium is dangerous, often preventable, and associated with a significant cost burden and increased morbidity and mortality. The diagnosis is often missed due to its subtle clinical manifestation, especially in the hypoactive type. Examples include substance intoxication or withdrawal, medication side effects, infection, surgery, metabolic derangements, pain, or even simple conditions such as constipation or urinary retention. The underlying cause of delirium can vary widely and involve anything that stresses the baseline homeostasis of a vulnerable patient. īy definition, delirium is caused by an underlying medical condition and is not better explained by another preexisting, evolving, or established neurocognitive disorder. The clinical presentation can vary, usually demonstrating psychomotor behavioral disturbances such as hyperactivity or hypoactivity and with impairment in sleep duration and architecture. It develops over a short period of time and fluctuates during the day. It is characterized by an alteration of attention, consciousness, and cognition, with a reduced ability to focus, sustain or shift attention. Delirium, also known as an acute confessional state, is a clinical syndrome that usually develops in the elderly.
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